Mr Jones died a senseless death, if the family had a Living Will and Health care Proxy the doctors,and nurses would have known in advance what his wishes were, instead of asking his wife. She states he did not want to be resuscitated, all this led to a major propitiatory distress, although morphine was called for by the nurse the resident in charged refuse to administered
Was it wrong that the doctor withheld the morphine, I would say no, reason in his judgement he taught by administering the medication it would cause more damage to the patient, compounded by the lack of a health care proxy, which inhibited him from doing what was right.
After much discussion about the patient status it was determined that due to the lack of a health care proxy a no code status was handed down and the patient died. They were no intention to hurt the patient or the family, but the lack of a health care proxy tied the doctor, and hospital hands, this is why not only patients, but all people need to have an Advance Directive made out, along with a health care proxy which should be taken to the hospital or brought in after the patient is admitted,so that doctors and nurses are on the same page
As I said they were no bad intention of neglect, genuine decision had to be made so that the patient had the right treatment. The end results was a dying process of intense suffering, feeling of helplessness on the part of the family, and lack of candid communication between doctor and patient depriving the patient some how of the gift of their last days.
This scene is seen very often, and is played out not only in the United States but also in Canada people have sense that there is something wrong with the way patients are cared for. If we look at the whole health care system it is made up of doctors, nurses, family caregivers, patients and the bereaved, all being an intricate part of the system.
What the patient focuses on is living rather than dying, seeing this as hope he or she can think of their well being, and if they sense they cannot be cured wants the family involve in their care. On the other hand the family caregiver feels they are very much part of the illness, which affects them as much as the patient.
The caregiver feels that they are a burdened with the responsibility, isolated, do not get help, the need to balance multiple roles, time constraint and lack of sleep, caregivers have to know when to ask for help, although they asked to be placed in that role it can lead to exhaustion and burn out.
The bereaved is often seen as complicated, which at times it can be, no one can say that they are over grieving the death of a loved one this can take quite a while. It is not that you have to forget the person when the time comes for you to move on with your life, most important for the bereaved is friends, to be there to lend an ear, hug them when they cry and to laugh, just simple being there without an agenda is all that is required.
The professional caregiver acknowledges that they lack training in end of life care, resulting of feeling inadequate when dealing with dying patients, and their families which lead to emotional withdrawal, self destructive coping mechanisms, and denial telling one " thank God we don't have time to bond with families anymore" how sad.
Bonding all systems together is a process that can take a long time. it is important for doctors to remember although they are there to help heal the patient other needs are required, that of spiritual and social which require the help of clergy and other professionals.
When life care can adopt all that is deemed acceptable to all dying patients it would be a success, without all players on the team discussing the issues at hand the system would fail.
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