Oct 03, · Reflective Essay Introduction. My placement was at a frailty ward with in the hospital which deals with the elderly who are experiencing an acute onset of a worsened disease conditions and neurological illness for example Parkinson`s, cerebral injury, tumours such as haemorrhage hypoxia and sub-arachnoid and are being referred by General practitioners, ambulance team and community nurses Nov 15, · The link provided below is for convenience only, and is not an endorsement of either the linked-to entity or any product or service Feb 03, · Note: This essay appears unedited for instructional purposes. I unexpectedly had the opportunity to gain additional perspective on the doctor/patient relationship during Christmas break, when I seriously fractured my left humerus from arm-wrestling gone awry. I was rushed to the emergency room, where an orthopedic doctor treated me
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The ward was also post-operative caring for patients who have received PEGs, RIGs and carotid endarterectomy. For this essay, I will be aiming on my personal experience and feeling on how I related with a patient Mrs Amanda pseudonym during my stay at a frailty ward with pain and End of Life management.
Throughout the essay l will reflect on how l provided holistic care to Mrs. Amanda until her last days on the ward which made me choose this experience due to the different aspects of care that will be explained in the essay that I learnt while she was on the ward.
Care doctor patient relationship essay, delegation and prioritisation will be explored along with team working, risk assessment and patient safety, doctor patient relationship essay, taking into consideration my role as a supervised student nurse whilst analysing the roles and responsibilities of those supervising me and what influence this has on my practice. The discussion will comprise of the knowledge reinforcing practice and evidence base for the clinical skills that l learnt and validating them with the accessible literature.
The essay will also include a reflection from my team work peer assessment during contributions in fixed team work and team based learning see appendix 1. When I arrived on the ward, my mentor Michael pseudonym briefed me about the patients on the ward.
I introduced myself to the patients because it is important that the patients are aware of who l am and my status if l am to provide nursing care for them. During this placement, Mrs Amanda was admitted following a fall in her bathroom at home issues and was brought in by her family members, doctor patient relationship essay. She had been also catheterised whilst on the ward because she had trouble of pass urine and had spent the last 8 weeks receiving holistic multidisciplinary care, for example nursing care, physiotherapy and occupational therapy and was due for rehab when medically fit for discharge.
Under the supervision of my mentor while attending to other patients on the ward, Mrs. Amanda called out to me that she was in severe pain since she had been admitted with lower back pain.
On approaching her I observed that she was in pain and once she had my attention she said she was in terrible pain and needed more pain killers. I approached Mrs Amanda and introduced myself with the aim of establishing a pleasant nurse-patient relationship.
I assured Mrs. Amanda that I will have a word with a qualified nurse and will be back. I walked up to Michael and asked that Mrs Amanda would need some pain killers as she is in severe pain.
Michael then asked me where is Mrs. And instead of getting the pain killers for Mrs. Amanda, he asked me several questions. How do you know that she is in such severe pain as you have just described doctor patient relationship essay me? Have you asked her with the trust policy of pain scale? see appendix 2 What type of pain killers have been given to Mrs. Amanda and for how long ago were these given to her?
He went on and on and I felt embarrassed and at the same time very eager to correct my mistakes. I was unable to answer any of the questions he asked and I presume I was overwhelmed with sympathy rather than empathy for the patient.
I brought Mrs. As a nurse it is important to use critical thinking to resolve problems related to direct patient care and as a student nurse, I asked for additional help since l did not know what else was happening to Mrs.
Amanda because she said she was feeling very exhausted. Following discussion with Michael, I felt that Mrs, doctor patient relationship essay. Amanda was uncomfortable, in pain and one of the healthcare assistants mentioned that Mrs.
To preserve safety under the NMC codeI made a referral to Michael so that we worked towards the best interests of Mrs. Amanda as this was a concern to me. This is where my time management skills came in place, doctor patient relationship essay, I made a timely report to the doctors who reacted appropriately since her oxygen levels and blood pressure were low.
To my understanding, blood pressure and heart rate are very important to know the patients wellbeing to avoid cardiac arrest. The multi-disciplinary team members obtained information that clarifies the nature of the problem while suggesting possible solutions. After re-assessment by the doctors that responded to the call, the doctor prescribed 48 meropenem for her since she had history of cystic fibrosis an inherited condition that causes sticky mucus to build up in the lungs and digestive system.
I had the competency in medicine administration but on this occasion l was observed by two qualified nurses including Michael who talked me through the procedure while asking me questions about cystic fibrosis which l answered but he gave me feedback that I had insufficient information about the disease but I turned this into a positive feedback and read about it, doctor patient relationship essay.
Amanda was deterioting. The ward sister discussed with the doctor that Mrs. Amanda may benefit from Opti flow and the team agreed for Opti flow trial. An Opti flow is a non-invasive device that warms and humidifies high flow nasal cannula air or oxygen which are delivered to the patient, doctor patient relationship essay. Doctors recognise and work within the limits of their competence through making the care of their patient their first concern. The doctor called the critical care outreach team to provide the Opti-flow but Mrs, doctor patient relationship essay.
Amanda was feeling tired. For example, one of the nurse showed her courage and commitment to patient care by explaining to the doctor that it was not appropriate to continue the Opti flow due to exhaustion and poor improvement of Mrs. The doctor listened to the nurses concern and responded by later requesting for continuous positive airway pressure which is used as a treatment for obstructive sleep apnoea, doctor patient relationship essay.
Since Mrs. Amanda had capacity, the doctors and consultant explained to her and the family members that some of her organs were failing to function and among the roles of a doctor is to maintain trust by being honest, open and act with integrity. Amanda was then placed on End of life Pathway see appendix 3 for End of life pathway for acute hospitals with her consent, transferred in a side room for privacy and referred to the palliative team.
A nurse is expected to provide safe and competent care so that harm such as physical, psychological or material to the recipient of the service is prevented. While End of life as a patient, she was now nil by mouth because she had difficulty in swallowing and to prevent more discomfort, the doctors and nurses agreed to switch her to humidified oxygen for comfort. While on humidified oxygen, Mrs. Amanda was sweaty and getting exhausted when me and one of the sisters were changing her. The ward sister then explained to the family that she was getting exhausted so they should limit making her talk.
Relating Mrs. Acute pain is of short or limited duration usually associated with traumatic tissue injuries, whereas chronic pain is a pain or discomfort persisting for about 3 to 6 months and may persist beyond the healing period. Chronic pain despite therapeutic interventions for example medications, doctor patient relationship essay, nursing carephysio and occupational therapists is classified as intractable pain which Mrs.
Amanda was experiencing, doctor patient relationship essay. Pain can be influenced among other things by culture, previous pain experience, mood, ability to cope or even belief and individuals should be treated differently.
Initially when I learnt that Mrs. Amanda was now on end of life management, I was interested to find out more about the patient and their condition but also sad to know that she will soon be a last office. When I met the doctor patient relationship essay, I felt sympathy towards her and the family and upon discussion she expressed herself that she felt like giving up and ending it all.
Looking at Mrs. Amanda l had a mixture of emotions, although I could understand why she would want to give up and the only reason was due to the pain she was starting to experience all over her body rather than just the back pain. I was quite confident at problem doctor patient relationship essay however this was a period where l was faced with a situation where l could identify the problem but was not able to come up doctor patient relationship essay a solution due to the lack of experience in end of life management of doctor patient relationship essay. On reflection it was a positive experience as it allowed me to see how people cope differently doctor patient relationship essay terminal conditions, and the impact it has on the family and carers, doctor patient relationship essay.
This being my first encounter of meeting a patient with acute pain and end of life management, I learnt so much and gain information especially about acute pain management having asked several questions and establish a good patient-nurse relationship. During this experience, the nursing team doctor patient relationship essay built a good professional relationship with the patient and their family.
The patient had plenty of time to discuss any concerns or issues that she had for example how she felt was important and her needs to be taken into consideration, doctor patient relationship essay.
I found the tool to be beneficial for effective management of pain because it was a good indicator as to when we would need to adjust her analgesia to ensure the patient was in the least amount of pain.
The principle of upholding professionalism under the NMC code is supporting appropriate service and care environments by raising concerns when issues arise that could compromise quality, safety and experience. Professionalism in nursing and midwifery is realised through purposeful relationships and underpinned by environments that facilitate professional practice.
Michael confirmed to me that Mrs. Amanda may need a new review by the palliative team to reassess her pain. I went to inform Mrs. Amanda of this, doctor patient relationship essay.
On getting to her, doctor patient relationship essay, I introduced myself with the aim of continuing our nurse-patient professional relationship and to obtain consent. I informed her that she will need a reassessment by the palliative team to change her pain killer or if there is need to increase the dose and that the doctor has been notified of this. This seemed to calm her down a little as I explained and listened empathically to her.
Nursing is the art of caring and we must listen empathically to what service users and patients want so that we can deliver the care they deserve. When one of the palliative team member came on the ward, she told doctor patient relationship essay doctor to prescribe PRN midazolam 2, doctor patient relationship essay. Amanda was very complaint with her medication. The Mental Capacity Act says that a person is unable to make a decision if they cannot do one or more of the following, understand information given to them, doctor patient relationship essay, retain that information long enough to be able to make the decision, weigh up the information available to make the decision, communicate their decision — this could be by talking, using sign language or even simple muscle movements such as blinking an eye or squeezing a hand.
Amanda had capacity and the multi-disciplinary team made sure that she was involved in her care. As the primary caregivers, doctor patient relationship essay, nurses must ensure that sensitive care and comfort measures are given doctor patient relationship essay the clients illness progresses. The doctor patient relationship essay of the urethral sphincters of the bladder causing urinary incontinence can indicate approaching death WHO With consent from Mrs.
Amanda, I informed her that the catheter is to be removed for her comfort and an absorbent pad will be provided which she accepted. Particularly women are at risk of urinary tract infection due to the short urethra and its closeness to the anal and vaginal areas, doctor patient relationship essay.
Nurses provide information and instruction in hygiene and diet to help prevent recurrences of urinary infection for example increasing the fluid intake for patients. So, l made sure l played my role as an advocate for Mrs. Amanda making sure that her comfort rounds were done and that she was comfortable before her last offices on the doctor patient relationship essay. See appendix 4 for comfort round.
In addition to caring for Mrs. Amanda, I was given the opportunity to be involved in meeting with the palliative care team for the hospital which enhanced the importance of good communication skills and accurate record keeping ensuring that all participants in Mrs.
In terms of communication I felt I was gaining confidence especially with the family members as I had built up a relationship which was both professional whilst being friendly and trusting. Hello, dear nurse!
Doctor Patient relationship
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Oct 23, · The ideal doctor-patient relationship is a partnership in which I am encouraged to experience as much sense of agency as is possible in a situation in which so Nov 15, · The link provided below is for convenience only, and is not an endorsement of either the linked-to entity or any product or service Oct 03, · Reflective Essay Introduction. My placement was at a frailty ward with in the hospital which deals with the elderly who are experiencing an acute onset of a worsened disease conditions and neurological illness for example Parkinson`s, cerebral injury, tumours such as haemorrhage hypoxia and sub-arachnoid and are being referred by General practitioners, ambulance team and community nurses
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