From her latest diagnosis, it was established that Mrs. Camillero is nearing her death. Her palliative condition has really deteriorated and she knows it. So, in order to deliver quality end-of-life care to her, the EN should act professionally. To do this, the EN has to establish a healthy interpersonal relationship with the patient and effectively communicate with the patient using excellent communication skills. At this point, the patient needs a provider who can treat her with dignity and listen to her (Gjerberg, Lillemoen, Pedersen & Førde, 2016). At the same time, quality palliative care can be guaranteed if proper documentation is done.
Mrs. Camillero’s life-threatening-illness has really impacted on her life. It has hindered her from engaging in the Activities of Daily Living (ADL). First, the disease has made her immobile. She cannot move from one place to another because she is incapacitated. Besides, she has lost her independence and cannot perform daily tasks such as bathing. Moreover, the disease has caused a lot od stress to the patient (Rehnsfeldt, et al., 2014). All the physical and psychological challenges faced by the patient result from the pains endured as a result of the illness. Therefore, to be helped, the patient should be given a holistic palliative care.
Pain relief medication is a necessary drug that should be prescribed to the patient. Just like any other palliative patient, Mrs. Camillero is experiencing a lot of pain. Her condition has made her to suffer a great deal. Therefore, she should be given pain relief drugs because they will help in minimizing her pains. Since the major goal of palliative care is to provide holistic service to the patient, it can be much better is the patient is given pain relieving medications (Hutchinson, et al., 2014). A proper management of her pains will make her to improve the quality of her life as she awaits her obvious death.
The family of Mrs. Camillero is supposed to be provided with a bereavement support. The support should be provided by the bereavement counselors, spiritual counselors, and social workers. These are people who are trained on counseling and can effectively handle sensitive matters such as provision of counseling services to the bereaved families (Katon, et al., 2013). A proper support from these experts can enable the family to overcome the loss of their loved one.
Despite their deteriorating conditions, palliative patients should be treated just like any other ordinary patient. They should be accorded autonomy to empower them to make important decisions regarding their lives. However, when it comes to palliative decision-making, the patient should be allowed to do in line with their cultural, religious, and spiritual beliefs (Rehnsfeldt, et al., 2014). Culture and religion are important considerations to make when making decisions because it determines what a person should do before and after their death. For example, as a Catholic, Mrs. Camillero had to be allowed to be with her family and priest immediately before she died. It gave her an opportunity to enjoy a dignified and fulfilling death.
The National Framework for Advance Care Directives
Enduring Power of Guardianship, Medical Power of Attorney and Anticipatory Direction with a single, Advance Care Directive Form (Southern Australia)
An Enduring Power of Attorney under the Powers of Attorney Act 2006 (Capital Territory)
An Instrument appointing an enduring Guardian under the Guardianship Act 1987 (New South Wales)
An Advance Health Directive under the Powers of Attorney Act 1998 (Queensland)
An Enduring Power of Guardianship under the Guardianship and Administration Act 1990 (of Western Australia)
The nursing profession is governed by the ethical principles of beneficence, non-maleficence, autonomy, and justice. If given an opportunity to serve Mrs. Camillero, I would not hesitate to apply all these principles. First, I would apply the principles of beneficence and non-maleficence refraining from causing any harm to the patient and doing my best to relieve the patient from his pains and sufferings. Besides, I will apply the principle of autonomy by respecting the patient, treating her with dignity, and give her a chance to make important decisions regarding her palliative care. Meanwhile, I will apply the principle of justice by analyzing the patient’s needs and meet them in a fair manner in which they should be prioritized (Cannaerts, Gastmans & Casterlé, 2014).
As a bereaved person, Rose needs to be provided with the necessary social support to enable her overcome her challenges. Apart from the support from the bereavement counselors, she should join the community and social support groups around her. There are so many such groups across the country. So, with the support of palliative care providers, Rose should be referred to available support groups. Here, she will get to mingle with other Australians who have a similar problem like hers (Rehnsfeldt, et al., 2014). They will share problems, counsel, and support one another to overcome the loss of their loved ones.
Joe has special needs that should be addressed by the healthcare provider. He is not like any other palliative patient because he condition has worsened and because he is almost dying. His needs include pain, depression, and loss of autonomy. He cannot eat on his own and requires constant support. At the same time, the patient has spiritual needs that should be met because he has to be accorded a dignified death (Institute of Medicine, 2012).
Joe is a patient who requires to be attended to by a team of palliative care providers including the Enrolled Nurse, physician, pharmacist, spiritual counselor, and social workers. Each of these professionals has a responsibility to collaborate with one another so as to effectively discharge their responsibility of providing individualized, safe, and holistic care to the patients as well as his family members (Hsu, et al., 2012). A proper collaboration between these professionals will help in addressing the physical, physiological, and spiritual; needs of the patient.
The quality of palliative care given to Joe is okay. As a palliative patient, Joe needs to be cared for alongside his family. In order to satisfy the needs of the patients, both the patient and his loved ones should be provided with a well-coordinated and properly managed holistic palliative care before and after the death of the patient (Rehnsfeldt, et al., 2014).
The patho-physiological changes and processes that might be experienced when caring for Joe include the changes in physical and emotional pains (Bodenheimer & Berry-Millett, 2009). The patient will have challenges in performing his daily living activities such as eating, walking, and bathing. All these need to be addressed while attending to him.
Bodenheimer, T., & Berry-Millett, R. (2009). Care management of patients with complex health care needs, the Synthesis Project. Princeton, NJ: Robert Wood JohnsonFoundation.
Cannaerts, N., Gastmans, C., & Casterlé, B. D. D. (2014). Contribution of ethics education to theethical competence of nursing students: Educators’ and students’ perceptions. Nursing ethics, 21(8), 861-878.
Gjerberg, E., Lillemoen, L., Pedersen, R., & Førde, R. (2016). Coercion in nursing homes:Perspectives of patients and relatives. Nursing ethics, 23(3), 253-264.
Hutchinson, K. M., et al., (2014). Ethics?in?the?Round: A Guided Peer Approach for AddressingEthical Issues Confronting Nursing Students. Nursing education perspectives, 35(1), 58-60.
Hsu, C., et al., (2012). Spreading a patient-centered medical home redesign: A case study.Journal of Ambulatory Care Management, 35(2), 99-108.
Institute of Medicine. (2012). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.
Katon, W.J., et al. (2013). Collaborative care for patients with depression and chronic illnesses.New England Journal of Medicine, 363(27), 2611-2620.
Rehnsfeldt, A.,et al., (2014). The meaning of dignity in nursing home care as seen by relatives.Nursing ethics, 21(5), 507-517.