Terminal Patient, Palliative Care

Terminal patient, palliative care

Introduction

In the patient’s terminal stage, providing information is an important act since it is a tool that will help you have knowledge about your health status, it will also serve to teach the patient and family about the importance of treatment, and the care that iswill provide him to relieve his ailments.

It is important that the nursing professional who maintains direct contact with the terminal patient has quality communication and with respect, both with the patient and with his family, with this the patient will have confidence of expressing his feelings, anguish, fear, andfrustration for what is happening. The patient, feeling emotional support from the professional animically he will feel good, will also help him understand that his family and his social environment will not abandon him or reject him.

Communication since its existence has been the fundamental basis of every human being, in the hospital, all health professionals must be kept in communication with the purpose of providing good care, the nurse role develops an important role and they have adirect relationship with the patient and their relatives. 

Nursing communication

So that there is an effective communication between the nurse, patient and relatives where there must be a link of trust, respect and empathy. The act of communicating is not only about hearing, if not having the predisposition of listening to it and we allow the patient to express their ailments, fears, and anguish.

Communication also has a therapeutic purpose in which the nurse provides support so that the patient can face the situation he is going through, in turn the professional encourages him to feel better, he must also know that he will always haveThe support of your family and your social environment. 

Principles for adequate information and communication in palliative care

Within these principles this:

• Need for communication of the patient and their environment: interpersonal communication in which the patient and family have the need for the professional to have will to listen to them and explain and clarify all their doubts.
• Communication styles: the information that must be honest, transmitted with adequate language, without giving hope of healing.
• Information methods: information can be transmitted in writing or with the use of other audiovisual materials.
• Attitude of health professionals: respect the decisions made by the patient or his family.
• Effects of effective communication: to provide support, trust, express yourself with respect and empathy, also teamwork with family and other professionals always respecting the rights and privacy of the patient.
• Communication of bad news: the health professional has the obligation to communicate the patient about the state of their health and the evolution of treatment without the concealment of information. 

Communication styles

In relation to communication styles, the family and the patient emphasize that the information must be true, honest without giving false hope of healing, and especially the language used must be clear and concise, the professional must also show empathy, listen in a wayactive and offer all explanations to the patient and family’s doubts. On the other hand, the lack of information or concealment of the same breaks the bond of trust in which the patient cannot express their fears, anguish.

When there is no good communication there is the probability that the patient breaches his therapeutic treatment in turn that this depressive, stressed and anxious. 

Information methods

There are different information methods in which the written is or the use of other materials such as audiovisual. The information preferences of each patient should also be taken into account. 

Attitude of health professionals

The attitude taken by health professionals is that every patient has the right to know the truth about their state of health and the terminal disease he suffers, that there should be no concealment of information. In addition they will be responsible for making the patient known information about the disease I suffer from I have reported the procedures and treatments that he requires to optimize his quality of life. 

Effects of effective communication

In the patient’s terminal stage it is important that there is effective communication which will be a beneficiary to improve their emotional condition, it will also allow the patient to know the importance of their treatment in order to counteract symptoms. It is also important to maintain an adequate exchange of information and respect the decisions that the patient takes them together with his family. 

Bad News Communication

In daily the health professional is in charge of informing patients of bad news such as serious diseases, abnormal laboratory exams, failed treatments, etc. The delivery of this news is somewhat difficult since it demands other skills in which the patient’s emotional reaction and their environment must be responded.

Nursing professionals today have gained importance in the communication of maladic.

To communicate bad news you must follow the six Buckman stages:

1. Adapt the moment and place
2. Base us on what the patient knows
3. Know what the patient wants to know
4. Provide proper information
5. Listen with empathy for the patient’s reaction
6. Facilitate monitoring and support 
7. Ethical and legal aspects of information and communication in palliative care

At present, knowing the truth is a right of every patient, and that all information has absolute confidentiality, in addition the patient has the ability to decide. Communication in the ethical field must be honest. Ecuadorian legislation covers the principle of autonomy, also protects that the patient must have timely information about their treatment and health -related processes. On the other hand, the concealment of the diagnosis or conspiracy of silence significantly makes it difficult for the patient to adapt to his disease which will not allow him to make decisions. 

conclusion

What I can conclude is that in the act of informing and communicating to the patient at the terminal stage the nursing professional plays an important role, so that there is an effective communication there must be a bond of trust between the nurse, patient and family, to histime the professional is in the ability to provide support and give him the care and treatments to improve his quality of life.

At present we have seen how nurses have gained field in decision making in which they perform them with scientific criteria always respecting the patient’s privacy, being empathic and working as a team with other health professionals whose purpose is to ensurepatient’s health.