Meaningful life and death

 

Many people still associate palliative care with care in the terminal stage of cancer, and patients with cancer remain more likely to receive it than those with other illnesses (S,Murray 2017).

The statement above was proved to be true to me when I was in Groote schuur hospital for my 3^rd block as a 4^th year student.I had a patient who had autoimmune encephalitis .This patient was a 26 year old female patient .She had been admitted at GSH for 3 months.My clinician assigned me to her on my first week.When my clinician handed over this patient to me ,he told me that the patients condition has been deteriorating very fast in the past 4 weeks so I should not try to do any miracles with her.When I first went to see the patient I saw a young lady who was in the same age group as me and who was suffering from a condition that is so hard to explain and from a condition that no one at such a young age would expect to suffer from.From our first session I told myself I’m going to make her one of my priority patients.I would see her every day and I would try to talk to wake her up and talk to her in our treatment sessions although in most of the occasions she would not even open her eyes.As weeks passed the patients condition got worse she had stop moving her limbs and had stop making any incomprehensive sounds when I was passively moving her limbs .On  my fourth week of neuro block my clinician called me one morning and told me that the doctors have decided to stop neuro treatment on my patient.A part of me didn’t understand this but then my clinician explained to me that the only medication she will be receiving is medication for pain and she might pass on anytime .The patient was then removed from my patient list and I was told that there was no need for me to see her again for physical therapy.I didn’t take these news well and I completely did not understand why I had to stop seeing her as one of my patients.However I didn’t question my clinician about this but at the back of my mind I told myself that I was going to take 10 minutes of my time and see this patient everyday until she was declared dead.I did this for 6 days and on my 5^th week I had my mock exam during lunch and it took an hour .By the time I finished my exam I had to grab something to eat fast since I did not have lunch and I had 2 more patients to see including 1 more patient who was the patient I was seeing without my clinicians knowledge .I saw 1 patient and the patient I was seeing without my clinicians knowledge and I had to leave without seeing my other patient on my patient list because we are suppose to finish our day at 14:30 and I was using the university transport. The following morning when I went to the block ,my clinician  had seen that I had not put one of my patients name on the daily stats .He asked me why did I not see one of my patients yesterday .I tried coming up with a story that I did not have enough time to him but he did buy the story he thought  I had left early.Instead of agreeing with him that I left early .I decided to be honest with him.I told her I saw the patient that I was suppose to longer give physical therapy.My clinician got angry at me and started telling me that it was illegal for me to see patients without their consent and later on told me that nurses take care of patients in that condition.

 

 

To me what the clinician said to me about patients in that state are taken care of by the nurses came to me as a shock because when I did my first year in nursing it was said that a patient who is terminally ill and is on their last stages of life receives palliative care from a multidisciplinary team .This is also confirmed by a Journal article written by  Boersma,

,Miyasaki, Kutner&Kluger 2014 ,which states that “Palliative care is provided by a team of doctors, nurses, and other specialists “ . Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided  with or without curative treatment ( Boersma et al 2014) .To me this statement made by the authors agrees with the way I approached this situation because the patients medication was stopped and she still needed some palliative care .

 

 

In this situation I learnt that I should have approached the situation in a different way .I believe if I had talked to my clinician and told him how I felt about the situation and gave him reasons on why I still wanted to see the patient and talk to him about palliative care .I would have been able to reason with my clinician and I would not have ended up in trouble for seeing a patient without his consent.

 

 

References

 

 

Boersma,I,.  Kluger,B,. Kutner,J ,.& Miyasaki,J .(2014). Palliative care and neurology : Time for a  paradigm shift. American academy of neurology journal , 5; 83(6): 561–567.