Pallaitive_Care_Essay

INTRODUCTION The following reflective writing essay will centre on a particular event that I witnessed. I will be using Gibbs’ model of reflection, from Gibbs, G. (1988). For confidentiality purposes, I will name my family member as Estelita who is a fifty five year old female. DESCRIPTION Estelita was experiencing shortness of breath and chest pain. She called an ambulance, whereby a doctor by car arrived, followed by a backup ambulance crew. The doctor who responded performed a primary survey on Estelita, after which she was transported to the nearest hospital by the backup crew who made her walk to the ambulance at the start of the journey and on her arrival at A&E. FEELINGS My initial feelings towards the backup crew were of total disbelief. Whilst the benefit of allowing Estelita to walk unaided might have saved the paramedic’s time, as it might have been near the end of their shift, this action could have easily made her condition worse. I think the minimum amount of manual handling would have involved placing her onto a carry chair and then onto the bed, therefore unnecessarily placing further strains on Estelita. EVALUATION I felt that the initial doctor followed a systematic primary and secondary assessment JRCALC, (2006) as well as keeping Estelita well informed about her actions and reasoning’s at all times as per the standards of conduct. This helped to alleviate her anxiety. However, in relation to the backup crew, The American Academy of Orthopaedic Surgeons states that ‘As a general rule, cardiac patients should be transported in the most gentle, stress-relieving manner possible. Try not to allow the patient to exert him or herself, strain, or walk’. Emergency Care and Transport of the Sick and Injured. 2005. (Page 413-414). I felt this was not the case in that situation as they did not offer her any form of assistance, as well as being rude and unhelpful. ANALYSIS I think that the knowledge and professionalism shown by the paramedic was unquestionable but the main gripe was the lack of care shown by the backup ambulance. Von Essen (1994) opposed the view that patients placed interpersonal aspects of caring as more important than care tasks. Interestingly, patients made few comments about technical excellence of health care professionals. Halldorsdottir and Hamrin’s (1997) study found that ‘patients emphasised the importance of professional competence over interpersonal aspects of care’. I think that as patients or family members, we automatically assume our health carers are technically competent and I felt that a more humanistic approach would not have exacerbated an already distressing situation. Thorne (1988) reported that patients perceived that communication with health care professionals was important in enhancing care quality. CONCLUSION The doctor found Estelita’s symptoms to be attributed to her condition Fibromyalgia which Wallace, Daniel J. (2003) states is a form of soft tissue rheumatism. A complaint was sent to the ambulance service regarding the crew’s conduct and a letter of apology was received. ACTION PLAN In my future career, I will adhere to the standards of conduct at all times and try to continue the chain of care until I handover my patient. Unlike the backup crew, I will try to remain professional at all times even though I might be faced by time, social and work pressures. REFERENCES Danielson C.B., Hamel-Bissell B. & Winsted-Fry P., eds. (1993) Families, Health and Illness: Perspectives on Coping and Intervention. Mosby, St Louis. ELIN M. HALLGRIMSDOTTIR MN BSc ICN, RGN. Accepted for publication 27 October 1999. Accident and emergency nurses' perceptions and experiences of caring for families Consultant, University of Akureyri, Research Institute, 602 Akureyri, Iceland Halldorsdottir S. & Hamrin E. (1997) Caring and uncaring encounters with nursing and health care staff from the cancer patients perspective. Cancer Nursing 20, 120±128 American Academy of Orthopaedic Surgeons. Emergency Care and Transportation of the Sick and Injured, Ninth Edition. Jones and Bartlett Publishers, Inc. - 2005 Health Professions Council. Standards of conduct, performance and ethics. [online] available at: http://www.hpc-uk.org/assets/documents/10002367FINALcopyofSCPEJuly2008.pdf Joint Royal Colleges Ambulance Liaison Committee – JRCALC, Fisher, J. (ed.), Brown, S. (ed.) and Crooke, M. (ed.) (2006), UK Ambulance Service Clinical Practice Guidelines. Coventry: IHCD Journal of Advanced Nursing Volume 33, Issue 4, Article first published online: 7 JUL 2008. [online] available at: http://onlinelibrary.wiley.com/doi/10.1111/jan.2001.33.issue-4/issuetoc Schlump-Urquhart S.R. (1990) Families experiencing a traumatic accident: implications and nursing management. AACN Clinical Issues 1(3), 522±534 Thorne S.E. (1988) Helpful and unhelpful communications in cancer care: the patient’s perspective. Oncology Nurses' Forum 15, 167±172. Von Essen L. (1994) What is Good Caring. Doctoral Dissertation. Uppsala, Sweden. [In Swedish ± Translated and Cited in HalldorsdottirS. & Hamrin E. (1997) op cit.].