Sensitivity; Progress and Bereavement

Helping relatives and patients to cope

ANGELA Grant, a Caribbean Welfare and Humanitarian Officer residing in the United States of America for the last 20 years, and pursuing her Master’s Degree in Nursing, is concerned about some of the nursing practices she has seen, since being here on vacation for the last two weeks. Among her observations include behaviours displayed by persons seeking medical care, or trying to get information about their loved ones in hospital, to no avail.

Against this backdrop, Grant, born to Guyanese and St. Lucian parents, and having attended schools in Georgetown, Guyana, feels compelled to share her expertise with local nurses, aimed at improving the quality of service they deliver. Grant had received training in nursing from the St. Joseph Mercy Hospital.

Last week, the Pepperpot Magazine carried the first of her observations and recommendations for the improvement of patient care in Guyana and today we bring you Phase II, focusing on what she considers as being three critical elements within the hospital setting. Those areas are: Sensitivity, Progress and Bereavement, three sensitive areas which are important when dealing with patients and families in hospitals.
Bereavement: Grant has reiterated that nurses and doctors should be trained in this field, adding that they both stand to benefit.

As Mental Health America puts it: “The death of a loved one is always difficult… It is one of life’s most stressful events and can cause a major emotional crisis. After the death of someone you love, you experience bereavement, which literally means to be deprived by death. Your reactions are influenced by the circumstances of the death, particularly when it is sudden or accidental, and also by your relationship with the person who died.”

Bereaved relatives have rights
“Professionalism must be a big part of this, and it must be done with respect for the bereaved relatives.” Grant said.
She said doctors who pronounce persons dead should be the ones making the announcement to relatives and that this information should not have to come from other sources, such as the media. She added that if this is a practice that is being done, then this is unprofessional.

She suggested that in every way possible, the professionals should try to console the family. She said, had it been in the United States, that matter would not be dropped that easily. It could have escalated into a lawsuit.
Mental Health America describes the death of a loved one as: “Dealing with a Major Loss” and that, “The death of a loved one is always difficult. Your reactions are influenced by the circumstances of a death, particularly when it is sudden or accidental. Your reactions are also influenced by your relationship with the person who died.” And in the case of the death of a child, that arouses “an overwhelming sense of injustice — for lost potential, unfulfilled dreams and senseless suffering.”

Sensitivity: Training for the staff in levels of sensitivity is also important, Grant says, and recommended this for nurses. She added that health care facilities should introduce training in levels of sensitivity to the staff. This will prepare them to not take it too sensitively when customers/clients ‘lash out’ at them, since it may be that they (the clients) are going through a phase in their lives and the behaviour might not necessarily be characteristic of them.
The Clinical Nursing Sensitive Indicators (CNSIs) are measures and indicators that reflect the structure, processes and outcomes of nursing care.

Progress: As is expected, there will always be persons there waiting for news and signs of change in relation to the condition of those they considered critical. The patients may sometimes be confused, deluded or agitated and the relatives, feeling powerless, want only good news. When this does not happen exactly as they want it, or answers are not forthcoming, clients can react with hostility. In such a case, it is required that the doctor gives that information, Grant says. She advised nurses against merely telling the client that they do not know. “It is better to say, ‘Ma’am or Sir, I will get you a doctor who can better explain,’” This, Grant explained, is in the light that customers can become frustrated and explode when no answers are forthcoming about their loved ones in hospital and they are powerless to help them.

She observed that even though people look at nurses, not as Gods, they do look to them with the expectation that as nurses they should be caring, compassionate and showing love. “When they do not get it, they feel dissatisfied with the treatment and swear they would never come back if they could help it. That makes both the hospital and nurses look bad,” Grant stated. On the other hand, if a person is hospitalised and gets good treatment, they will always want to come back and so that augurs well for the institution.

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