Cultural influence on Pain Assessment for Indigenous Patients
1. Mr. Smith’s cultural influence in his pain assessment and the strategies used to address him adequately:
As per the case study, Mr. Smith belongs to Aboriginal and Torres Strait Islander and as the research this indigenous group of Australia had well established traditional cultures, beliefs and practices which is handed over from generation to generation. For the Aboriginal and Torres Strait Islanders, the hospital is seen as the place where a person meets with death. Misinterpretation is the main problem as they do not complain about their pain and as a result that brings severity of insufficient pain management. Sometimes they are considered as drug seekers and hence, isolated in the hospital. However, as a medical staff, it could be suggest that communication should be severely done with these patients so that they could complain their problems and do not isolate them in the hospital as this would make them more reserved and they could not complain their pain (Cacciatore, 2012).
2 (a) Reflect on any judgments and prejudices that you may have when caring for Mr Smith:
Reviewing the case study of Mr. Smith is it understood that Mr. Smith is undergoing through a rough time along with adverse health condition and emotional setback. An insight into the family history of this individual highlights the lack of care and affection towards Mr. Smith. Understanding this situation, it is recommendable that Mr. Smith should undertake certain psychological counseling sessions to curb, his depressions. Moreover, it also falls under the responsibility of the Palliative Care Unit, to address Mr. Smith condition with proper sympathy and care (Health.qld.gov.au, 2015).
2(b) Review the following: Code of Ethics for Nurses, Code of Professional Conduct for Nurses, EN Competency Standards:
Code of ethics for nurses: The code of ethics for nurses was conceptualized in order to set some ethical guidelines for the nursing professionals in Australia. According to this ethical code, it falls under the responsibility of the nurses to take care of the patients with full dignity and sincerity. It also includes the practice of organized economic and viable management of the patient’s health and safety issues.
Code of Professional Conduct for Nurses: The principles of this code of conduct are framed in parity with the guidelines of the ethical code for nurses. The guidelines of this underlines the overall professional values incorporated with impartial and honesty towards the patients. It also emphasizes on the issues of mutual faith, well being and maintenance of patient’s confidentiality (Nursingmidwiferyboard.gov.au, 2015).
Codes of Ethics and Professional Conduct for Nurses
EN Competency Standards: The Australian Nursing and Midwifery Council (ANMC), established in 1992 in collaboration with the NMRAs have forwarded a set of standards for enrolled nurses of Australia. The major domains of this exert towards the ethical and professional practices, their behavior towards the patients and on the rights of patients. The other domain accommodates the thinking process and overall management procedure. It can be stated that these set of standards attempts to cover all the minute details which address the overall professional requirement and also the care, safety and collaborative relationship among the nurses and the patients
(Nursingmidwiferyboard.gov.au, 2015).
The non-judgmental code for nurses underline the principle related to the code of ethics. These non-judgmental standards incorporate the guidelines which lay emphasis on the equal treatment to the patients with complete sincerity and dedication.
3. Compile a list of questions you would ask Mr Smith as part of a holistic health assessment:
Questionnaires prepared in order to collect information related with Mr. Smith’s physical, emotional, mental and social condition:
i. For the purpose of holistic assessment, Mr. Smith, I would like to know about your past and present family situation?
ii. Mr. Smith would you kindly throw some light regarding your medical history?
iii. Why you are not willing to stay at home with your family members?
iv. Can you kindly let us know about your present medical complications which are the cause of your present suffering?
v. Mr. Smith, can you kindly tell me the reason behind your agitation and depressed mental condition?
4. Provide Mr. Smith with a brief description (with APA referencing) of the following and apply it to this scenario: Advanced Health Directive, Enduring Power of Attorney, and Organ Donation:
Advanced Health Directive: This organization aids in guiding the patients their future health care, in situations when the patient concerned it not capable to take decisions. This directive also takes the takes the accountability of the health condition, patient’s allergy towards particular medicine and the cultural and spiritual faith of the patients (Nhs.uk, 2015). Considering the medical condition of Mr. Smith who is diagnosed with a past medical record of lung and hepatic cancer, acute respiratory diseases at present his health condition is also not stable. At present Mr. Smith is undergoing gradual and progressive health deterioration and in this regard it is essential for the particular subject to take the help of Advanced Health Directive in order to take care about the issues related to the future medical ailment of Mr. Smith.
Questions for Holistic Health Assessment
Enduring Power of Attorney: In England and Wales, under the Office of the Public Guardian (OPG) in parity with the Mental Capacity Act, 2005 the process of enduring power of attorney has been formulated. According to this legal procedure, under certain adverse condition, an individual is legally applicable to decide someone who will be legally eligible toy related undertake certain financial and property related decision on behalf of the concerned individual. It is essential to note, that the appointee for such a legal procedure should be more than 18 years of age (Ageuk.org.uk, 2015). In parity with the case study as it is observed that Mr. Smith have a disturbed social background with himself being a divorcee for long years, he have only two daughters left to take care of him. Apart from this the new relation of Mr. Smith adds further controversies to the particular case. Therefore, according to the requirement of the case it is recommended for Mr. Smith to undertake the procedure regarding enduring power of attorney in order to execute his financial decisions.
Organ Donation: Under the initiatives taken by the National Health Service, organ donation can be done on voluntary note by the individuals who desire to donate their organ are or during their lifetime. This noble act of organ donation put forward a helping hand towards those thousands of patients in need. This donation procedure is officially registered under NHS and is also maintains the confidentiality (Donation, 2015). An insight into the medical condition of Mr. Smith, reveal that the condition of his lungs and liver are adverse. As he had been previously diagnosed with hepatic and lung cancer it is essential for Mr. Smith to seek the help of Organ Donation which may provide him with successful medical transplants and thereby improve and increase the life expectancy of Mr. Smith.
Therefore, the above explained processes may be helpful towards Mr. Smith’s present situation. As both the mental and physical health of Mr. Smith is not favourable, it is advisable from him to seek help from the advanced health directive and also take initiative to appoint someone of his choice to take care of his financial matters. As for organ donation, it is suggested that Mr. Smith could look for the possible chances of organ donation because of his progressive adverse health condition.
5. Suggest alternative strategies (complimentary therapies) other than pharmaceutical pain management that could help Mr. Smith’s pain:
Understanding Advanced Health Directive, Enduring Power of Attorney, and Organ Donation
Understanding the medical complications of Mr. Smith, on a suggestive note, it may be stated that application of certain complimentary therapy may aid in the betterment of his health condition. This alternative therapeutic approach includes acupuncture, Alexander technique, herbal medications, ayurveda, osteopathy and many more. Application of complimentary medications mainly herbal treatment, yoga and naturopathy may help in recovery of Mr. Smith health condition.
6. List of appropriate referrals for Mr. Smith to other members of the multi disciplinary team:
As per the case study, Mr. Smith is suffering from Anorexia, Ascites, Dyspnoea and Hiccups. Hence, Anorexia is caused when there is disturbance in both mind and body and therefore, the referral could be given to medical doctors, counsellors, psychologists and dieticians. As the patient is suffering from Ancites, that means accumulation of pale yellow fluid in the abdominal cavity which might lead to cancer, the referral should be given to oncologist and special observation on the liver functioning. It is obvious that Mr. Smith could be affected by Dyspnoea as he could realise he is in the last stage and thus, he could be referred to psychologist and if further needed to the cardiologist. In case of Hiccups, the patient could be referred to pharmacologist (Doka & Lingertat-Putnam, 2011).
7. Support or referral offered to Mr. Smith’s family:
As per the case study, Mr. Smith had been very rude to his family members and also did domestic violence upon his family. Hence, after the death of his wife, his children didn’t want to take care of him or meet him because of his past behaviour. In this circumstance, the social workers could provide referral to the family of Mr. Smith (Todd, 2013).
8. Outline of patho-physiology with respect to Mr. Smith’s condition:
Mr. Smith is suffering from Anorexia and this affects both the mind and body as Mr. Smith is depressed from his life and is feeling sorry for the misbehaviour he did with his family and thus, not feeling to eat and hence, causing Anorexia. Ascites is caused by the accumulation of yellow pale fluid in the abdominal cavity that might further cause cancer. As Mr. Smith was past history of alcohol abuse until he was admitted to the hospital, this could be the cause of ascites in his abdominal cavity. The ascites causes the risk factor to the liver as there is increased pressure in the blood vessels of the liver (Doka & Lingertat-Putnam, 2011). Considering the case study, it could be presumed that Mr. Smith ascites has caused due to liver scarring that had eventually caused due to liver damage and could further cause Alcohol Liver Cirrhosis (ALC). Mr. Smith was suffering from dyspnoea as he knew he is in his last stage of life and hence, causing shortness of breath. Mr. Smith was in his last stages of life and there are chances that he would feeling guilty of what he had done to his family and therefore, wanted to apologize to them and meet them, this mental condition of Mr. Smith could also cause shortness of breath. Gastroesophageal reflux might be the cause of hiccups in Mr. Smith case as he was already suffering from Anorexia (Cacciatore, 2012).
9. Data that determines Mr. Smith is at end of his life:
As Mr. Smith is suffering from Anorexia, Dyspnoea, hiccups, and Ascites, it could be said that he is in his last stage of life. He is also refusing to eat and giving unreasonable reason that he does not like the food of hospital. It is obvious that if he does not take his food his recovery could not be possible and his fluid intake was also not sufficient. He was also suffering from COPD that is itself the last stage of the disease (Wiese et al. 2013).
References:
Ageuk.org.uk,. (2015). Age UK | The UK’s largest charity working with and for older people.
Cacciatore, J. (2012). Through the Touch of God: Child Death and Spiritual Sustenance in a Hutterian Colony. OMEGA – Journal Of Death And Dying, 64(3), 185-202. doi:10.2190/om.64.3.a
Doka, K., & Lingertat-Putnam, C. (2011). Book Reviews: Briefly Noted: People Planning Ahead: A Guide for Communicating Healthcare and End-of-Life Wishes, the Colors of Grief: Understanding a Child’s Journey through Loss from Birth to Adulthood. OMEGA – Journal Of Death And Dying, 62(1), 93-96. doi:10.2190/om.62.1.e
Donation, O. (2015). NHS Organ Donor Register. Organdonation.nhs.uk. Retrieved 23 May 2015, from https://www.organdonation.nhs.uk
Health.qld.gov.au,. (2015). Home | Queensland Health. Retrieved 23 May 2015, from
https://www.health.qld.gov.au
https://www.nhs.uk
Nhs.uk,. (2015). NHS Choices – Your health, your choices. Retrieved 23 May 2015, from
Nursingmidwiferyboard.gov.au,. (2015). Nursing and Midwifery Board of Australia – Home.
Retrieved 23 May 2015, from https://www.ageuk.org.uk
Retrieved 23 May 2015, from https://www.nursingmidwiferyboard.gov.au
Todd, S. (2013). ‘Being there’: the Experiences of Staff in Dealing with Matters of Dying and Death in Services for People with Intellectual Disabilities. Journal Of Applied Research In Intellectual Disabilities, 26(3), 215-230. doi:10.1111/jar.12024
Wiese, M., Stancliffe, R., Dew, A., Balandin, S., & Howarth, G. (2013). What is talked about? Community living staff experiences of talking with older people with intellectual disability about dying and death. J Intellect Disabil Res, 58(7), 679-690. doi:10.1111/jir.12065
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