Analysis Of The Movie Wit

2. Address Mrs. Thomas’s Physical pain and decline. Explore Mrs. Thomas’s attitudes and feelings about the use of narcotics. Some patient’s choose to forgo pain medications because they fear decreased alertness and want presence with family and friends. Non-narcotic and non-sedating medication options should be explored and discussed. Help Mrs. Thomas verbalize her fears about the medications. Explain the difference between addiction and dependence. Explore Mrs. Thomas’s openness to alternative methods of pain control such as visualization, music therapy, self-hypnosis and mediation. Encourage her to listen to her body by resting when needed and participating in life when she has the energy. Mr. and Mrs. Thomas both require education about palliative care options for management of symptoms associated with her disease.

This assignment is a reflective account on communicating with a patient who cannot communicate verbally. To remain confidential I will call the patient, Patient A. I’m going to discuss the importance of non-verbal communication within a healthcare setting. Patient A was a 63 year old lady suffering from MND which resulted in her losing her speech.

According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues

In almost every case of a terminal disease, pain is intolerable and seeing someone in such agony is heartbreaking. For example, Brittany Maynard, a 29 year old brain cancer patient who had to move to Oregon so she can avail of the Death with Dignity act. “Maynard knew that her form of brain cancer would be excruciating. She would endure swelling of the brain that would very likely cause seizures, painful headaches and the gradual loss of bodily function. Doctors know that for about 5 percent of the population, no amount of morphine can block the agonizing pain the terminally ill endure” (EDITORIAL: Dying with dignity). Palliative care can often be provided for the dying patients and alleviating pain to provide comfort for the dying has always been the priority. “Palliative care focuses on relieving the symptoms, particularly the pain, of incurable illness.” (Palliative Care) But, in relieving pain through the prescribed medications there are also side effects that are caused by the prescribed pain suppressors and two examples will be lethargy and it compromises breathing. In most cases the effectivity of the pain medication may no longer alleviate the pain. If a patient will be in such agony for the remaining days or weeks the quality of life is no longer present. The agony of pain prevents a patient from performing even just the bodily functions.

Dr. Ira Byock’s latest book, The Best Care Possible: A Physician’s Quest to transform Care Through the End of Life, is a remarkable book written from a personal perspective as one of the foremost palliative-care physicians in the country. Dr. Byock shares stories of his experience with patients in his clinical experience to illustrate how end-of-life care affects each person. He explains what palliative care really is and how to make humane choices in a world obsessed with conquering death. Byock presents an agenda for end-of-life care that stresses compassion, dignity, and each patient being viewed as a unique case with the opportunity to partake in shared decisions amongst a team of professionals and family members. Dr. Byock is an advocate of dying well in a society marked by a fear of death; his highly personal account provides thought-provoking vignettes of how people struggle to make the right decisions in the winter of their lives. Byock urges society to embrace the reality of death and transform the medical community into an environment that will allow patients to live the last of their days in comfort with dignity and peace. This book is a vitally important piece of literature for everyone to devour with fervor. Everyone needs to understand the inevitability of death and the environment end-of-life care can present in what will be the final moments of life.

The movie “Wit” was very touching story about 48 year old English professor, Vivian, who is diagnosed with Stage IV ovarian cancer. Her physician gets her to agree to an aggressive chemotherapy treatment which is a research experiment. He tells her that the therapy is the best way to cure here cancer. Vivian went through eight months of rigorous and often painful experimental treatment especially the final weeks of her life. One of her former student, Jason, is a researcher on the team. Jason is very intelligent person but insensitivity to Vivian. He always come in the room and question such as “how are you feeling today?”, which after while loses all meaning. On the other hand she has her primary care nurse, Susie, shows compassion and sense of code of ethics which brings her into conflicts at time with the physician.

Another obstacle to controlling pain in said population is that there is an “increased prevalence of cognitive, sensory-perceptual, and motor problems that interfere with a person’s ability to process information and to communicate [as

In the New York Times bestseller Being Mortal, surgeon and author Atul Gawande tackles just what may be the most difficult challenge of his profession, learning how to handle the ‘end-of-life process.’ Throughout his book, he recites the stories of several individuals, in which the trajectory from a state of independence to one of death can easily be traced in each. Although Gawande does acknowledge that death is inevitable, he emphasizes that individuals of society, especially those that work in the health care field, have not yet learned how to deal with this slow process well, if at all. Surprisingly, he does not blame patients or the intrinsic difficulty that death itself brings, but in fact is relentless in the criticism of his fellow physicians, stating ‘we’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival…it is to enable well-being.’ (Gawande, Atul. Being Mortal pp.259) This paper aims to further analyze Gawande’s position on end-of-life care, understand why palliative care must play a larger role than interventional medicine during a patient’s last few weeks and determine whether a physician’s role during this crucial time should be that of a ‘healer’ or a ‘sustainer of the soul.’

A Good Death by Carolyn Adams talks about being present while assessing a patient. Carolyn Adams sits on the side of the patient’s bed to talk to them so they feel like she is not in a rush to get out of the room. Sometimes peoples standing posture shows that they are in a hurry to get somewhere else. In this story is it expressed that palliative care nurses are not miracle workers, they are there to allow the palliative patients to have a “good death” (SOURCE, PICARD, 2000). The purpose of this assignment is to effectively reflect on a nurse’s story, identify the themes that are present and to integrate Carper’s (1978) ways of knowing into the story.

Patients with chronic or life-threatening illnesses may turn to palliative care for its symptom relieving benefits as well as its ability to improve their quality of life. A key factor in quality palliative care is effective communication between medical professionals and the patient as well as the patient’s caretakers. Pain management, continuity of care among caretakers and medical providers, and concentration on the patient’s personal preference are all major aspects of palliative care. Good palliative care should begin with a discussion on advanced care directives, preferably initiated by a physician. (Fine, et al. 595,

Understanding a patients’ experiences in relation to pain management is an important evidence based practice in the field of nursing. The significance as a nurse is in the understanding of the patient’s perception of pain in order to administer the appropriate treatments. This particular study was performed to understand the patients experiencing pain that have been hospitalized for cancer treatments. The objective was to obtain different perspectives in order to determine what is believed to be proper pain management.

The concept selected is pain management. The reason this topic was selected, is many nurses in the critical care setting are unable to recognize the non-verbal signs and symptoms of pain in a sedated patient. It is often forgotten that sedation does not equal pain management. Pain is subjective. Its existence relies on the ability of the patient to report to the nurse. Ventilated and sedated patients are unable to report pain verbally. This causes patients to unnecessarily feel pain. This paper will examine the concept of pain

Pain management in palliative care has been inadequately addressed and treated by clinicians in recent years (Wilkie and Ezenwa, 2012). This paper will identify and explore a few of the many of the contributing factors to the inadequate management of pain as it relates to palliative care, including the impact of pain management, inadequate education, and misconceptions. In an effort to understand the underlying themes and corresponding actions to address this disparity, it is first necessary to understand fundamental definitions and differences between palliative care and end-of-life care. Wilkie and Ezenwa suggest that though palliative and end-of-life care both address the “pain and symptom management,” of disease; palliative care specifically

Palliative care is a system of holistic care aimed to satisfy the requirements of the chronically ill, typically within their home and community rather than as an in-patient1. Hospice is based on the same principles of care, however, it requires that a patient be deemed with six months or less to live and that life-sustaining treatments be ceased, creating an important distinction between the two. Hospice and palliative care both provide comfort, but hospice is for comfort during end-of-life. Pain and palliative care patients have indicated that receiving that care not only reduced their pain that was once intolerable either completely or to a substantial extent, but it also maintained or increased their hope and outlook on life1. In this country, palliative medicine is a relatively new field of medicine. It wasn’t until 2014 that the WHO began to recognize “palliative and end of life care services as essential and integral to health systems worldwide”2.

: I applied knowledge and skills to manage pain and other distressing symptoms for the patient at the end-of –the life stage. I worked with his family in palliative care decision making. The patient was placed on IVF and the pain management in hope that his children from other parts of the world can make to say a final “good buy” to their father.