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Importance of communication skills to health providers
Importance of communication skills to health providers
Importance of communication skills to health providers
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outlined as follows:
1. Defining the problem
2. Measuring the magnitude of the problem
3. Developing a conceptual framework for understanding the key determinants
4. Identifying and developing strategies
5. Setting priorities and recommending interventions and/or policies
6. Implementing interventions and/or policies and evaluating outcomes
7. Developing a communication strategy
Problem-Solving in Public Health, 550.608.01, R. Lawrence, 2007 The exploration of these steps will be informed by the published literature, public
Resources, conversations with key informants at the Johns Hopkins School of Public
Health, and my recent coursework as an MPH student. And finally, interspersed
Throughout will
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John W. Gardner (1912-2002)
To this point, the actual problems associated with end-of-life care in the US have only been alluded to. Certainly most readers have a sense of what the issues are, given the universality of the experience. Indeed, listening to people’s stories anecdotally reflects back the magnitude of the problem. In fact, the majority of the faculty interviewed for this paper spontaneously told stories of their loved ones’ deaths, which were predominantly stories of bad, not good, deaths. Be that as it may, a careful exploration of the magnitude of the problem, the second step in the public health problem-solving paradigm is essential. Because communication with the public is integral in public health, the magnitude of the problem will be presented in “sound bites,” organized by domains of concern, namely quality of care, cost, impact on family, friends, and caregivers, and access to services.
Quality of Care
As many as 50% of those with cancer or other terminal illnesses experience unrelieved pain or other symptoms during their final days. (Rao et al., 2002;
SUPPORT, 1995; Bernabei et al., 1998; Byock, 2001)
From both the patient and family perspective, hospice provides high quality
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Balabhai Nanavati Hospital. The number of deaths which occur in the ICU after withdrawal of life support is increasing with one survey finding that 90 % of patients who die in the hospital do so after a decision to limit therapy. The goal of a physician has to be enlarged to include assuring the patient of a “good death” Developments in technology now make it possible for almost all patients to have a death that is dignified and free from pain. Palliative care and intensive care are not mutually exclusive options but are rather coexistent. Intensive care clinicians must be as skilled and knowledgeable at forgoing life-sustaining treatments as they are at delivering care aimed at survival and cure.
Abbreviation: NMBA - Neuro Muscular Blocking Agent
Preparation of the patient, the family and the clinical team
Withdrawal of life support is an unprecedented event for family members and clear and explicit explanations on the part of the clinician alleviate anxiety.
Patient needs are
· Receiving adequate pain and symptomatic management.
· Avoiding inappropriate prolongation of dying.
· Achieving a sense of
The family of Jahi has experienced limited resources as well as limited possibilities, however the quality of life has a strong hold on the medical decisions made by the family. According to Johnson and Rhodes (2010), quality of life (QOL) is one of the main focuses by the hospice movement (p. 64). It is known as the general well being of individuals and societies. This includes fields of international development, healthcare, and politics. The consideration of quality of life in making medical decisions regarding healthcare may involve judgments about the worth of life, and that ...
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).
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
In “How Doctors Die,” Dr. Ken Murray explains some different real stories about people having terminal diseases, and how their doctors and physicians treat them. Moreover, the author mentions about difficult decisions that not only the doctors but patients and the patients’ family also have to choose. When the patients’ diseases become critical, the doctors have to do whatever they can to help the patients, such as surgical treatment, chemotherapy, or radiation, but they cannot help the patients in some cases. In additions, doctors still die by critical diseases, too. Although they are doctors, they are just normal people and cannot resist all of the diseases. Like other patients, the doctors having critical diseases want to live instead of
family chooses to take their loved one off of life support. A PVS patient has no
When a patient is unable to make care decisions for themselves, it is necessary to involve those closest to them, most often family members. Providing a supporting environment to family members is another way that the best interest of the patient can be maintained. Families and friends can make a huge difference in the life of the patient after discharge. Instructing families in a way that is easy to understand helps eliminate potential barriers to communication. Families should be aware of what things to look for, what would constitute an emergency, and how to safely handle
The problem explored in the article was stated as a problem statement. In this article, the authors explain about the stressful situations of families having loved ones die in the intensive care unit. They also state that this problem is very important because there is poor communication between staff, physicians, and surrogates in the plan of care for end-of-life measures (Lautrette et al., 2007).
Susan Wolf spent years questioning the ethical and legal aspect of physician-assisted suicide. “As I have before, I oppose the legitimation of physician-assisted suicide and euthanasia.” However, life provided practical experience when her father became terminally ill with cancer and pneumonia. He became weak and dependent. He was left with three choices. He could stay in the ICU, go to the pulmonary care unit, or turn off the feeding tubes and IV hydration. Turning off the tubes was the most difficult choice, but it was the best choice he had. There was no point in prolonging his suffering because death was inevitable.
At this point one is put on a ventilator. A ventilator is a machine which maintains the circulation of blood, oxygen and nutrients to organs around the body. Putting a patient on life support is very costly to the family of the patient and even the hospital. Once a person is brain dead, they are said to be legally dead and the time and date of death is reflected on their death certificate. In South Africa it is not stated that doctors can withdraw life support once a patient is declared brain dead due to ethical debates (Fleischer, 2003).
As a result, life-sustaining procedures such as ventilators, feeding tubes, and treatments for infectious and terminal diseases are developing. While these life-sustaining methods have positively influenced modern medicine, they also inadvertently cause terminal patients extensive pain and suffering. Previous to the development of life-sustaining procedures, many people died in the care of their own home, however, today the majority of Americans take their last breath lying in a hospital bed. As the advancement of modern medicine continues, physicians and patients are going to encounter life-altering trials and tribulations. Arguably, the most controversial debate in modern medicine is the discussion of the ethical choice for physician-assisted suicide.
Physicians have a lot of power over their patients, many physicians advocate for the legalization of euthanasia (Shai 79). The physician’s duty is to ease the pain of the patient and, since many of the terminally ill patients experience unbearable pain, they do what they can and opt for euthanasia (Shai 79). Doctors are by law require to meet the needs of the patients and many times patients request for the doctors to alleviate the pain, although this could mean the termination the patients life. Physicians see the pain that their patients suffer and know what methods can ease the pain, not every patients suffering from chronic diseases will be given the same treatment, however if the patient is given the treatment of euthanasia, there is a reason behind that action. Pain is a contributing factor to the patients request to be euthanatized furthermore research has shown that the amount of pain they experiences rises to forty percent in last couple days of their lives.(Ho and Chantagul 254). Not only do patients with cancer experience untorable pain, but other terminal ill patients suffer as well. None of the patients who live through the pain what to be destroyed by i(Ho and Chantagul 254). It is difficult to imagine that someone has to carryout the rest of there days in pain and with not a single option but to wait it out. This makes patients
Overall the need for a better based end of life care strategy is warranted globally. More of a focus should be given on care and high quality service for patients. As of now too much decision lies with the healthcare professionals and this can lead to faulty decision making because the health care providers are doing what they believe is in our best interest. In reality the patient or ourselves only have the true idea how we would like our final days to be carried out. By developing and carrying out an end of care plan we can take the decision making out of the family and doctors and place it on the patient. By all counts the need for change is apparent within the healthcare industry in regards to end of life care. By considering this unique change a great deal of improvement can be derived from this decision making process.
Puckett , P., Hinds, P., & Milligan, M. M. (1996). Who supports you when your patient dies?. RN, 59(10), 48-50, 52-3. doi: 1996037794
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.
“Machines can extend the length but not always the quality of life” (Cloud,2000,p.62). As doctors, they need to think about the well being of the patient and if any methods could really help the situation. It is hard to let someone that is close to us die, but we need to look beyond the fact that you will miss them. You need to think about what is best for the patient and if they are terminal; prolonging their life is not the best thing. It is important to prepare for our own death and make our wishes known.