Palliative Care Interview
pls give it to writer that did my outcome synthesis paper # 00 026027 Please see the attached instructions. I am placing two orders, pls give it to the same writer , so that the idea will flow. PLS DO NOT GIVE MY PAPER TO A PERSON WITHOUT MEDICAL KNOWLEDGE AND BACKGROUND. There is a list of recommended books but you can use other books that can be accessed electronicaly.
This interview will be conducted for academic purposes. As such, you will need to have a clear purpose and objectives for your interview session. Begin by identifying a nurse practitioner whose skills, knowledge, or experiences seem pertinent to this course’s content. The nurse practitioner could be working with patients and families with pain or palliative care issues; a researcher or author who has studied issues related to pain or palliative care; or a nurse practitioner working in another capacity who has special expertise related to pain and palliative care.
This interview will be conducted for academic purposes. As such, you will need to have a clear
purpose and objectives for your interview session. Begin by identifying a nurse practitioner
whose skills, knowledge, or experiences seem pertinent to this course’s content. (palliative care and pain management)
The nurse practitioner could be working with patients and families with pain or palliative care issues; a researcher or author who has studied issues related to pain or palliative care; or a nurse
practitioner working in another capacity who has special expertise related to pain and palliative
care.
The interviews may be conducted in a variety of ways (from formal to informal) and in settings
comfortable for both interviewer and interviewee (typically face-to-face, but phone, text, or
email might be appropriate in some instances). Because an interview requires a professional’s
time, it is imperative that you have your questions prepared in advance of your meeting. You
may wish to include some of the following topics in your interview.
• An explanation of the course and the homework assignment
• A brief description of your interest in the area of pain and palliative care
• Questions that will prompt the interviewee to provide information on her/his management
(or recommendations for management) of the following:
o General themes related to pain and palliative care.
o Issues related to family-centered pain and palliative care treatment and
management.
o Communication
o Spirituality
o Cultural Diversity
o The use of aggressive therapies.
o Grief and bereavement.
o Issues related to specific body systems: cardiovascular, respiratory, GI, neuro,
skin, musculoskeletal.
o Technical information about pain and palliative care management is
accomplished.
o Social, ethical, or financial costs associated with pain and palliative care
management.
o Advice to a nurse practitioner wishing to work with issues of pain and palliative
care in practice.
o Other questions and discussion related to your specific interests.
• Challenges for the nurse practitioner working in pain and palliative care services.
• Rewards for the nurse practitioner working in pain and palliative care services.
The paper should have three sections:
1. an explanation of who was chosen and why; (400 WORDS )
2. a summary of what the interviewee said;(400 WORDS)
3. and a discussion of what the student learned during this activity that may be helpful in entering practice. (400WORDS)
The paper should be written in APA style, including the tone
and use of language discussed in the APA manual, and requires sufficient support from
appropriate and current academic references. Each section should be 400 to 600 words in length.
RECOMMENDED TEXTS
Arbour, R. (2005) AACN home theatre on cd-rom: Palliative care: Symptom reprieve and
drug therapy. AACN
Curtis, R. J. & Rubenfeld, G. (2001). Managing death in the ICU: The transition from cure to
comfort. AACN
Medina, J. & Puntillo, K. (2006) AACN protocols for practice: Palliative care and end-of-life
issues in critical care. AACN
Wallace, M. & Staats, P. (2005) Pain medicine and management: Just the facts. Philadelphia:
McGraw-Hill.
Palliative Care Interview
Author's Name
Institution
Introduction
The nurse chosen for this interview is Edmond. Edmond is a registered nurse who has worked extensively in the field of palliative care nursing, with a special focus on end-of-life care. A unique feature about Edmond is that before becoming a nurse, Edmond was a singer. He asserts that this experience offered him a transglobal immersion in the power of interaction and human emotion. This gave him a base for his second profession as a nurse, enabling him to guide and understand his multicultural patients to express their eminent wishes (personal communication, March 15, 2014).
Edmond graduated from nursing school in 1999. His first specialty was in the cardiothoracic field. Here, Edmond was exposed to the underrepresented and chronic needs of the critically ill and intensive care patients. Prior to his clinical experience, Edmond was the caregiver of a relative who was suffering from HIV. During this time, there were no antiretroviral drugs. This formed a formative experience which propelled him to his current professional choice. In addition, Edmond volunteered for several support groups for palliative patients. This helped Edmond to understand how to deal with and support a person in the process of dying. Helping his relative navigate HIV/AIDS confirmed to him that nursing would be a rewarding choice (personal communication, March 15, 2014).
Edmond has worked with palliative patients for nine years. Here, he has been able to work with the critically ill patients and their families. Before Edmond took over his current position, the hospital lacked an appropriate person to deal with the needs of palliative care patients. Many hospitals face the same predicament (Medina & Puntillo, 2006). Edmond has also received specific training in end-of-life care. In his training, he has learned the practices of palliative care, pain management, loss and grief and the cultural, ethical, spiritual and communications issues surrounding the dying process. Edmond has also won an award in a state-sponsored cancer pain initiative.
Edmond also illustrated a story that showed what he loved about his work (personal communication, March 15, 2014). Once in an ICU setting, Edmond encountered an elderly man who was extremely incapacitated due to stroke. The elderly man had no blood family. However, he had many friends. Edmond helped the family to figure out the necessary steps to determine the patient's goals. In addition, he helped the friends to find the patient's advanced directive paperwork. The elderly man had an amazing passage. Before his illness, he ran an open “mic†night in town. His friends visited and shared the stories of his life. There was laughter, music and tears in the patient's room, and he was showered with love from his friends. This event reminds Edmond of why he chose this path. Due to these factors, the knowledge, skills and experiences of Edmond are pertinent to the context of palliative care.
Purpose of Interview
Edmond exemplifies and accentuates the philosophy of palliative care. This interview sought to determine what drives the professional onwards in palliative care delivery. In addition, the interview also sought to discern the various challenges facing palliative care from the perspective of a professional working in this specialty. The interview also aimed at identifying the best way of delivering quality end-of-life care in terms of communication, the grief process, spirituality, culture, medical therapies and cost. A face-to-face interview was conducted. Questions pertaining to the aims of the interview were presented to Edmond in a concise and articulate manner. This was done to save time, since Edmond works in a busy environment.
According to Edmond, there is a general perception by family members that relatives dying in health care setting do not receive sufficient care (personal communication, March 15, 2014). This is in terms of symptoms control, such as dyspnea and pain relief. Unfortunately, despite the imperativeness of end-of-life care, few hospitals have incorporated this care into their hospital policies or quality improvement process (WHO, 2012). There are diverse challenges that face palliative care. According to Medina and Puntillo (2006), these barriers may be attributed to communication barriers between healthcare workers, patients and family members, discord among team members in regards to the goals of care and a fast-paced environment. These issues warrant further studies to comprehend them from the standpoint of an experienced professional; thus the justification for this interview.
According to WHO (2012), palliative care aims to augment the quality of life in patients and families facing problems linked to life-threatening illness. This approach is realized through the relief and prevention of suffering by identifying, impeccably assessing and treating pain and other physical, spiritual and psychosocial problems (WHO, 2012).
Summary of Interview
The interview was divided into sections according to major themes. These included the general themes related to palliative care, the challenges faced, rewards of working in palliative care and advice from the professional. The general themes related to palliative care include communication, cultural diversity, spirituality, use of aggressive treatment in palliative care, grief and bereavement, body systems and costs associated with palliative care.
Communication
According to Edmond, communication with the patients and family members is usually complex (personal communication, March 15, 2014). This is further complicated by culture. He notes that he has to determine the illness-related issues which he can discuss with the patient and family. He notes that most professionals often collude with the relatives to keep the patient in the dark. This is complemented by an article by Chatuverdi, Loiselle and Chandra (2009). However, he believes that an open communication approach should be used. He uses an empathetic approach to broach the subject with the patient and family. He believes that it the patient's right to be furnished with the information pertaining to diagnosis, prognosis and outcome.
Spirituality
In addressing spirituality, Edmond asserts that palliative care should aim to address the patient in a wholesome manner. However, one should ascertain whether the patient has this need. He believes that professionals should not force religious or spiritual discussions or practices on the patient a fact that is supported by Broeckaert (2011). Edmond also believes that the health professional should be sensitive towards the views of the patient in terms of spirituality, in order not to get offensive or defensive. Most of the patients he has encountered are catholic, and they are permitted sacramental visitations by the priest or clergy.
Cultural diversity
Edmond notes that death does not choose a culture. Chronic and terminal illnesses afflict people from all cultures (Chatuverdi, Loiselle & Chandra, 2009). In becoming culturally competent in his care provision, Edmond has continuously sought to become culturally literate. As an example, when he encounters a Chinese patient, he goes ahead to read more about the Chinese culture. Through such knowledge, he has discovered that the Chinese view death as a life step. In addition, this knowledge enables communication with the family from a different culture. The Chinese often have an overall decision maker in terms of health. Therefore, Edmond has to determine this member in order to engage him in the decision making of palliative process.
Use of Aggressive Treatment
According to Edmond, treatment at this stage should be aimed at minimizing discomfort in the patient (personal communication, March 15, 2014). When a patient has advanced cancer, there is no point in attempting chemo or radiotherapy. He notes that the side effects of these interventions generally worsen the patient's condition. This is also noted by Wallace and Staats, (2005). The intervention that he considers imperative during palliation is the relief of pain and breathing discomfort. Therefore, he has a pouch in which he carries “his morphineâ€. However, he notes that the painkillers should not be administered in high doses. He also does not advocate for deep palliative sedation for patients with refractory symptoms.
Grief and Bereavement
In dealing with grief and bereavement, Edmond has learnt to recognize the various stages of grief. These comprise denial, anger, bargaining, depression and acceptance (Hebert, Moore & Rooney, 2011). By understanding these stages, Edmond is able to play a better role as an advocate of the patient. However, Edmond notes that the grief process is personal, and the professional should not attempt to rush or lengthen the stages. In addition, Edmond has to provide bereavement support to the family members via emotional support.
Issues related to specific body systems
According to Edmond, the most imperative body system during palliation is the respiratory system (personal communication, March 15, 2014). The respiratory system is especially relevant as the end-of-life approaches. He notes that one can evaluate worsening of a patient condition by the change in the breathing rate and depth. Patients often develop stridorous and noisy breathing as dying approaches (Curtis & Rubenfeld, 2001). He gives oxygen via a face-mask in an attempt to...