Case 02:
Q1 To list the ethical issues regarding pain management and cultural beliefs in palliative nursing.
The following are important factors to take into account (although there is a substantial variety based on geography, economics, and culture): Failure to create an appropriate physician-patient relationship; inability to identify pain as an issue in patient care. lack of enough understanding about the proper prescriptions for analgesics.
Q2 How would you respond in this situation?
Anxiety and melancholy are common emotional responses that people have while they are in physical discomfort. The patient's failure to find relief from their suffering may lead to emotions of helplessness and even despair, which may make them more susceptible to developing a more persistent type of depression.
Q3 Explain the role and legal parameters of families in decision-making within palliative care nursing.
Family members (FMs) have important roles to play in the care of patients. These roles include contributing to decision-making, assisting the medical team in the delivery of treatment, improving the overall quality of patient care, providing assistance with home care, and meeting the expectations of the patient's own family as well as those of society.
Q4 Outline the nursing interventions for this patient based on your nursing observations and assessments.
The provision of moral support, assistance with personal cleanliness and dental care, supervision of fluid intake and output, ambulation, the delivery of meals, and general condition monitoring are all examples of nursing interventions. Other nurse interventions include the planning of discharge and education.
Q5 As Macey is nearing the end of her life, how can you involve her family to care for Macey? How could you support their family?
Interventions from the nursing staff
The provision of emotional support, self-hygiene and dental care, monitoring fluid intake and output, ambulation, the delivery of meals, and general condition monitoring are all examples of nursing interventions. Other nurse interventions include the planning of discharge and education.
Participation of families in the treatment of patients
A decrease in stress, an increase in communication, a reduction in conflict (including litigation), and an improvement in the health of children with chronic health disorders are some of the benefits that patients and their families enjoy as a result of receiving treatment that is oriented on the family.
Help with nursing care for the family
Nurses can include consistent information in the treatment plan and encourage families to use community and counseling services to reduce and prevent stressors to assist families in effectively coping with stress and crisis in health-related situations. This will aid families in effectively coping with stress and crisis in health-related situations.
Q6 Identify professional boundaries regarding communication of services and nursing interventions in the management of a palliative patient.
There is a barrier between the nurse's authority and the patient's vulnerability in the form of professional limits. When nurses break professional boundaries, whether deliberately or accidentally, their needs are given more priority than those of the patients they are caring for. The following are some examples of breaching the limits of one's professional field:
The disclosure of private or confidential information, Keeping patients' or their confidential information private,
Putting yourself in the position of a "super nurse" by appearing as if you are the only one who can care for or understand the patient is a good way to position yourself in this role. An example of favoritism would be to spend more time with a patient than is required, to take a side in a disagreement involving a family member, or to do personal favors that are beyond the scope of your employment.
Q7 On your next visit, you see that Macey is having delirium and is not able to communicate properly. Macey is groaning and clenching. Macey is breathing shallow and mouth wide open, trying to get a breath. Macey is on a subcutaneous syringe drive with pain relief and antiemetics. Macey has not produced any urine for the last 12 hours and has not had anything to eat or drink since the day before. Based on your nursing observation, identify the end-of-life care needs for Macey.
As part of end-of-life care, patients and their families get aid on several fronts, including the medical, the emotional, the social, and the spiritual. End-of-life care is provided to relieve the patient of as much discomfort as possible, including pain and other symptoms. End-of-life care includes several types of assistance, such as hospice care, palliative care, and supportive care.
Q8 Reflect on self-care when nursing palliative patients and their families.
If you or a member of your family are providing palliative care to someone who has a terminal disease, you may be eligible for support services of your own. You may get the energy and vitality you need for your role as a professional by maintaining healthy eating and sleeping habits, taking time to relax, regularly engaging in physical activity, and looking out for your welfare.
Q9 What actions would you take to address this situation? What support is available at the workplace to assist you?
1. Competencies and behaviors pertinent to nursing
All nurses must have the skills necessary to provide palliative care to terminally ill patients to alleviate their suffering, enhance their quality of life, and manage their symptoms. Symptom management, open lines of communication, and patient advocacy are the three fundamental pillars that underpin the delivery of palliative care, which are also the three fundamental pillars that underpin the profession of nursing.
2. To improve the quality of nursing assistance;
Self-care planning opportunities are made available to employees as part of the company's overall wellness initiatives.
Encourage support for nurses and midwives among all nurses and midwives, nursing and midwifery students, employers, educators, and concerned family and friends by spreading the word about nurse and midwife support.
Efforts should be made to make counseling services more accessible.
Think of clinical supervision as a formalized kind of employee assistance. The Palliative Care Bridge is a resource that provides details on clinical supervision as well as care for those providing care.
Give staff regular opportunities to participate in self-reflection via organized activities.
It is important to take into consideration the formation of formal or informal teams of allied health professionals who are assisting patients with palliative care for debriefing and inter-professional support, in particular for rural and distant practitioners such as the general practitioner, nurse, counselor, psychologist, and dietician.
Monitoring for indicators of burnout might be beneficial for leaders of palliative care teams; one such instrument is the Maslach Burnout Inventory.
2.1) To list the ethical issues regarding pain management and cultural beliefs in palliative nursing.
2.2) How would you respond in this situation?
2.3) Explain the role and legal parameters of families in decision making within palliative care nursing.
2.4) Outline the nursing interventions for this patient based on your nursing observations and assessments?
2.5) As Macey is nearing the end of her life, how can you involve family to care for Macey? How could you support their family?
2.6) Identify professional boundaries regarding communication of services and nursing interventions in the management of a palliative patient?
2.7) On your next visit, you see that Macey is having delirium and is not able to communicate properly. Macey is groaning and clenching. Macey is breathing shallow and mouth wide open, trying to get a breath. Macey is on a subcutaneous syringe drive with pain relief and antiemetics. Macey has not produced any urine for the last 12 hours and has not had anything to eat or drink since the day before. Based on your nursing observation, identify the end-of-life care needs for Macey.
2.8) Reflect on self-care when nursing palliative patients and their families.
2.9) What actions would you take to address this situation? What support is available at the workplace to assist you?
