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Cultural diversity in healthcare
Cultural considerations in healthcare
Cultural considerations in healthcare
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This essay will provide a detailed analysis and critique of the role of a Paramedic and the impact that they may have when dealing with palliative care patients who are at the end of their life and the patients significant others. The purpose of this essay is to analyse and explore the current theories and guidelines surrounding end of life care and how these can relate to Paramedic practice. It is also a Health and care Professions Council (HCPC) requirement that Paramedics are aware of varying cultures, equality and diversity and how this can impact upon their practice (Health and Care Professions Council 2014), the HCPC also states that Paramedics must ensure that they promote and protect the interests of their patients’ (Health and Care …show more content…
Professions Council 2008) and this essay will look at how these requirements of the HCPC are reflected in end of life care. When dealing with patients at their end of life and their significant others there is often several different agencies involved in the patients care and treatment (National Health Service (NHS) England 2016).
One key agency involved with patients suffering from a terminal illness is Macmillan Nurses, who provide specialist care for those suffering from a terminal illness both directly and indirectly, their role varies from administration of specific medicines which can help improve a patient’s wellbeing in their last few days to providing advice and support to the patient and their significant others (Skilbeck et al. 2002a). However, the role of Macmillan Nurses has been called into questions due to constant changes in policies relating to palliative care and improved access to palliative care services, it has been argued that they are not keeping up to date with changes and further training is needed to improve their skills and clarify their scope of practice in the community (Skilbeck et al. 2002b). Along with Macmillan Nurses there is also the role of a Hospice in some terminally ill patients care. A Hospice usually provides residential care for those requiring advanced and ongoing medical treatment, they can provide nursing care, medications and psychological and emotional to support to patients as well as supporting the patient’s significant others (Macmillan
Cancer Support 2011); however, Hospice can also provide outreach teams which provide the same care and treatment but within the patient’s home (Thomas 2006). The role of a hospice has been praised for reducing admission rates to acute hospitals and providing appropriate care which does not require treatment in Accident and Emergency which is useful for Paramedics when trying to direct patients to the most appropriate care pathway (Cherlin et al. 2016). One of the key services that Macmillan Nurses and Hospices can provide for an end of life patient is that of pain relief and management of other symptoms such as nausea and agitation (Reddall 2009), this is important for Paramedics as it is widely stated that failing to address the pain and distress symptoms of a patient during their end of life can go against the basic ethical principles of Paramedic care (Parkinson, 2015). As Paramedics are limited in the types of medication they can provide for pain relief, nausea, agitation and other common experienced symptoms of end of life patients that they can provide by utilising these alternative agencies appropriately Paramedics may be able to effectively manage an end of life patients pain and symptoms outside of what they are able to provide (Sanders, McKenna and Lewis 2014).
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
Palliative care is medical or comfort care that reduces the severity of a disease or slows its progress, but does not provide a cure (Dreeben, 2007). Different people have different needs when life is ending. Working with the incurable may sound depressing but death is a certainty and what we do each day for these patients as physical therapist assistants, matters. Providing care effectively and appropriately has a huge impact on the patient, therefore acquiring the ability to comfort and care for a patient at such a critical stage in life, is an amazin...
Everyday there are hundreds of ambulances, fire engines and police cars being called to the scene of emergencies. I’m sure you hear the roar of their sirens, but you don’t think twice about them and are able to tune them out. The only time most people even think about the sirens is if they are forced to wait at a light or move over to the right shoulder and let them pass. When you look back and think about those sirens, where do you suppose they are going? Most people probably think that they are going to a car accident with entrapment, or a person with crushing chest pain to try and intervene and get them to the hospital.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
It is important that patients and family members understand the conditions under which the patient is suffering from. People have an obligation of preparing themselves for end of live. This can be done by writing a will or an Advance Directive to guide the medical personnel and family members on what the patient wants. It can also be done by assigning a medical care proxy to decide on the patients behalf (Groopman and Hartzband, 2011). Medical personnel need to consider the patients wish and act as per the law when deciding on end-life options. Most of the decisions made by terminally ill patients are biased and compromised.
In today's society, one of the most controversial health-care-related ethical issues is assisted suicide for terminally ill patients. Assisted suicide is not to be confused with ethically justified end-of-life decisions and actions. Nurses have a responsibility to deliver comprehensive and benevol...
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
Green, P. (1984). The pivotal role of the nurse in hospice care. CA: A Cancer Journal for Clinicians, 34(4), 204-205.
Most nurses are drawn into the debate when they are treating terminally ill patients. They believe that even though it is the doctor that prescribes the lethal substances or withdrawals them from their treatment it is them, the nurses that stay with the patients until the end. Some nurses choose to help with assisting a terminally ill patient if requested knowing the legal and professional repercussions and some choose not to. There are developed guidelines stating that nurses have the right to refuse to assist a patient who has requested death assistance if it goes against their moral principles, but with that their oppositions must be stated ahead of time. Nurses on both ends are required to understand their rights and their patients’ rights (Ersek
G’s inpatient care. The key principles to work on are 1) Focus on the quality of life- Many people who are living with a terminal illness often talk about quality of life and strive to retain control over it. It is important for us to understand what does quality of life actually mean to each patient and how can we contribute to attain or maintain the goal. 2) Take into account the patient’s past life experience and current situation- Experiences shape and make us the person we are today, but they also shape our views and expectations of a situation. It is easy to talk about the ‘here and now’ with patients whilst failing to pick up on the vast richness of their past and questioning from where their ideas and views have arisen. 3) Care which encompasses the dying patient and those who matter to them- There is no easy task when each individual may have entirely different needs, may be at different stages of acceptance and understanding of the situation, and different expectations of what healthcare professionals are able to offer. Good communication, skills and expertise of the palliative care multi-disciplinary team is the key to offer a support network for those who involved in patient’s care. 4) Respect patient’s autonomy and choice- Sometimes, we may find that our own values are challenged in a way that patient may not always make decisions which we believed to be in their best interest. If the patient is thought to be competent
The nurse becomes the confidant, the guide through the darkness, a source of comfort for those experiencing the trauma of losing a child. To successfully fulfill these nursing roles, in addition to roles that must be fulfilled to meet other patient’s needs, one must acknowledge their own definition of death and educate themselves on cultural and societal norms associated with death and dying. It is important to identify one’s own definition of death and dying but also understand that one’s preference does not define the death experience for others. The individuality and uniqueness of each death experience means that one definition of death may be hard for one to accomplish. It is important to maintain an open mind, nonjudgmental spirit, and impartiality for the cultures and practices of others surrounding death and dying. A culturally competent nurse is not only responsible for acknowledging the cultural norms of others but also respecting and educating themselves about the death rituals of their patient’s culture and providing the family with as many resources to safely and effectively fulfill their cultural practices. Education is empowering for the nurse who is navigating the death and dying process. Education often supplements ones credibility with the dying patient and their family which can ease overall anxiety and further promote ones role as a patient advocate and provider of
A ‘good death’ is something that can help us to evaluate how to formulate improved end-of-life care, free from discrimination regardless of a person’s social level with no stereotyping. Learning to respect difference and diversity and to ensure that everyone is treated as equals with their end-of-life care. Diversity is a concept that forms acceptance and respect of individual differences. Whereas, difference gives us variations within the connection of control leading to
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.