The purpose of the study was to test and determine the effectiveness of an observed structured clinical examination (OSCE) with the focus on improving palliative care skills for advance practice nurses (APNs) and medical fellows. The outcome of this pilot test is endless for the use of training other disciplines in health care that deal with issues of palliative care. The effectiveness of this pilot showed with the use of three stations testing instruments learners and faculty gain valuable resources. These instruments tested one’s skills, their ability of breaking bad news to patients and family, setting effective and practical goals of care with the patient, and assessing a patient’s mental status. Focus groups were also used to gain learner perspective on the training and provide feedback on what could be improved in the training sessions.
Sample Procedure The targeted population was a nonrandom selection of twelve learners across the medical field that would be dealing with palliative care chosen on a volunteer basis. Within the sample was seven APN students, of which on one student related during a focus group had any prior experience with this type of training. The physician trainees consisted of three medical fellows in the field of geriatrics and two palliative care fellows of which they related some exposure to OSCEs, but not in relation to palliative care. While this was an appropriate sample size for this formative study and inclusion of a larger population to
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.
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
Comparatively, Bailey et al. (2014) studied the effects of implementing interventions to improve end of life care for inpatient veterans. The problem statement was determined to be that end of life care in the inpatient setting was lacking, which drove the aim of the study to improve EOLC and to minimize suffering of the patients (Bailey et al., 2014). The researchers theorized that this could be accomplished if recognition of end of life was increased and if home-based palliative interventions were implemented. Therefore, the team sought to study the effectiveness of implementing staff education of three items: evaluating patients who are actively dying, communicating end of life interventions with patients and families, and implementing home-based best practices for end of life care (Bailey et al., 2014). The purpose here was to improve inpatient end of life care.
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
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.
The Shortland Wetlands have became one of the most popular and well-known attractions in Newcastle for its extensive wildlife, many activities and intensive research on conservation of many topics. (Wetlands.org.au)
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).
Attention Deficit Disorder (ADD) is a neurobiological disorder. Recent research shows that the symptoms of ADD are caused by a chemical imbalance in the brain. (Rebecca Chapman Booth)
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
The first half of this clinical placement, I was on a palliative ward. While others might find it difficult caring for patients at the end stage of life or in great deal of pain, I find that it gives me a great deal of satisfaction that I was able to provide care for these client in my own unexperienced way of palliative care. Being a patient myself of a very serious illness in the past, the goal of a palliative care team which is to provide quality of life during these difficult stages of the client, hits close to my heart. I might consider working in the palliative care unit in the future.
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.
Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a
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.
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 never met her in my life before and only heard her voices through the phone. I knew how important she was to my family because after all she's my grandma; however, I couldn't connect with her. She lived 7,739 miles across the world in the province in Fuzhou,China from me. I knew nothing about Fuzhou, China besides the fact that it was located in the southeast. On Tuesday, June 25th 2013, I made the journey to finally join her and experiences a completely different lifestyle. There I end up learning a valuable lesson that still strongly influences my identity today.