Introduction Nurses play a critical role in facilitating palliative care as part of the multi- disciplinary. Palliative care is referred to as care offered to people with lifelong health conditions and who are living in the last months or years of their lives (Caxaj, Schill & Janke, 2018). It is aimed at relieving pain and making the life of the patient as comfortable as possible when they have a terminal illness. This essay identifies the role of a multi-disciplinary team in caring for patients at John. The paper also discusses the cultural factors, beliefs, and practices of John, which may influence his care. The impact of the nurses' personal beliefs on John's care is also discussed in this article. Collaborative, ethical decision making is the process of using ethical principles and moral principles in making decisions regarding the well-being of the patients. Palliative care for a patient involves a multi-disciplinary team consisting of professionals such as general practitioners, consultants, psychiatrists, dietitians, nephrologists, nurses, and pharmacists, physicians, and also spiritual leaders. Every member of the multi-disciplinary team plays a crucial role in helping to fulfill the wishes of the patient and helping them to live the last days of their lives. One of the ethical principles which are relevant when offering Mr. John care is the principle of autonomy. Autonomy is the ability of a person to make decisions for themselves as long as they can make the decision (Hernández-Marrero et al., 2019). John can make his own decisions since he is an adult and of sound produced. The multi-disciplinary team has to provide Mr. John with all the necessary information that they need to decide the kind of care they want (McAndrew, 018). John has decided that he want to die at home, and hence the multi-disciplinary team should facilitate Mr. John to receive care at home.
The other ethical principle which is applicable in the case of John is beneficence. This principle requires the team to balance the benefits of treatment and its costs/risks (McAndrew, 2018). If a treatment intervention poses more risk, and it's not bound to improve the life of the patient, the medical team should opt against this intervention. Since Mr. John is suffering from end-stage renal disease, his decisions to die at home should be respected and should be helped to receive palliative care while at his home with his family (Cormack & Mazanec, 2019). Palliative care in Australia requires adherence to the cultural beliefs, traditions, and values of the patient (Advance Care Planning Australia, 2020). When Mr. John is receiving palliative care, the multi-disciplinary team should ensure that all decisions made in collaboration with the patients consider and respects the principles of culturally sensitive care. Mr. John comes from the Aboriginal and Torres Islander community who have preserved their heritage and cultures over the years. According to Callister (2013). the Aboriginal people prefer to die at home rather than dying at home. Dying at home helps in ensuring that their wishes before death are respected. Dying at home also ensures that a person goes through all the rituals before and after death. Since these ceremonies take precedence over all other activities, some of the ceremonies that take place include the smoking ceremonies, which are conducted in the living room of the deceased to drive away from the spirit of the dead (Kelley et al., 2019). The other ceremony includes the painting of ochre in the space the person was living before they died and celebrating the life of the deceased with song and dance. It is therefore difficult for these ceremonies to take place if John dies in the hospital. Furthermore, most Aboriginal people prefer to die at home so that they can enjoy the last moments of their lives with their families. They can also get traditional
medicine administered by elders to reduce their pain. In traditional Aboriginal society, the elders and the family play a critical role in decision making, and they value respect for their interpersonal relationships (Kirk & Coyle, 2016). Active listening and accepting the decisions of elders and family members is an essential aspect of interpersonal relationships. This, therefore, means that trying to persuade a person like Mr. John to change the decision that they have made is a sign of disrespect, and it is undesirable behavior. In the Aboriginal culture, relatives of a terminally ill patient might not want their kin to be told the truth about the seriousness of their condition because they believe that positive thinking promotes good health (Mazanec et al., 2019). Just like the Aboriginal people, I believe in the role of traditional medicine and spirituality in healthcare. I come from a background where conventional herbal medicine is highly valued, and therefore, I understand the importance that local people place on this medicine. I also believe that traditional herbal medicine, when combined with modern medicine, can be very useful in reducing pain for a person receiving palliative care. This will, therefore, help me to support Mr. John's family as they use traditional medicine to help Mr. John as he receives care at home. I also believe in spirituality as an essential intervention. Spirituality gives a person renewed hope and faith that they will get well. It is also a form of therapy since it helps a patient psychologically, and hence they can cope with their conditions and get prepared to die. I also believe in the need to consult family and the elders when making important decisions regarding healthcare. This is because, despite autonomy, people close to the family have the best interest of the patient at heart, and the decision made by the patient is bound to affect close family members. Therefore, when offering care
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to Mr. John, I would understand his rationale behind consulting in all the decisions that he made. Another belief that could impact on the type of care I provide Mr. John is that I believed that people should be treated and handled the same way irrespective of their traditional beliefs and customs. I had this belief because I think it is difficult to understand the expectations, culture, and customs of every patient. I, therefore, saw it good to treat all people with decorum and respect, notwithstanding their cultural background. However, I have now come to understand the importance of respecting and appreciating all cultures so that patients can receive optimal and patient-centered care. This, therefore, means that in the future, I need to be keener to understand how patients want to be handled to offer them highly effective and productive care. The strategy I will use to manage this is that I will ensure that I remain professional while offering care to Mr. John (Gardner & Doherty, 2019). I will not allow my personal beliefs and values to get in the way of my work because I have established that people have different believes and values, and hence it is important to respect them. My focus will be offering patient-centered care to ensure that Mr. John gets optimal results. Conclusion Ethical decision making is very critical when offering palliative care. One of the ethical principles considered when making decisions regarding Mr. John is Autonomy and beneficence. The multi-disciplinary team caring for Mr. John needs to respect his right to make informed decisions on his treatment. Respect for culture, beliefs, and traditions is also critical when offering palliative care. The medical team should seek to understand the culture and traditions of the patient so that they can adhere to their wishes and ensure that the patient receives the best care during this
period. Some personal beliefs differ with the beliefs and traditions of the patient, while others are in line with their beliefs. It is critical for a nurse to maintain professionalism and ensure that personal beliefs will not affect the quality of care offered to a patient.
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