Reflective Essay On Breaking Bad News To Patients Nursing Essay

Reflective Essay On falling out Bad News To Patients Nursing EssayIm writing a contemplative essay based on Gibbs model of refection, this is a six pointedness evaluation process and promotes honourable practice through evaluation of experiences, acquired immune deficiency syndrome learning and conk out understanding on how to deal with similar situations in future practice, the six stages comprise of description, musical noteings, evaluation, analysis, conclusion and finally an action protrude (Gibbs, 1998). The department of health (DoH) advises primary c be, to use reflective practice and encourages structured working with all superior within the community and hospitals of the local authority (DoH, 2000), which is incorporate in my reflection.All names and identities r to each one been changed to maintain confidentially in accordance with the jurisprudence of conduct (NMC, 2009). I will seek an experience I had whilst based in a local devote hospital, discussing a situ ation that I entangle uncomfortable with and unsure how to fuck emotionally, psychologically and professionally. This situation evolved afterward a uncomplaining had been well-favored prominent intelligence service by a physician and talks intimately the events after this occurred.I feel it is important to discuss get awaying bad news as this area of converse is often an area that even the professional person finds difficult (Brewin, 1998). The inter-professional teams all have different education and prep confidential information to different views as to how the subject should be arranged and the best right smart to break bad news. Schildman et al. (2005) stated in that location is a need for particularised education on breaking bad news, ensuring all professionals where proficient in this area with an aim to improve skills and continuity.By bad news Buckman (1984) exposit as each development wedded that is likely to dramatically substitute a uncomplainings v iew of their future. The bad news that is delivered may not be about lowest illness or death that could be a lifestyle altering condition like diabetes, heart malady or HIV (Peate, 2006). Arber Gallagher (2004) defined bad news as any information devoted that is not welcome. Traditionally delivering bad news has been considered the doctors role, contempt having little education or preparation in this area (Vandekieft, 2001). Although a wet-nurse may not be delivering bad news directly, it is an ineluctable part of healthcare (Price, 2006) and an integral part of their role (Tobin Begley, 2008). It is however, important to flirt with that the role of breaking bad news is not the responsibleness of erect one profession but should be a shared responsibility with all the inter-professionals within the multi disciplinary team (Jevon, 2010).Mr M, 72 year senile male, admitted to the ward and initially presented with intense intermittent pain in pelvic area and legs. After se veral investigations with other hospital inter-professional teams Mr M underwent tests such(prenominal) as x-rays, cat s sewers and MRI scans. This led to a diagnosis that Mr M had bone and lung metastases, this is also k this instantn as secondary crab louse. Metastatic crabby person occurs when the cancer cells breaks from the primary site, relocate to another(prenominal) area of the body and thusly forms secondary tumours (American Cancer Society, 2010). Cancer is deemed as the most feared diagnosis in todays society (Kalber, 2009). The junior doctor had discussed these results with Mr M, whilst he remained on the ward and without another member of staff with him during the conversation. It is suggested that bad news should be delivered to the patient by some(a)one they know (Lomas et al, 2004). This leads to a much debated subject as to who should break bad news (Brewin, 1998), due to the belief that some doctors are not well prepared and have lack of training and preparation for this line of work (Vandekeift, 2001). Whereas, the nurses have more than communication with the patient and can build a better rapport (Jevon, 2010). The doctor with Mr M should have made him aware, that he had terminal cancer but we were unable to verify this. The written information in Mr Ms notes where thought by the nurses to be to brief and accordingly not well preserve due to a lack of in-depth flesh out but the doctor could argue the notes were ok, they had ac association he had spoken to Mr M about his results.After the doctors consultation Mr M was positive and upbeat and nonetheless trying to do as much as he could for himself. afterward that day he had spoken to me stating that the doctor indispensablenessed to run more test, informing me that they were going to look for the primary cancer site as this may be treatable. My intrinsic feeling was that Mr M thought he could be cured. This made me feel awkward and uncomfortable being or so him and I found it di fficult to know what to say to him, as I was aware of his terminal diagnosis. I was unsure as to what information the doctor had told Mr M or if the doctor had checked he had understood. As doctors have different education and views than the nursing staff it leads to professional indifferences. Mr Ms demeanor may have been his way of move and could have indicated that he was in self-renunciation. Denial is a way for the separate to cover and regain some control, when bad news is delivered leading to an uncontrollable situation like a diagnosis of terminal illness (Burgess, 1994). I felt as if I was withholding information from him that he should be aware of. This made me feel as if I was lying to Mr M, something I was uncomfortable with and I felt compromised ethically, as I was more that aware of his rights to be certain and my code of conduct that states I should be open and honest (NMC, 2008). This made me want to avoid conversation with Mr M as I was unsure how to share t he situation and was worried in case he asked me any questions, as this could have led to boost distress to myself or Mr M. However, it is normal when giving or receiving bad news to feel psychological distress but if supported and managed well you can avoid damaging long price effects (Fukui et al, 2009). I had discuss with nurse in charge that I had concerns about Mr M and queried if he had definitely been told of his terminal diagnosis. Mr Ms pique and demeanour was monitored by the nursing staff over the next deuce weeks, with occasional subtle prompts for him to ask any questions or to comment on how he felt. After this time the palliative care team were informed of Mr Ms situation and invited to the ward by the nursing team, to talk to Mr M and explain his illness was terminal, help him acknowledge this and start to come to terms with his situation and prepare himself and his family with what was to come. The palliative care team have more experience and practice in commu nication with those diagnosed with terminal cancer.The terminal patient can experience numerous different emotions (Peate, 2006), these have been studied by Kulber-Ross in the 1960s and Murry-Parkes in the 1980s. They both suggest that there are five stages of heartache and structured these into models of bereavement (sometime known as the grief cycle). Kulber-Ross (1969) stated that not each person will react in the same way or go through all the stages in order. The five stages are Denial, Anger, Bargaining, Depression or grief and then Acceptance. A death patient will often go through these stages whilst approach shot to terms with their own death (Kulber-Ross, 1969).I felt it was good that Mr M had taken onboard some of the information the doctor had told him and he was in good spirits and trying to do as much as possible. That Mr M was able to communicate well with the nursing team and had benefited from the expertise, kindness and knowledge from all the inter-professional teams from the porters who regularly moved Mr M and showed patience and understanding regarding his pain, to the reassurance given him by the radiographers and their expertise to minimise his discomfort, pain and the palliative care team who showed patience and understanding and with their unique knowledge were able to help Mr M come to terms with his terminal cancer, understand it better and help him cope with his situation. All these people are specialist in their own handle and were involved with Mr Ms care amongst several others. It was good that personally I had built a good rapport with Mr M, which helped me to be aware of his behaviour and highlight my concerns with the nurses. Enabling me to raise awareness and question the nurses as to if Mr M had been informed of his diagnosis or question was he in defense mechanism?I thought it was bad that no-one who had worked regularly with Mr M i.e. a nurse was with the doctor when he was told his diagnosis and that it was a junior doctor that Mr M did not know very well. The information about the discussion hadnt been recorded in detail, as to what was said and if Mr M had understood this information. So we had to retain assumptions due to the lack of detail, we could only get hold if Mr M was in defense through time. Also that I felt I had to avoid communication with Mr M as I found it difficult due to his terminal illness and was unsure what to say to him. I realised talking about dying directly with the dying patient an area I was uncomfortable with and felt unprepared for and therefore avoided the situation. This is echoed by Trovo de Arujo and de Silva (2004) where he suggested that many people will approach communication differently with a dying patient this includes avoidance patterns, which may be due to difficulties in coping with human suffering and death.I have to assume the doctor had given Mr M the correct information about his diagnosis, which left the conclusion that Mr M had not fully unde rstood this information or was in denial about his terminal cancer. I should have contacted the doctor who consulted with Mr M to ascertain as to how the information was given and how he felt Mr M had responded to this. Explaining Mr Ms current behaviour and his understanding that they were still looking for the cause of the cancer and this when located could be treated. This may have improved the situation, by leading to the doctor returning to re-explain to Mr M with another member of the ward. It is now thought that the doctor may not be the most catch person to give bad news and in some situations it may be better for a nurse to do this role (Resuscitation Council UK, 2006).If I was presented with a similar situation, I now feel I would manage the situation better, as I have learnt through reflection of these events. sometimes caring for a dying patient can be intimidating as in our nursing role we believe we are there to improve a patients health so they will get better (Peate , 2006) but the reality is we have a unique role to wait on the patient to health or to a peaceful death (Henderson, 19996). common land sense and forward planning, the use of a structured model can help prevent any distress or communication disasters (Walker et al, 2001). I feel that the communication of bad news should be delivered to a patient avoiding medical terminology (Back et al, 2005), as this reduces misinterpretation (Innes, 2009). The inter-professional teams will benefit the individual by supporting each other and drawing on each others knowledge, helping to reduce long term distress (Fukui et al, 2009) or further avoidance of distressing situations. It is also important to be aware that every patient will react differently to bad news (Kulber-Ross, 1969) and to immortalise their family will also require lots of information and support at this time (Dougherty Lister, 2008).