The Holistic Management of a Patient with Palliative Care Needs - Essay Example

Patients normally go through so much during their ailing period. There are those that go through chronic or even acute pain. This normally requires palliative care to be given to them accordingly. This paper is dealing with an in-depth analysis of the holistic management of a patient with palliative care needs. There is also further analysis of care given to patients who have symptoms of pain. This paper also further looks at the weaknesses and the strengths of this care given to the patient. The life of a patient by the name McClain Rudolf is also featured in this paper. (Barnett, 2000) Health is a very important aspect to the normal functioning of the body. Despite efforts that human beings make to keep healthy, there are moments when one’s health deteriorates. Sometimes this may be caused by negligence of the individual or sometimes it is not. Nevertheless the world has got millions of cases of patients that are suffering from various ailments. There are normally both short term and long term diseases. All these diseases are normally well handled by health care practitioners. This is in line with the knowledge that they have in line with taking care of patients. (UNAIDS, 2004) One of the major characteristic that patients have is pain. Research however shows that not all diseases and ailments are accompanied with pain. There are some ailments that are not painful at all yet the patient’s health continues day by day. Pain in patients is an aspect that nurses and other health care givers handle it day by day. McClain was born in the year nineteen forty seven. He is currently sixty years old. He was going up and about his business enjoying good health until the year nineteen ninety seven. This is when he started having some slight stomach and muscle pains. Since he had never had any types of sicknesses throughout his lifetime, he ignored the pains. After a period of three months he decided to go to hospital for check up. That is when he was diagnosed with HIV/AIDS. This news was a great shock to him. When he revealed them to his wife, she decided to leave him. This was after she went for the same test and she was found to be HIV negative. (Burris, 1994) The nurse attending to Mr. McClain Rudolf says that he never accepted the fact that he was HIV positive and that his wife left him. This was because he had great love for his wife Marshel. He was admitted to the hospital in the same year, that is, nineteen ninety seven in December. He has never left the hospital premises since then. Pain is referred to as an experience that is emotional or sensory based that is quite unpleasant in nature. This is normally associated with damage in one’s body tissues. Analysis of this issue shows that the damage may already be there or there may be chances of the damage occurring. It is normally linked to the various activities that do take place in a person’s nervous system. This whole concept is delivered to the brain. Doctors assert that the messages of pain are transmitted through an individuals’ spinal cord. The information is not conveyed consciously but rather unconsciously. This is in relation to the tissues in the body that are nearly getting damaged or those that are already damaged. Nociception in human beings normally results in pain. In fact pain is defined as an occurrence that comes about due to a feeling that is unpleasant to the person. It is in most cases experienced consciously. There are two types of pain, namely; (Dranove, 1993) Nociceptive pain Neuropathic pain The neuropathic pain is known to destroy the nerves that cause the overall sensation of pain in the body. Analysis also shows that there are times when pain emanates from the brain. Research shows that the pain is caused by some types of lesions. This pain causes a lot of discomfort to the individual. It is also very hard for doctors to treat such a pain. There are also situations when pain results from illness in the mental part of an individual. It is normally referred to as psychogenic in medical terms. Any time that the body goes through pain, it tries to fight back so that the pain is stopped. This is carried out through the body’s defence system. This is also carried out by the body as a learning strategy so that that which is caused pain is not wilfully repeated. The signals in the body of the sensation of pain are normally transmitted by the nociceptive system. This is in relation to any stimuli that is damaging in nature. This normally leads to the nervous system that is central based to work towards ensuring that the pain or the injury that is caused to the person is minimized accordingly. The intensity of pain in an individual’s life is known to vary. It can also be discontinuous at times. This is whereby the patient talks of pain that is on and off. That means that there are at times when the patient is not in pain. Such information is normally very important when doctors are analyzing the pain. Pain can also be continuous or more permanent in nature. Patients normally describe pain as dull, burning, throbbing or even shooting. This varies from one patient to the other. Considering Mr. McClain Rudolf, he says that his pain is more of continuous in nature. Since the year nineteen ninety seven, his pain has been continuous. (Feldstein, 2003) That is why the doctors and the nurses advised him to stay in hospital and have close observation and care from them. The only thing that varies is the intensity or the way he experiences the pain. There are at times that he experiences very sharp pains in his abdomen. This makes him to writhe in pain. During such moments the nurses have to give him some drugs that minimize the pain. According to Mr. Rudolf, these sharp abdominal pains highly affect him during the night. This makes him not to have enough sleep. He says that he has ever since gotten tired of calling the nurses whenever he is in pain because he feels like a bother to them. The nurses in the hospital noticed this and have therefore assigned a nurse to be monitoring him during the night. The nurse assigned to Mr McClain says that he notices when he is in pain when he twitches his facial muscles. He closes his eyelids tightly and sometimes he shades tears. Sometimes he turns around so much in pain. Pain is normally quantified by medical practitioners from a range of approximately one to ten points. Where zero means no pain and ten means unbearable pain. Localisation of pain is also very important. This means the exact place that the patient is feeling pain. This information normally enables doctors to easily identify the problem that one is suffering from. According to medical practitioners there are some pains which may be of referred type. At times the pain may also be diffuse. Visceral disease is the one that results in referred pain. (Middaugh 1997) This normally happens when viscera fibre enter into the patient’s spinal cord. This result in a message sent to the brain that is perceived to be emanating from a certain area. For instance patients that normally have heart damage have symptoms of pain in their left shoulders. Therefore the pain is transmitted in the brain as emanating form the shoulder yet it is the heart that has a problem. Pain is normally qualified by doctors using information that the patient gives them. A patient has to explain when he or she started feeling the pain. Patients are normally asked questions concerning what they were doing when they experienced the pain. Like in the case of Mr. Rudolf, his pain started when he was just resting and he could not really figure out what had really caused it. The quantity of pain in Mr. Rudolf’s life has been a combination of different qualities. There are times when has pain is very sharp. Other times he has burning sensations on his skin. He feels like throwing up at times. His heads throbs when he remembers what his wife did to him when she came to know that he was HIV positive. Mr. Rudolf’s pain has been rated on a severity scale to be eight point five. This is so much pain for any one to bear. This is because the pain that he experiences does not allow him to do anything else. He can’t sit with the pain but he is forced to lie down. This patient has got both acute and chronic pain. (McCaffery, 2006) Acute pain is known to be caused by damages to the tissues that are soft in nature. They may have inflammation or infection. Chronic pain on the other hand can be caused by illness that is developing or due to any other imbalance in the body. This can also make the patient to have some other psychological problems. Patients with HIV/AIDS normally need intensive palliative care. This due to the fact that in most cases they have so much pain that they undergo. This is especially during the very last stages of this ailment. They do not just experience the physical pain only but also the psychological pain. (UNAIDS, 2004) Palliative care is normally sedative in nature. It is where the healthcare givers do all that is at their disposal to ensure that patient does not feel a lot of pain. As for the case of Mr. Rudolf, the nurses in the hospital are really carrying out palliative care therein. This is through giving him drugs that ease the pain that he is going through. There are moments when Mr. Rudolf is in so much pain that pain relieving drugs only do not work for him. The nurses at such times also give him drugs that make him sleep. This makes Mr. Rudolf able to sleep. So in case he was feeling a lot of pain it works out that the pain is highly reduced. Palliative care also involves giving the patient so much attention. Analysis shows that when a patient is in pain and a nurse goes over to talk to the patient, it eases the extent of pain felt. This is due to the fact that the patients mind or brain will not just be working or looking out for any pain indicator in the body. (McCaffery, 2005) Nurses that are attending to Mr. Rudolf are also incorporating this concept as they care for him. When they see him writhe in so much pain, they move closer and talk to him. The nurses ensure that they don’t talk about the pain but they try to divert his mind to other issues tactfully. After some minutes one finds that the intensity to which he was complaining of the pain has declined. Palliative care involves showing a lot of love to the patient. This is due to the fact that physical pain can be increased by other psychological factors. For instance for Mr. Rudolf, while it is very true that he is going through so much physical pain, other psychological factors making him feel worse. The healthcare givers that have been attending to him for all this period also agree to this fact. That when he starts thinking of his wife and children, he complains of so much pain. Before his complains intensify one can hear him murmuring words about his children and his wife who later on got married to Rudolf’s best friend. This issue normally bothers and also causes him so much psychological pain. Palliative care has also been incorporated in the hospital’s policies. This has been well planned and implemented so that palliative care equipment are in the wards. The hospital wards that have patients that go through so much pain have got television screens. The nurses and other healthcare givers ensure that they put video tapes that are so inspiring. They have words of hope and not of defeat. (Shulman, 2006) Also television programs from well known evangelists are put on. This helps in shifting the patient’s mind from the pain. Looking at Mr. Rudolf, he is known to even smile when he watches the video and the television programs. Sometimes he nods his head. It also gives the patients topics to discuss amongst themselves that distracts their mind from the pain that they are going through. This is helping Mr. Rudolf so much. In fact he says he has favourite programs that he never wants to miss. One of his favourite television programs is that of humour. He laughs his heart out and one can be sure that during these times even though he may be in pain, he doesn’t feel it to a higher degree. HIV/AIDS patients normally go through a lot of anxiety. They see like they are going to die the next minute. They normally have no hope of living and leave alone enjoying life. Everything becomes so meaningless to them. Palliative care normally handles these issues that they go through. Mr. Rudolf is normally talked to just to reassure him that he is very important. The fact that his wife deserted him doesn’t mean that he is useless. (UNAIDS, 2004) Holistic care strategies are also very important when giving care to patients. This is due to the fact that the pain that is normally affecting them does not just emanate from one source. Holistic care includes taking care of the emotional, physical and also the spiritual elements in the patient. Healthcare givers do understand that patients have to get a holistic type of care for them to improve. (Lippincott 1972) For the case of Mr. Rudolf, holistic kind of healthcare is also given to him. This is due to the fact that whatever he is going through is also causes pain to his physical, spiritual and emotional being. The physical pain is reduced through giving him pain killing drugs. This enables him not to feel the pain to a greater extent. The emotional part of this patient is also attended to. This is through talking to him words of hope. This is because he has lost so much hope in life. He is shown love through words that express love. This involves how much he means to the world. He is hugged by the caregivers to help him feel emotionally loved by other people. This is a very paramount way of easing pain in someone’s life. The spiritual part is also well taken care of. Generally the hospital also has got programs where preachers pray for the patients. They are also issued with bibles which they read at any time that they feel like. Mr. Rudolf says that for all this time that he has been in hospital, the word of God has been his biggest source of strength. This is through knowing that although his family may have deserted him, but God’s love is so steadfast. He confesses of praying the most in the times that he goes through so much pain. Prayer is a very powerful tool and has so far enabled Mr. Rudolf to come this far. Many HIV/AIDS patients normally have spiritual pain. They are normally very bitter with God and wonder if he is a loving God why he allowed them to go through the disease. The television programs also feature preachers who speak encouraging words. They are words of faith, patience and a hope for a future and a tomorrow. This enables Mr. Rudolf to be spiritually healthy. The nurses are helping Mr. Rudolf to come to terms with the situation. In fact they have been taking him through the process of accepting his health status and the necessary adjustments that he has to take. They normally take him and other patients through a teaching where they can find deeper fulfilment, meaning and purpose for their lives. This is really working well for the patient. The care that is given to Mr. Rudolf has got both strengths and weaknesses. The strengths of the care are that it enables him to feel less pain. For instance the drugs that he is given help him such that the pain is eased. This is one of the strengths of the care. Another strength lies in the fact that the care that he is given is not just focused on the physical aspect only. It is quite holistic in nature. The nurses ensure that the care is also emotional, physical and spiritual. This is a great strength since healing is also emotional and for his case, he also has great emotional pain. Spiritual care is also known to work wonders in patients’ lives. Furthermore, Mr. McCain gets a balanced diet from the hospital. This is very important to a HIV/AIDS patient. Food also plays a big role in healing. The drugs that he is given work well because of the balanced diet he gets from the hospital. This includes food rich in carbohydrates, proteins and vitamins. The food is also availed in good time which would be very hard if he was not in hospital since he has no wife or children who would care for him. (Feldstein, 2003) The healthcare that Mr. Rudolf gets in the hospital settings is also timely. This is due to the fact that a patient with HIV/AIDS is normally prone to other infections. When they do affect him he gets treatment very fast due to being near doctors and nurses who have the experience. This is also a strength in relation to the care that he is receiving. The care that has been given to Mr. Rudolf also has weaknesses. For instance, he is normally given drugs to make him to sleep so that he does not feel so much pain. This actually tampers with the normal operation of his body. The drugs may also have some negative long term side effects on him. The other weakness concerning the care that he is getting is in relation to the settings. The hospital settings can be a reminder to the patient concerning the ailment. He is far from normal environment settings. For a patient to improve, he or she needs an environment that drifts him from pain and sickness in general. The hospital environment normally has patients that die on a daily basis. This means that he gets reports of deaths of other patients and even witnesses their deteriorating health. This can make him worse instead of making him improve. In conclusion, palliative care is very important to patients that have a lot of pain. Pain is normally an experience that is quite unpleasant to an individual. It causes so much discomfort. The intensity of pain may differ from one patient to another. For the case of Mr. McCain, he has sharp pains in his belly. His head sometimes throbs and generally he has unbearable pain. (Burris, 1994) He gets palliative care from the nurses in hospital. He is given drugs to ease the pain. Other facilities like television are used to divert his attention from the pain that he is going through. The care that he is getting is holistic in nature. This means that it caters for the emotional, physical and spiritual elements in his life. This care has both strengths and weaknesses. One of the strengths is that the drugs ease the pain. The weakness is that the hospital environment is sometimes discouraging to him since he witnesses death of other patients. Read More