Pain and Palliative Care Clinic

Professional practice: Akiva and Tara have just completed all educational and experiential requirements to be licensed as obstetricians. They want to open a birth clinic together. They will take out a large loan to finance start-up costs. E

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

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

The doctors were pretty sure that Pierre had less than 6 months to live, so he fell well within the guidelines for hospice coverage. Should hospice coverage be limited to those with 6 months or less to live, or should other be covered? 6 months is a random figure and I think that the covering other could help families deal with hospice care a little better; it would give them a better understanding of what hospice-type services is entailed. It also could be too expensive for covering others and how can you know for sure if 6 months is suitable.

Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception.

When I was fourteen, I went to South Korea and visited my grandmother who was diagnosed with Alzheimer’s. She was staying with one of my aunts in an apartment complex that restricted many of her daily activities and years later, her dementia progressed and passed away. Within the short time I spent with her, it was difficult for me to help her with her daily activities while maintaining her dignity. Therefore, when reflecting her death, I wondered about the type of care my grandmother had received. My potential learner gains from reviewing the literatures on this topic are how to successfully give a patient with dementia complete palliative care.

A coordinated healthcare service is required to provide services to the continuum of care for the patients that are in these facilities. As the Director of HIM

Since 2011, I had been actively involved in the national medical student organization called ISMKI. Then in 2013, I was chosen as a representative from my organization in multi-professional health student forum called HPEQ Student. From that forum, we worked together toward our common goals to implement IPC and to increase the health service quality. This goal is surely challenging since there are a lot of barriers and stigma between each health professional. One of the programs that we proposed was a National Health Collaboration (NHC) conference, which I involved as the organizing committee. We socialize the IPC issue to health student in this conference. Another program was an advocacy about IPC to the policy-maker such as health minister

What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and

Palliative care is a relatively new concept. Palliative care programs have become more numerous and better utilized since 2000 and continue to grow. It is now accepted that the palliative care model is appropriate for patients with life-limiting illnesses. Chan et al. (2013) stated that the ultimate goal of palliative care is to relieve suffering and to maximize the quality of life for dying patients and their families, regardless of the stage of illness or the need for other medical treatments (p. 133). As life-expectancy increases, there is a growing need for these services. People are living longer with chronic diseases and palliative care services can provide an extra layer of support to patients and their families. Evidence has shown that 13% - 36% of hospital inpatients qualify for palliative care services (Robinson, Gott, & Ingleton, 2014).

Pain is one of the most influential symptoms that leads individuals to reach out to health care professionals to seek relief. Pain is subjective and unique to each person. Some individuals may have a higher pain tolerance than others. According to Frandsen (2014), “Pain is an unpleasant, sensory, emotional sensation associated with actual or potential tissue injury” (p. 889). Pain may be caused by a variety of elements, such as tissue or nerve damage and surgery. There are three main categories that pain is classified by, which are origin, duration, and cause. The main focus of this paper is on acute pain, chronic pain, and phantom pain. It is crucial to know how to assess each type of pain, as well as how to enhance it, or decrease the pain.

You have made excellent points. I do not believe that health care professionals neglect to treat patients in palliative care in the correct settings. The care one receives is based on what type of locations they are in. Hospitals and hospice centers often have employees with higher education levels and an increased passion for their job. I believe that health care providers want to ensure that one is comfortable at the end of life. I have visited Alive Hospice here in Nashville and was able to see the the great amount of care they provided to their patients. I have attached a link to their website below. I am curious to know your opinion on why you think one would not receive adequate care at the end-of-life phase.

Palliative care was designed as a state of the art measure that alleviated suffering in the patents which allows for better communication to be transpired between the health care team that will alleviate strains for the healthcare members. Clinicians need to be more involved and advocate for consultation based upon identifiable triggers requiring consultation, and elicits feedback from staff about certain interventions. The clinicians acting as an advocate for the patients must remain knowledgeable in recognizing the shift in the patient’s course that indicates the need for palliative care and communicate poor prognoses and outcomes with the patients, loved ones, and offer palliative care when death is prominent. Despite the many barriers identified here, clinician must be champion for palliative care on both hospital, unit, and as well as, on the level of the patient. (Perrin & Kazanowski, 2015)

This leader in medical schools has made its brand a premium one with many things, such as its study abroad programs and internationalism, its creative platform for students and staff for their research’s and as an engaging medical school. It is located

Health System has been developed; the most basic unit is a Sub-Health Post or Health Post in each Village Development Committee area. However, the expansion of the Health System has not been matched by an expansion in the domestive resources, workers and supplies, and the available resources are not efficiently distributed. In