BMJ Supportive and Palliative Care †Free Samples to Students

Question: Discuss about the BMJ Supportive and Palliative Care. Answer: Introduction: Palliative care is an essential medical and nursing care for improving quality of life of persons with life-limiting illness. Palliative care refers to a specialized nursing and medical care for patients with life limiting health conditions (Glaser, Strauss, 2017). The palliative care provides relief to patients that improve their quality of life. Palliative care has a role in relieving patients suffering and their families through a holistic assessment and treatment of psychosocial, physical, and spiritual symptoms. Personal values and beliefs shape palliative care provider interactions that are important to delivering effective palliative care. The following essay a self reflection that explains how to provide best holistic end of life care to a person while managing personal values and beliefs and their effect to interaction with a patient. Holistic end of life care is a comprehensive approach for assessing and treating persons in their last days of living. A holistic approach aims at assessing and treating the physical, spiritual, and psychosocial aspect of a palliative patient. The approach recognizes that patients are human beings and are made up of mind, body and the spirit. Balboni et al. (2016) defined holistic end of life care as a comprehensive care that acknowledges and recognizes a person as a whole and there exist interdependency among ones social, psychological, biological, and spiritual aspects. A holistic care approach has to include medication, communication, self-help, education and complimentary treatment (Morton, Fontaine, Hudak, Gallo, 2017). The approach considers all the aspects that affect the treatment process and the patients emotions, thoughts, opinion, attitude and cultures. The holistic end of life care approach is based on equality, relative openness, respect, mutuality as the patient under care is allowed to participate in decision making. The holistic end of life care has several benefits to palliative care providers, patients, and their families. First, holistic approach increases the nurses understanding of the patient physical illness and their specific needs. The holistic approach is comprehensive and involves educating patients to increase their self awareness. The patients are able to understand their condition and its effects that enable nurses to get a clear inquiry of the patients suffering (Gillan, Van der Riet, Jeong, 2014). Secondly, the holistic care approach enables communication between the nurse and the patient. Communication is important to creating therapeutic relationship in palliative care (Balboni et al. 2016). The therapeutic relationship between the nurse and the patient enable the nurse to provide education on self care and have a conversation that reveals patients feelings, emotions, and desires while receiving health care. Thirdly, the palliative care provider is able to understand the patie nts culture, values, and belief. The nurse understands the likely attitude, perspective and values that the patient holds. This enables the nurse to appreciate and offer a respectable palliative care to the patient. Holistic end of life care is also beneficial to the patients families. The approach takes family into considerations when making patients palliative decisions. Aged people like to be close to their families and help offer emotional support to the patient (Mathews, Johnston, 2017). The nurse is also able to provide stress, anxiety or depression treatment to the family as a result of one member unhealthy condition. Another benefit of holistic care approach is that patients have dignified death. The patients are involved in decision making and conversation and their death is not a surprise (Glaser, Strauss, 2017). Patients are able to plan for their advance care. The patients is also able to identify substitute decision maker in case the patient cannot communicate or unab le to make sound decisions. Holistic end of life care is therefore beneficial in providing comprehensive nursing care that improves quality of life through psychological, social, physical, and spiritual approach to assessing and treating patients. Personal values and beliefs of a nurse have an impact when interacting with a palliative patient. Personal values are stable and longlasting beliefs that an individual hold as important and set standard orders that a person lives and make choices (Connor, 2017). Beliefs develop into values when someone commits to them and grow to being important in their life. It is important for a nurse to understand personal values to make rational, responsible, consistent, and clear decisions. Personal beliefs and values of a nurse in palliative affect nurses relationship with the patients and their family. My personal belief and values have been shaped by my background. My decisions while providing holistic palliative care will be highly influenced by personal values and beliefs. One of my personal values and belief that can affect interactions with palliative patient is spirituality. Spiritual care is an important aspect to providing a holistic end of life care. Spiritual care involves a nurse recognizing and responding to human spirit needs. I think spiritual care and spiritual wellness of a patient are culturally bound and there is not standard method of offering spiritual care. I also think that spirituality care should be a role of spiritual experts such as pastoral team. Gardner, (2017) stated that spiritual care difficulties are caused by nurses differing beliefs and perception of spirituality as contentious, taboo and sensitive subject hence assuming it importance in holistic health care delivery. Centeno, Ballesteros, Carrasco, Arantzamendi, (2016) found that nurses spiritual awareness and understanding can improve end of life care delivery. Human beings need spiritual care to when faced with trauma, sadness, or ill health that leads them to struggl e with self worth, meaning of life, expressing themselves, and require faith support. Spiritual care help treat spiritual distress to restore patients belief system. According to my personal beliefs and values, I find it uncomfortable to talk about death with a patient. I understand the importance of communication in delivering quality palliative care but find it hard when it has to be a topic on preparing the patient for last days. I belief death is something that takes loved ones life away leaving grief and agony to family and friends. I feel like talking much about death leads to death occurring earlier than it would have happened if I didnt talk about it. Coelho et al., (2016) stated that communication is an important aspect of providing a holistic palliative care. Conversations about death enable the patient to share about their agenda and preferences. Communication helps nurses to identify and address all needs of the patient which is central to holistic approach to palliative care. Teixeira, (2016) acknowledged that communication in palliative care is a complex challenge to excellent care. Therefore lack of proficient when communicating ca n overlook patients goals and wishes of the care undermining the holistic palliative care. In summary, personal beliefs and values influence a nurses ability to provide effective and holistic end of life care. Palliative patients need a holistic end of life care to relieve pain, improve quality of life, and have a dignified death. I found that I have to change my perspective and attitude about spiritual care and communication and appreciate their role in providing holistic palliative care. Spiritual care helps to treat spiritual distress while effective communication enhances conversations with the patient that enable them to prepare and have a dignified death. Therefore, nurses should understand and appreciate a holistic approach to providing effective palliative care. References Balboni, M. J., Sullivan, A., Enzinger, A. C., Epstein-Peterson, Z. D., Tseng, Y. D., Mitchell, C., ... Balboni, T. A. (2014). Nurse and physician barriers to spiritual care provision at the end of life. Journal of pain and symptom management, 48(3), 400-410. Centeno, C., Ballesteros, M., Carrasco, J. M., Arantzamendi, M. (2016). Does palliative care education matter to medical students? The experience of attending an undergraduate course in palliative care. BMJ supportive palliative care, 6(1), 128-134. Coelho, S. P., Costa, T., Barbosa, M. M., Capelas, M. L., De Mello, R. A., Sa, L. (2016). Palliative Home Care, for a Holistic Approach to the Patient and Family. Palliative Medicine, 30(6), NP294. Connor, S. R. (2017). Hospice and palliative care: The essential guide. Taylor Francis. Gardner, F. (2017). Critical spirituality: A holistic approach to contemporary practice. Routledge. Gillan, P. C., van der Riet, P. J., Jeong, S. (2014). End of life care education, past and present: a review of the literature. Nurse Education Today, 34(3), 331-342. Glaser, B. G., Strauss, A. L. (2017). Awareness of dying. Routledge. Morton, P. G., Fontaine, D., Hudak, C. M., Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams Wilkins. Mathews, G., Johnston, B. (2017). Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives. Current opinion in supportive and palliative care, 11(4), 315-327. Teixeira, E. (2016). Mindfulness Meditation: One Holistic Approach to Reduce Pain and Suffering in Patients with Chron-ic and/or Life Threatening Diseases.(2016) J Palliat Care Pain Manage 1 (2): 1-2. J Palliat Care Pain Manage, 1(2).