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Communication in end of life care essays
Communication in end of life care essays
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In the documentary of “Being Mortal”, surgeon Atul Gawande speaks about how being a doctor is one of the hardest things. For this reason, it is based off of what he mentioned “that in doctoring school they only teach you a small percent of what you actually need to know”. By this he was saying that the schools teach students on what to do with the concept of medical procedures and how to do them, but they do not teach you about the “being moral” side of dealing with a patient’s health issues. Later in the documentary, one of the doctors mentions that he “wishes he could do better, that he also feels like it is a failure for doctors and the mental mentality they use now was not trained to deal with surreal issues that they face now with patients
when they were in medical school”. When “being moral” for doctors it concerns how to keep patients positive, looking for more possible answers, and also when or how to tell a patient that they are dying. This is the part that becomes complicated because for some patient’s health, there is no right or possible answer to help them recover. Just as much as a patient want to stay alive, the doctor also wants to help keep them alive or alive for longer. But this is where morality and being realistic comes into place and changes the positive outlook of the situation into a negative one. Telling a patient that they are going to die is never an easy thing to do for doctors and it is even harder for the patients to hear it. The next step that doctors and patients have to face is that what to do next. For most doctors this means that they have to figure out the best way to tell their patient that their time is coming. Which is difficult because as a human and especially as a doctor you never know when the right time will be. But the best time is to do it as soon as possible. For patients this is their time come to realization that they will not be on earth or be with their families for much longer. Which causes them to start making arrangements to finish or start the process of making sure that their loved one will be taken care of when they are gone.
The writing style of the author is quite interesting to me. Atul Gawande’s honesty, a major aspect of his writing style, beautifully highlights the good and bad of any medical profession. For example, Gawande’s argument over the use of patients for resident training
In the text, Gawande states, “I punctured a patient’s lung, for example-the right lung of a chief of surgery from another hospital, no less-and given the odds, I’m sure such things will happen again.” This shows how fatal errors can occur during a surgical procedure however, it is something that surgical residents have to grow accustomed to since mistakes like this are likely to reoccur. Gawande also mentions that when practicing on a patient, mistakes are bound to happen however, it is a part of learning. In the text, Gawande states, “She let me continue with the next steps, which I bumbled through. I didn’t realize how long and floppy the guide wire was until I pulled the coil of its plastic sleeve, and, putting one end of it into the patient, I very nearly contaminated the other.” This quote proves that although mistakes can happen, it is a part of the learning process. In this specific part, Gawande talks about how he nearly made a severe error however, he was able to learn from his mistake and complete the procedure successfully. This shows how practicing on patients is necessary for the advancement of the medical field. Therefore, although ethical and practical tensions may arise, practicing on patients is needed in order to save the lives of many in the long
The medical values learned in chapter 11 are, emotional detachment, professional socialization, clinical experience, mastering uncertainty, mechanistic model, intervention, and emphasis on acute and rare illnesses. The three that I mainly care about are, emotional detachment, mastering uncertainty, and clinical experience. Emotional detachment is a very important medical value because this can strongly affect not only the patient but the doctor as well. The doctor is supposed to sustain emotional detachment from patients. (Weitz 276). A doctor should try and keep their distance because their emotion can strongly affect the patient. How a doctor reacts or approaches a situation will show how they are with emotional detachment. Mastering
On the topic of Atul Gawande’s novel Being Mortal: Medicine and What Matters in the End, an ongoing issue has brought into question what we should do with the elderly and ill that are in need of care. On the one hand, some argue that they should be put in nursing homes and seek treatment for their problems because they can no longer take care of themselves. From this perspective, the elderly have a greater chance of getting injured if they are not taken care of properly, thus are seen as unfit to live on their own. On the other hand, however, others argue that the elderly should be allowed to live on their own as long as they maintain a healthy lifestyle. Atul Gawande, one of this view’s main proponents, urges us to realize that no one is immortal
Diligence is a virtue. This is a theme Atul Gawande presents to the reader throughout Better: A Surgeon’s Notes on Performance. In each story, Gawande provides insight on medical studies he has previously embarked upon. For example, in “The Mop-up” the author tells us about a time when he went to India to observe the efforts to eradicate polio. Gawande explains how he followed a supervisor around and how vaccinations were performed. Additionally, in another chapter he debates on whether physicians should take part in death sentences. Throughout his adventures Gawande provides numerous enriching personal accounts of controversial events and what it is like to be a doctor; each with diligence playing a key part.
Klinenberg mentions, “by the summer of 1999, Chicago was better prepared for the heat, pamphlets about heat risks were everywhere in the city and the media provided accurate health warnings.” (Klinenberg 4505 of 7026) The Department of Public Health developed a system for coordinating emergency medical services and the Department on Aging expanded its network of isolated seniors, educating participants about seasonal survival strategies.
In studying Plato’s Law’s, Levin was able to find themes in the work to create a doctor-patient model which successfully moved away from that of the paternalistic model and include autonomy without leaving the patient. By recognizing and accounting for the fallibility that is innate in all humans, Levin is able to eliminate the problem of assumed moral knowledge. In shifting the possible power imbalance between doctor and patient by adopting a balanced asymmetry, the model avoids an unwarranted power divide that caused the downfall of the two models proposed by the Emmanuels’ and Pellegrino and Thomasma. Also, moral education is implemented to prevent doctors from having too much power and control, which aids in keeping clear of the paternalistic model.
Twenty four centuries ago, Hippocrates created the profession of medicine, for the first time in human history separating and refining the art of healing from primitive superstitions and religious rituals. His famous Oath forged medicine into what the Greeks called a technik, a craft requiring the entire person of the craftsman, an art that, according to Socrates in his dialogue Gorgias, involved virtue in the soul and spirit as well as the hands and brain. Yet Hippocrates made medicine more than a craft; he infused it with an intrinsic moral quality, creating a “union of medical skill and the integrity of the person [physician]” (Cameron, 2001).
Almost doctors and physicians in the world have worked at a hospital, so they must know many patients’ circumstances. They have to do many medical treatments when the patients come to the emergency room. It looks like horror films with many torture scenes, and the patients have to pay for their pains. The doctors have to give the decisions for every circumstance, so they are very stressful. They just want to die instead of suffering those medical treatments. In that time, the patients’ family just believes in the doctors and tells them to do whatever they can, but the doctors just do something that 's possible. Almost patients have died after that expensive medical treatments, but the doctors still do those medical procedures. That doctors did not have enough confidence to tell the truth to the patients’ families. Other doctors have more confidence, so they explain the health condition to the patients’ families. One time, the author could not save his patient, and the patient had found another doctor to help her. That doctor decided to cut her legs, but the patient still died in fourteen days
Everyone has or will experience a loss of a loved one sometime in their lives. It is all a part of the cycle of life and death. The ways each person copes with this loss may differ, but according to Elisabeth Kübler-Ross’s novel On Death and Dying, a person experiences several stages of grief: denial, anger, bargaining, depression, and, finally, acceptance. There is no set time for a person to go through each stage because everyone experiences and copes with grief differently. However, everyone goes through the same general feelings of grief and loss. There are also sections in Kahlil Gibran’s “The Prophet” that connect to the process of grieving: “On Pain,” “On Joy and Sorrow,” and “On Talking.” Kahlil Gibran’s “The Prophet” reflects on Kübler-Ross’s model of the different stages of grief and loss.
When one initially chooses a career path, one rarely looks at all the negatives that may be associated with that choice. Most career paths have some negatives associated with the field, but few face the moral dilemmas associated with modern healthcare. Those who choose to be in the healthcare profession today are faced with moral and ethical dilemmas that would make King Solomon tear his hair out. In many cases, doctors, and sometimes nurses, are faced with life and death decisions without the benefit of knowing the patient’s, or the patient’s family’s, wishes. However, aside from those tragic times when a patient’s wishes are unknown, healthcare professionals must always put their own morals aside, and act
In Wislawa Szymborska’s poem, “On Death, without Exaggeration”, the idea of Death is assigned characteristics of Deaths waged war against numerous quantities of emerging life that, itself, destroys life. Szymborska grew up in Poland during the Second World War, she was surrounded by Death, in addition, the experiences she had helped her to cope with Death and remain hopeful. The poem seems to make the reader think Death is an inevitable part of life and in order to appreciate life one must accept Death. However, if you read closely in the last line of the second stanza, “which is always beside the point” (7), Death is revealed to be indifferent, not accepting. Szymborska uses persona, irony, and personification to create rich
Professionalism is an adherence to a set of values comprising both a formally agreed-upon code of conduct and the informal expectations of colleagues, clients and society. The key values include acting in a patient's interest, responsiveness to the health needs of society, maintaining the highest standards of excellence in the practice of medicine and in the generation and dissemination of knowledge. In addition to medical knowledge and skills, medical professionals should present psychosocial and humanistic qualities such as caring, empathy, humility and compassion, as well as social responsibility and sensitivity to people's culture and beliefs. All these qualities are expected of members of highly trained professions.
Change is Possible at Any Age It is always possible to be better; your best performance can be improved upon, no matter what you level of expertise is. In the article Personal Best, Atul Gawande (2011), a surgeon who specialized in endocrinology, talks about how he thought he was at the peak of his career, he had “hit a plateau” and “the only direction things could go from here was the wrong one” (p.1 & 2). He comes to find that with the help of a coach, there is room for growth and greater achievement. Gawande talks about how he came up with the idea of hiring a coach to watch him perform surgery after an experience he had playing tennis.
The TED Talk featuring Dr. Abraham Verghese was very accurate in its depiction of how some of today’s medical professionals do not get the full picture of the patient. The TED Talk was is from 2011, so some changes have been made to this, but not all. During this time and era, most doctors were working under strenuous conditions such as working long hours, seeing numerous patients in a day, and being stretched by having to do many duties due to their title and limited filled positions in their desired career. But, this does not give them the “ok” to deny each and every patient the correct singularity that they deserve. The beginning story he tells of refers to a woman who has advanced stages of breast cancer that has spread to other regions in her body. She had been to numerous doctors before