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Importance of communication within healthcare
Importance of communication within healthcare
Importance of communication within healthcare
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The Importance of Effective Communication between Doctors and Nurses during End-of-Life Care in the Intensive Care Unit
End-of-life care, as defined by the U.S. National Institute on Aging, is the term used to describe the support and medical care given during the time surrounding death. The Intensive Care Unit (ICU) is a specialty area that cares for critically-ill patients who are facing life-threatening problems. The goal of the ICU is to help patients and their families get through this difficult stage using advance medical interventions and continuous emotional support. But sometimes, patients may not recover and death can be imminent. ICU nurses are the first ones to notice when a patient’s condition is not improving despite all the interventions. Oftentimes, some doctors will continue treatments and will not yet discuss the poor prognosis either with patients or their families.
Problem
When I experience the challenge of dealing with the end-of-life issues, I always wonder how we can all work together and communicate better to improve the dilemma. In this research, I will be looking for answers to the following clinical questions:
1. Why effective communication is important between doctors and nurses in the ICU.
2. How communicating effectively can relate to better patient outcomes, including their families during the end-of-life care.
I am hoping to find solutions to these problems that I can use in my nursing practice.
Background of the Problem
As I personally observed in our ICU, ineffective communication between doctors and nurses can affect the delivery of care. Unclear communication during the end-of-life care in the ICU can raise ethical questions and pose a challenge to those who are involved. Incons...
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...arch are to gain more knowledge and apply the solutions that I will find from evidenced based practice to my own. Identifying the barriers to effective communication and finding ways to overcome them can help improve the gap. As a critical care nurse, I have to provide exceptional patient care to sustain life, but must also accept the circumstances when a patient’s death is inevitable. I will bring the information that I will discover to my place of work, hoping that we can learn from it for the benefits of the population that we serve. The notion that the ICU is a known place for prolonging life and delaying death will find its essence if doctors and nurses will collaborate and communicate, effectively. When communication needs are met, there will be increase in trust and satisfaction not only for patients and their families, but also for those who provide care.
Charalambous, A. (2010). Good communication in end of life care. Journal of Community Nursing, 24(6), 12-14. Retrieved from EBSCOhost.
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
The Public Health Imperative measures the quality of life of an individual during times of severe chronic illness. This health imperative is characterized by: the potential to prevent suffering caused by the illness, major impact, and high burden. In the recent past is has become evident that care for older people, who have potential to become terminally ill, must be focused on. The types of patients may also lose the capability to make some of their most important decisions which include actions made by health professionals that are related to their end of life situation. Luckily actions were made to identify certain priorities pertaining to the public health and end of life issues. These priorities were established by the National Association of Chronic Disease Directors and the Healthy Aging Program at the Centers for Disease Control and Prevention. These end of life health priorities which address short-term, medium-term and long-term needs are also called advanced care planning. It can be concluded that communication between professionals and among families about the patient can enhance the effectiveness of advanced care planning.
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
Tulsky, J. A. (2005). Interventions to Enhance Communication among Patients, Providers, and Families. JOURNAL OF PALLIATIVE MEDICINE (8), 1. S95 - S102.
Betcher, D. K. (2010). Elephant in the Room Project: Improving Caring Efficacy through Effective and Compassionate Communication with Palliative Care Patients. Medsurg Nursing, 19(2), 101-105.
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
The introduction paragraph gives information on communication and the impact that it has on patient-nurse relationships. It gives the reader an understanding of what is involved in true communication and how that it is a fundamental part of nursing and skills all nurses need. It leads those interested in delivering quality nursing to read on. Showing us the significance that communication makes in the
The purpose for this research study was to develop a communication strategy for family members of patients dying in the ICU by evaluating a format consisting of a proactive end-of-life conference and brochure to see whether the intervention could minimize the effects of bereavement for the families left behind. This research provided the family members with more opportunities to discuss the patient wishes, to express emotions, to alleviate feelings of guilt, and to understand the goals of care.