Saturday, 25 February 2012

Specialist Care

I hate this, I am sat at my desk looking at a patient recently sent to me from one of our cystic fibrosis wards.

Because we have wards staffed with nurses who are highly skilled and experienced in CF care I very rarely get to work with this kind of patient. Also because we are a high dependency unit I very rarely have to provide end of life(palliative) care. This patient is flirty-four, this is by far the oldest CF patient I have even heard of. She has been moved Into my care for end of life nursing.

It's not that I don't want palliative patients however my knowledge of her condition is textbook only, I fully admit I lack the skill and intuition that CF nurses have.

As a result my end of life care for this lady will be merely adequate, any dying patient deserves more than that.


Vincent said...

It's not clear to me how this patient has been referred to you when you specialise neither in CF nor in palliative care.

But I don't understand why adequate care is not good enough. If it is not good enough, how can it be adequate? Or am I missing the significance of jargon words?

I seem to remember hearing on the radio that "adequate" teaching was no longer good enough.

This is as illogical as a drive to eliminate "below average" outcomes, whether in health, social care, education or anything at all.

If there is an average, then some instances will be above, and some below. This is what average means. Just as adequate means good enough.

Asclepius said...

Technically all nurses are expected to be able to provide palliative care however its uncommon on my unit because the level of treatment high dependency patients receive is more or less the opposite of palliation(withdrawing all therapeutic treatment and monitoring, leaving just comfort related medications and interventions). So I can provide end of life care that will control the patients death, keeping on top of pain and chest secretions. However there is so much more to CF palliation than that.

We are not sure why this patient arrived either, I am trained to provide advanced respiratory support which is one aspect of CF care, however Cystic Fibrosis effects most of the organs in the body, without working on a CF ward for some time it is extremely hard to keep on top of all the nuances with this condition.

I strongly suspect the patient was moved to us for political reasons(interhospital power struggles between specialties) However I couldnt prove that and I am low enough in the chain to be caught in the cross fire without actually knowing the reasons.