Clinical Link Learning Activities - Essay Example

? Clinical Link Learning Activities College Introduction Provision of person-centered life care requires comprehensive and well coordinated assessment process which can support patients in their own unique pathways. (National end of life care program, 2010 pp. 16). People at the end of life often experience wide ranging and complex needs hence the need for effective holistic assessment. Inadequate assessment and duplications of assessment can lead to complications and frustrations. Holistic assessment serves to address these challenges in addition to respecting a patient’s preferences and choices (Cancer Action Team, 2007). The department of health stresses the importance of assessments that covers social, environmental, psychological, cultural, spiritual, financial and physical (Department of Health, 2008). The assessment is geared towards giving priority and preference to patient needs. Effective record sharing and maintenance minimize duplication and repetition. It is necessary that all life care practitioners and support groups to acquire the necessary expertise and experience in order to contribute in enhancing quality care. Evaluating the process of preparing cancer patients in their journey Diagnosis of cancer and Treatment plan agreed The cancer patient should undergo this assessment since cancer illness is progressive and incurable but can be managed to ensure the patient leaves a quality life. The planned active treatment and assessment occurs at a key point at around the time of diagnosis. This is after several test detected cancer in its early stages. The planned treatment scheduled periodic clinic session with the patient for active treatment and assessment. The team of consultants included a Doctor and a clinical Nurse Specialist who are charged with responsibility to treat and assess the patient. The competence and experience of the team is important in ensuring quality assessment and treatment (Department of Health, 2009). Holistic Assessment The assessment lasted a fairly reasonable time since the patient was just about to start the active treatment phase. The session was timely as it occurred at the onset the disease. These routine assessments will provide the opportunity for the assessors to identify the changes in needs of the patient (Cancer Action Team, 2007). The plan included an initial assessment by a Clinical Nurse Specialist but also provided for engagement of a Surgical Ward Sister. The professional assessors have the requisite knowledge and competence to conduct the assessment (McMullan, 2003 pp.285). The plan had not provided for self-assessment was not provided in the plan but I thing it can play an important part in identifying patient’s preferences (Robert, 1982 pp. 81). The assessor describes the process and details of assessment to the patient and seeks consent since the process should be between patient and professional. Consent seeking is important not only for purposes of preference but also on the bases of clinical ethics (Greene, 2005 pp. 61). The plan provided for several assessment contents namely: Background information and assessment preferences It is recorded from the patient care record and captures details such as name, date of birth, gender, religion, occupation, dependants, allergies, diet, hospital consultant and next of kin. The preferences include date of last evaluation with copies, know the needs identified and actions taken. This is laudable since it will ensure continuation and avoid duplication. Information on key points, date, assessor name and site of assessment are also planned for inclusion. Address consent for assessment and presence of carer or family member. These last two are very important since the former address the notion of patient need while the later include participation of the next important person beside the life care professional (Cassileth, 1980 pp. 834). Physical well being The session entails description of the problems that include cause, intensity, duration and rate of change. The effects of the problems are ascertained in relation to normal activities. Obtain past management of the problem such as treatment and equipment, review progress of management and ascertain further needs (Molassiotis, 2005 pp. 657). Social & Occupational well-being Ascertain patient’s overall situation, limits, support or additional support in relation to work and family, family, social and recreation, managing at home and in the community (Vachon, 2008 pp.220). Psychological well-being Find out a description of the problem, the history of the problem, personal impact on the patient, effect on others, strategies to manage the problem (treatment), review if treatment/management is working and ascertain further needs (Landis, 1996 pp.225). Spiritual considerations Knowledge of the patient cultural background is important as it might determine aspect of spiritual care. This is a sensitive area and the questioning may require some caution. (Puchalski, 2000 pp.135). Spiritual matters are quite subjective and the assessor needs to be equipped with alternative terms. Recording, maintenance and sharing Information Standards and benchmarks are set for the functions stated namely recording, storage and sharing. Taking Action This is the essence of the exercise and the session should be able to identify solutions and action plan. The solutions could be self initiated or they could agree on a referral to a local service. Treatment commencement The plans enlisted the service of a surgeon and a radiotherapist for surgery and radiotherapy respectively. This marks the beginning of the patient’s journey in treatment and life care. Surgery and radiotherapy are important treatments in ensuring that cancerous cells are removed or destroyed. The plan indicated commencement of treatment after a period of about two weeks to enable the necessary preparations such as financial arrangement and psychological preparedness for patient and family members. Holistic assessment is not planned to take place at this point because the patient had just undergone surgery and need recovery and the treatment implication to be felt. Ongoing hormone treatment while signaling end of treatment The planned hormone treatment is an ongoing exercise to moderate the effects of radiotherapy and assist in cleaning the blood and minimizing the threat of breast cancer returning. In some cases the hormones can kill cancer cells or make cancerous cells grow slowly. Holistic Assessment This is planned as the second assessment session to be assessed by clinical nurse specialist or therapeutic Radiographer. This assessment refer to earlier one and takes into account pertinent issues identified in previous sessions. Clinical follow up for regular check This planned stage is important for ensuring possibilities of any complications are addressed an early stage. The patient undergoes regular mammography sessions for breast cancer. The session also checks on progress of earlier treatment to ensure any emerging needs and patient preferences are timely addressed (Snee, 1994 pp.155). Holistic assessment sessions are not separately planned since the regular check double as sessions for assessments. Regular checks ensure assessments are regular and inline with the need to identify any changes at the earliest opportunity. Disease/Cancer progression Patient is at liberty to request medical attention due to developments associated with cancer progression. Patient emerging challenges could be conditions of fatigue, anxiety, unease and inability to meet job demands. Holistic Assessment session The patient is assessed by the general practitioner or Clinical Nurse Specialist. The continuous assessment sessions are designed to address changes along the treatment and maintenance path of the cancer patient journey. This is important because the sessions and stages in the disease progress leads to different needs and preferences. Conclusion The Holistic was scheduled before treatment and just after treatment and this provided a good opportunity to identify the needs and preferences of the patient before treatment commenced. The assessment details were to be obtained in reference to the stage in treatment stages. Details captured during the assessment before treatment were to be different from the ones after the treatment or in the long term survival. Caregivers and family members who support the patient to cope with the ailment should be accorded the requisite help (Northouse, 2012 pp.30). Cancer support group These are groups that offer a setting where cancer patients can exchange experiences. They are groups that gather people who share a common health interest. The support groups are important since they offer a system where the patients can harness their group capabilities to address the common challenges. The support groups take several forms that include community support, networks, cancer support groups, forums and charity trusts. Support systems vary from those that assist patients with specific types of cancer to those that assist patients with other forms of cancer. Structure and function of the group The group was composed of social workers, psychologists and medical professionals such as clinical nurses, general practitioners and ward sisters. Other participants comprised family members of cancer patients, caregiver to cancer patients and survivors of cancer diagnosis. The meeting was organized at a community center in the outskirts of the city and was well attended. The group comprises a director, coordinator, communicator, librarian, accountant, project leader, administrator and a liaison nurse. Support groups can develop very different organization structures that may include inclusion of professional experts, formal and informal while still others are run by business entities (Kurtz, 1997 pp 36). This structure enables the group to effectively communicate and run numerous projects/campaigns in creating awareness and raising funds. The library facility is run to enhance information sharing among the members while the nurse assists in providing patients with therapy and assessment. The cancer support neighbor group is a non- profit organization that offers services and education support among other social and psychological support to persons affected by cancer. The organization aims to improve the life quality of persons affected by all types of cancer. The organization supports the patients, carers and the families. Support comes in the form of information, emotional, practical, educational, and financial support (Docherty, 2004 pp.90). The cancer support neighbor group also champion fights against discrimination and advocate for changes in legislation and policy. Cancer support funds and sponsors nurses in health and life care professionals. The group support research on cancer through funding although the current funding is low but the organization is committed to increase the funding in future. It also participates in limited community services like cleaning exercises. Cancer support neighbor group has an online presence mainly for its global audience. The online forums present an ideal platform for individuals to share the diverse experiences across the globe (Beuchot, 2005 pp. 67). The platform is one of its main channels for raising cancer awareness and soliciting funds from individual contributions and organizations. Functions Providing emotional and physical support Cancer patients experience unique challenges such as worries, concerns and feelings. The group through its various forums provides emotional and physical support. The support makes the patient feel less distressed or isolated. Due to human nature, experience shows that a problem shared is a problem half solved. Provision of information The forums provide current and mostly free information that can not easily be found elsewhere. Any challenges due to unique situation are shared since the forums and groups comprise large numbers of members and this increases the chances of identifying a patient with similar challenges. Equipped with the necessary knowledge and information, the patients are able to gain confidence and empowerment which propel them to handle other challenges in life (Barak, 2008 pp. 70). Interpersonal comfort and stress management The group encourages members to make friendships and share experiences with each other and this enhance comfort and minimize stress. Sourcing for funds The group source funds from various sources such as business organizations, public, trusts and government. The funds facilitate management of the group and provision of services to the members. The community organize events such as local marathon races to raise funds and enhance cancer awareness. Initiate and implement projects/programs Some of the programs may include creating cancer awareness to the general public or campaign and petition government to create relevant policies and legislations that address cancer patient’s needs such as eliminating discrimination, stigmatization and healthcare changes. Carers and family members The group provides counseling to the members on how to handle the various challenges affecting their patients and this is also shared among the various family groups. Caregivers that embrace social support can quickly gains mastery and control and help patients cope well with hospital diagnosis (Gielen, 2001 pp. 315-322). According to Ferris et al, (Ferris, 1995 pp.35), caregiver need support through universal precautions, seeking respite care, pursue bereavement care because they bear the burden in care giving. Donations for research This function ensures that the treatment and therapy functions are continuously reviewed and improved for the general good of the patients. Investment in cancer research is one of the most important approach to addressing the processes and systems that ensure an effective holistic assessment and eventual managing cancer menace (Austoker, 1988 pp. 99). Holistic Assessment The community compliments the assessment done by professional by focusing on the social, occupational, psychological, spiritual well-being. These are the functions that are mostly handled by the carer of family member in a normal rather than hospital setting. Review home and community engagement. Members share experiences on how they manage diet, movement, personal care, housekeeping and resting. Sharing experiences help overcome challenges especially for diet maintenance which include sources of diet and how to enhance appetite. Finances and work. The community assesses and decides on the financial situation and decides on ways to help the patients. The community assists members to find work and to evaluate member’s current work and establish whether it fits the recommended settings as advised by the doctor (Bell, et al, 2011 pp. 526). The group educates members in matters pertaining to finances, inheritance plans, insurance and living will. Family and relationships. The group helps to address matters regarding to family, children, friend and spouses and help members overcome and address them. They provide counseling for free to members. Content and purpose The meeting was conducted to discuss a new medical policy developed by the government. The members were evaluating the implications of the policy document. The members had earlier campaigned for a reduction in taxation or a total removal of tax on equipments used for treatment of cancer. The members had a feeling that since cancer cases are on the rise almost reaching epidemic levels, the government should prioritize reduction of medical cost to make it accessible to more patients. The meeting laid down a proposal to petition the government and planned ways to seek public and stakeholder support. The purpose of the meeting is noble and the media channels suggested are very likely to produce the intended results. Government participation in healthcare and especially through development of healthcare policies plays a significant role in the management of diseases especially terminal illness (Twinn, 1996 pp. 54). Conclusion Recent trends in cancer are causing serious concerns and the debate is currently whether the levels are at epidemic levels depending on the regions across the globe. A wide range of causes for the disease exist wit the main culprit still remaining to be tobacco. Many countries have tried controlling consumption of tobacco as a preventive measure although there are still lingering challenges especially in regard to the economic implications of controlling tobacco consumption. (Jha,1999 pp.105). References Austoker, J. (1988) A history of the Imperial Cancer Research Fund, 1902-1986. Oxford University Press: London Barak, A. Boniel-Nissim, M. Suler, J. (2008). Fostering empowerment in online support groups. Comput Human Behav. 24:1867–1883. Bell, R. Hu, X. Orrange, S. 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