It is important as a primary care provider to have effective
communication skills for quality health
management. Communication skills come
from experience in the classroom and in the practice setting
spending time
talking with patients and gaining confidence in the art of communication. It is
just as important
that providers have effective skills at discussing end of
life care for patients and their loved ones. Learning
this vital skill allows
the patient and loved ones have a full understanding of the diseases process and
the
stages to the process of dying. According to Metzger, August,
Srinivasan, Liao & Meyskens (2008) primary care providers form the
backbone of an integrated team by providing an unbiased medical perspective,
providing continuity during a stressful disease course, supporting patients and
their families through emotional ups and downs, negotiating or mediating
decisions, monitoring for complications, and providing perspective on the
illness.
Providing
guidance for patients and their loved ones during end of life care needs to be viewed
as a special gift that providers are allowed to be a part of. Developing the skills needed to be an effective
communicator needs to be honed by the practitioner. Han, Keranen, Lescisin & Arnold (2005) stated that no
educational intervention has yet been devised to allow residents to learn and
demonstrate communication skills with actual seriously ill patients in real
clinical settings, although several experts argue that this would be ideal. In
addition, skill development requires practice; educational interventions that
simply increase knowledge may not necessarily lead to improved action. According
to the JAMA (2000) physical care is expectedly crucial, but is only one
component of total care. Whereas physicians tend to focus on physical aspects,
patients and families tend to view the end of life with broader psychosocial
and spiritual meaning, shaped by a lifetime of experiences. In addition,
providers should recognize that there is no one definition of a good death and
quality care at the end of life is highly individual and should be achieved
through a process of shared decision making and clear communication that
acknowledges the values and preferences of patients and their families.
Provider’s
patients and loved ones all play a critical role in creating the experience at
the end of life. As our experience on death and dying expands, further research
is needed to define our role during the period of the dying process and provide
quality end of life care. The challenge for providers is to understand the
feelings of patients and loved ones and be effective at communicating the disease processes
and permit a variety of expressions for a good death for everyone involved.
Reference
Han, P., Keranen, L., Lescisin, D & Arnold, R. (2005).
The Palliative Care Clinical Evaluation Exercise
(CEX): An Experience-Based Intervention for Teaching End-o-Life Communication Skills. Academic Medicine: 80(7), 669-676
Metzger,
Q., August, K., Srinivasan, M., Liao, S & Meyskens, F. (2008).
End-of- Life Care: Guidelines for Patient-Centered
Communication. American family Physician, 77(2) Factors Considered Important at the End of Life
by Patients, Family, Physicians, and Other Care Providers. The Journal; Of the American Medical
Association, 284(19), 2476-2482. doi:10.1001/jama.284.19.2476
Very good post, in addition, I would say that another hurdle is being able to be empathetic with those terminally ill. You need to truly understand how they are feeling to come to the correct final decisions.
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