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Embed code for: E-tivity Children Complex Care-5
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From this programme we tend to utilise the term 'child' but children's palliative and complex care can include the population of patients from perinatal to late adolescence. Using the literature you have read to date, consider and critically debate the challenges of providing care to this varied patient population. Explain the relevance and challenges of the age span for the specialitiy and your own clinical work. (400 words +/- 10%) This essay will discuss the challenges of effective communication in the Emergency Department, with both the child and their family. The difficulty of the assessment of pain will also be explored. Brown (2007) explains that in order to provide successful paediatric palliative care, all healthcare professionals need to communicate effectively and work together in order to develop a care plan individualised for the patient and their family. In Heller and Solomon (2005) study, they stated that continuity in relationships was most important in order to develop a strong relationship between patient, family and health professionals. Unfortunately, this can be difficult to develop in an ED setting as patient's have constant ineraction with different staff and teams. According to Salde et al (2015) a lapse in communication in ED is due to its episodic nature, time constraints and lack of pre established relationships. This can have a detrimental effect on developing relationships between healthcare professional's, paediatric patient's and their families. Feelings commonly encountered by patient's and families were anxiety, fear, loss of control and frustration (O'Gara & Fairhurst, 2004). In the ED principles of pain evaluation and management apply to all ages, but presents unique challenges when it comes to infants, children and adolescence's. When paediatric patient's attend the ED, it is often after an acute episode/injury or worsening of a condition and can be quite stressful for both the patient and family. According to McGrath & Frager (2001) pain in children is often underestimated and undertreated. For the majority of cases that come through the doors and are able to verbalise, a pain scale is utilised. However for the minority of cases, due to cognitive impairment and patients who are unable to communicate this can become quite difficult in assessing. Unkown to oneself, observational and behavourial assessment are used instinctually in the case of an emergency. If the healthcare professional has not had much experience with paediatric patients it can be difficut to assess and deliver the correct dose of medication. To conclude, healthcare professionals need to take the time to develop good relationships, even in rush environments, with both the patient and the family members. Pain is a subjective experience and needs to be properly assessed and treated accordingly. According to Dufault & Sullivan (2000) well managed pain is associated with 'faster recoveries, fewer complications and decreased healthcare resources'. (Total = 406 words) Reference List: • Bown, E. (2007) Supporting the Child and the Family in Paediatric Palliative Care. London: Jessica Kingsley Publishing. • Heller, K. and Solomon, M. (2005) 'Continuity of Care and Caring What Matters to Parents of Children with Life-Threatening Conditions'. Journal of paediatric nursing, 20(5), pp. 335-346. • O'Gara, P. and Fairhurst, W. (2004) 'Therapeutic communication part 1: general approaches that enhance the quality of the consultation'. PubMed: Accident and emergency nursing, 12(3), pp. 166-172. • Slade, D., Manidis, M., McGregor, J., Scheeres, H., Chandler, E., Stein-Parbury, J., Dunston, R., Herke, M. and Matthiessen, C. (2015) Communication in Hospital Emergency Departments. New York: Springer.