PIKES Protocol: In 1994, Robert Buckman, a medical oncologist has created an action protocol for transmission of bad news. His protocol was developed as part of an interviewing-skills course at the University of Toronto, which describes important considerations to help in relieving the anxiety for both patients receiving the news, and for health professionals who share it (Pereira et al., 2013). Beckman's protocol includes brief "ground rules" and "practice points" that summarize key propositions that nicely illustrate different ways to respond to patients, demonstrating both ineffective and more therapeutic interventions, The S-P-I-K-E-S protocol is a strategy and not a script, it is a step-by-step procedure that incorporates …show more content…
Furthermore, it's important for the nurse, after greeting the patient to sit squarely and face the patient through trying to avoid sitting behind physical barriers, such as a desk while patient is in a hospital bed, pull up a chair, or if there isn’t a chair, ask permission to sit on the edge of the bed as being seated less¬ens the intimidating visual impact of the nurse towering over the patient, which can make the patient feel vul¬nerable and give the patient a feeling of some form of partnership in the discussion, also, it’s easier to achieve level of eye contact in the seated position which conveys honesty and integrity (Carter-Brown, 2010; Baile et al., …show more content…
The first one is that prognostic estimation in the ICU is inherently uncertain. Families know this and want to discuss this so, it may be helpful to both explain the uncertainly that is inherent in all prognostication "I wish I could predict exactly what is going to happen, we are not that smart. Some people will do better than I expect, and some will do worse" or clarify the nature in ICU condition by saying "Unfortunately, being in the ICU is a little bit like being on a roller coaster, unexpected things happen and they can occur quickly. I do promise you, however, that if anything changes, we will touch base with
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
It is important to preserve the dignity of all patients in the care of nurses and to not make them feel as though they are worthless. For example, when someone is incontinent and cannot care for themselves anymore, such as some residents in long-term care, it is important to help them remain dignified. The resident should be able to feel as though they are respected and are given the appropriate amount of privacy as we are working in their home. With this being said, it is very crucial for nurses to provide residents’ in long-term care, as well as patients in the hospital, with great care while still preserving their dignity and maintaining their privacy. It is important for the client to feel as comfortable as they would if they were in their own home. With this, Registered nurses must appreciate and respect each person in whom they care for. This respect is seen through the nurse as they explain to the patient what they will be doing as they are caring for them, as well as providing care within the wishes of the person. Patients in the hands of the Registered Nurse, appreciate caring as a core value during their stay in the hospital. This is proved as Davis (2005) states, “From a patient perspective, the caring presence that emanates from nurses, positively impacts patients’ hospital experience,” (p.127) As nurses, caring is the absolute root of nursing practice. Preserving patients’ privacy and dignity involves aspects such as closing doors or screens and making sure they are covered while doing so, (Royal College of Nursing, 2015). The Code of Ethics outlines the importance of Registered Nurses supporting the person, family, group, population or community receiving care in maintaining their dignity and integrity, (Canadian Nurses Association, 2008). All these factors involved with the Code of Ethics greatly impact the nursing practice of
The process of EBP has several models with common elements that start from uncertainty in the clinical setting, and lead to making an informed decision by assessing and implementing the latest research evidence into practice (Stevens, 2013). Melnyk and Fineout-Overholt (2010) define the seven step process of EBP as:
Upon the first point of contact between a nurse and patient, the way a nurse communicates through words, gestures or facial expressions can affect the patient's perception of the nurse. Communicating professionally helps to portray the nurse in a good light. This is important as having a positive perception of the nurse's image and behaviour is crucial to building patient trust — one of the key elements of a therapeutic nurse-patient relationship (Bell & Duffy, 2009; Wadell & Skarsater, 2007). The need for the establishment of therapeutic relationship is supported by th...
As health care providers, nurses strive to instill confidence in their patients and their loved ones. A nurse is respectful to their colleagues as well as their patients. Nurses promote patients’ independence, patients can be confident in the knowledge that a nurse will do what is best for them, respecting their privacy and dignity. This means that a nurse does not share the patient information for personal reasons nor does the nurse get involved in a patients personal relationship if it is not medically relevant (NCSBN, 2011).
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
According to the table on page 131, there are three stages to treatment. The first stage is when the person assumes they can’t do something with is call th...
This may be affected more in some fields of nursing than in others due to the amount of time each nurse can be spent with each patient, but should always be incorporated as much as possible. Potter et al. mentions that "by establishing a caring relationship, the understanding that develops helps the nurse to better know the patient as a unique individual and choose the most appropriate and efficacious nursing therapies" (2013, p. 85). By getting to know your patient, it makes your routine slightly easier as you can engage in practice knowing how that patient reacts, thinks and copes with different situations. It also allows that bond of comfort and trust to exist that will have the patient open up to personal feelings and other necessary subjective data needed to fully care for the individual as well as develops credibility when patient education is initiated. This is something that may develop over time but in the acute setting can be established by simply remembering the name of the patient, sometimes that may be all that is necessary for the patient to feel known by the nurse. Just reciprocating conversation about life, their experiences, their fears, and their thoughts on health is substantial for developing a caring moment and incorporating the fourth caritas process between the patient and
Many years from now, I will take this experience with me to better myself as a nurse. I know for the future that it is in my patient’s best interest, if I collaborate with other health care professionals. In order to maintain patient safety, I must always remember to work together with my fellow collogues to obtain a positive working environment. In order to be a good nurse, I need to always understand that I am part of a team to help those in need. I want to incorporate providing efficient care to each and every patient the best way I possibly
The patient is more likely to focus all their questions and concerns to the nurse. When then the
This study showed that nurses can communicate well when a patient-center approach is used. There is need within health care for nurses to recognize that patients are more than a task that needs to be completed. That the patient themselves are an important element in their own care. By educating and giving nurses the evidence-based research available they can fill this gap. Continued research needs to be conducted on patient’s experiences of how nurses communicate. Showing us the behaviors that patients place high values on. Thus enabling nurses to use a patient-centered
Lautrette, A., Darmon, M., Megarbane, B., Joly, L. M., Chevret, S., Adrie, C., et al. (2007). A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478.
A prognosis is the likely course of a condition or chance of recovery (oxford dic). When confronted with a poor prognosis to an unfamiliar condition the individual is likely to develop psychological stress, grief and depression, which arouse physical, emotional, cognitive and behavioural responses (Kasparian, 2013). In addition, the likelihood or degree of these responses is also dependent on the individual themselves for example, their emotional and physical capabilities, personality, age and gender (Kasparian, 2013). Through the breakdown of the responses in this order physical, emotional, cognitive and behavioural, discussing what they are and how they are aroused. This essay aims to provide an understanding of these four likely responses an individual experience’s when presented with a poor prognosis to an unfamiliar condition.
Many persons go into the healthcare ground because they want to work with people. For these nurses, it is the nurse-patient relationship that is one of the most significant things. By understanding the nurse-patient relationship, nurses can be better furnished to work with their patients and, eventually, deliver superior care for them. Hildegard Peplau's model of nursing emphases on that nurse-patient relationship and recognizes the diverse roles nurses take on when working with patients.