HS933 OSCE Critical Reflection The following is a critical reflection of my performance during an objective structured clinical exam (OSCE), as part of my training for the role of Psychological Wellbeing Practitioner (PWP). An OCSE is an assessment technique whereby a student demonstrates their competence under simulated conditions (Fidment 2012). For this OSCE, my competence in undertaking a treatment session with a patient was under examination. The treatment session I undertook involved discussing the patient’s progress with behavioural activation (BA), a cognitive-behavioural intervention used for people experiencing depression (Richards and Whyte 2011).
I excelled at Carolina and quickly earned the respect of my professors, primarily due to my conviction that no amount of life experience or ability should curb an endless appetite for learning and a submissive, humble, and teachable spirit. Upon completion of my degree I spent 4 years working in various clinical settings, primarily in intensive care units as well as hospice. I began the FNP program at the Catholic University of America, where I have performed well and gained an incredible amount of knowledge. However, my passion and direction has been shifted towards palliative care, and I do not believe CUA’s program is the most appropriate to prepare me for this goal. I believe advanced practice nursing is poised to take a leading role in many areas of practice, and that palliative care should be at the forefront of focus in advancing nursing practice. The compassion, dedication, clinical expertise, and commitment to evidence which improves outcomes and treats holistically, are universally recognized and respected traits of the nursing profession, and advanced practice nursing should approach palliative care with the same explosive tenacity with which it has embraced primary care of the underserved, recognizing a new population of those in need who lack the appropriate providers necessary to enhance
Research Topic Hospice patients often receive palliative care to help them cope with the stress, pain, and anxiety that comes with hospice care. Galfin, Watkins, and Harlow (2011) explored the need to train palliative care nurses how to provide not just physical care, but also psychological care. The authors reference previous studies that addressed similar training programs, but point out that many lack an explanation of what the palliative care entails, or statistical evidence to show if guided self-help improved patient’s psychological distress.
Literature Review The present-day misconception of palliative care possibly comes from the circumstance that palliative care was used interchangeably with hospice care until the 1980s. (Clark & Seymour, 1999). Clark and Seymour (1999) extensively write on the beginnings and evolution of palliative care. They describe the progression of palliative care as a whole and explain the movement from palliative starting out as supplemental care to terminal patients to the concept division of palliative and hospice care. They describe the differences in each and explain why palliative is its own concept that differentiates from hospice care. In 2002, the World Health Organization defined palliative care as “an approach” that increases the quality of life of
Although nurses have their experience to guide their practice, as the health professional most involved with the client at the end of life, there is a need for review of current assessment tools and management strategies to ensure the care given is evidence based and best practice.
In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal
Introduction According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues
Changing my perspective of palliative care Over the past five weeks, I have learned what palliative care really is all about. I found that there were areas that really changed my perspective as well, about what palliative care is. Some of these include, but are not limited to, when palliative care
RELEVANCE TO NURSING Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.
In order to understand palliative care, is to understand what palliate means. Palliate is to relieve The vision of a hospice center is to be recognized as a Center of Excellence in providing and catalyzing world class advanced illness care. The core values of a hospice center is; Complete Customer Satisfaction, Culture of Trust, Leadership to Grow, We are all Learners and Teachers, Live within the model. There is a booklet known better as the “little blue book” called Gone from My Sight: The Dying Experience written by Barbara Karnes, that can be found anywhere around in the hospice center and the primary source, and remains the most widely used patient/family booklet on the signs of approaching death. It sheds light on how to better understand death and grasp the situation prevailing among the patient and their loved ones life. A poem comes along with the booklet titled Gone from My Sight by Henry Van Dyke which illustrates a beautiful picture of death and dying. My favorite line from the poem: “Gone from my sight. That is all. She is just as large in mast, hull and spar as she was when she left my side. And, she just is able to bear her load of living freight to her destined Language and cultural barriers obviously compound the challenges of being professionally appropriate and compassionate. Patients and families may be in need of compassion, advice, and guidance from doctors and nurses, but often the realities of a given situation include a press for time and both physical and emotional exhaustion among providers and families.” For my last objective I wanted something that I can interpret what i’ve learned throughout this process of palliative care and turning into a physical
Nursing professionals help individuals, families, and communities to attain, maintain, or recover optimal health and quality of life. The needs of patient care have evolved together with the healthcare system for a few decades, setting higher standards and delegating more roles for nursing professionals. Nurses, especially those with a bachelor’s degree, should always maintain continued education and teach other healthcare professionals as well. This is to equip them with the tools required to deliver a holistic patient
Improving End of Life Care in the ICU A literature review conducted by Crowe (2017) examines the role of ICU nurses in providing high quality end of life care in the ICU. He states that palliative nursing in the ICU is de-emphasized due to an increased focus on curative treatment. Four
Associates Degree Nurses versus Bachelors Degree Nurses Kimberly Boren Grand Canyon University September 1, 2012 Nursing education has progressed throughout history from one of uneducated lay persons to the current standards we know today. As the career has progressed it has become apparent that there is a need for a skilled labor forced trained to deal with the sick and dying, “the provision of nursing care by American women…demonstrated the effectiveness of skilled nursing on improving outcomes for sick and injured soldiers” (Creasia & Friberg, 2011, p. 4). However, as the career progresses so does the need for more specialized training amongst nurses to help them deal with the changing atmosphere of patient care. The future
Introduction This report is focusing on elderly patients who are on a palliative care unit, and how they are respected and their dignity is persevered throughout their end of life care in a hospital setting. Throughout the Inter-Professional Learning (IPL) seminar sessions, there was many student midwives, student adult, child and learning disability students. There were many topics suggested and discussed between the group, which helped aid us choosing our focused topic. Grumbach and Bodenheimer (2004) reinforces the argument about IPL groups are important, as they found that when health practitioners work together has a positive impact on the patient outcomes. Therefore, they believe that IPL groups should be fundamental part of health professionals
I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.