Discussing and critiquing the national palliative care standards using the case study provided.
Considerations for the Palliative Care Setting
Frank arrived on the Palliative Care unit late on a Sunday afternoon at 2pm, he was welcomed by his RN who
undertook the following assessments and discussions between him, his wife and two daughters:
• Welcome and orientation to the ward
• Falls Risk Assessment
• Braden Pressure Risk Assessment
• Pain Assessment
• Allied Health Referrals made
• NOK contact details
• Modified Karnofsky Score of 40-50
• RUG- ADL 10+
• SAS Tool Partially Completed 5 of the 7 symptoms only (planned to discuss fatigue and bowel issues
tomorrow as patient was sleepy and Sofia had gone home to get clothes and come back to sleep the night
at the palliative care unit
• Palliative Care Phase – "Deteriorating"
What might be some things I need to consider as an RN caring for Frank and his family ?
• National Palliative Care Standards ?
• NSQHS Standards?
• NMBA Standards?
• What do I know about GBM illness Trajectory?
• How will I recall information on GBM?
• Where are some of the best locations to access EBP on GBM and current standards of care?
• What is my role in supporting Frank's wife and family?
• What is a SAS Tool?
• What is the Problems Severity Score/ (PSS)
• What is a Modified karnofsky Score?
• What is a RUG-ADL Score?
• How do I determine the Palliative Care Phase that the patient is in?
• Do I need to start having some difficult conversations and ask Frank and his wife what they understand about
his prognosis?
• What some of the complications that Frank may face?
• Are there any specific symptoms that I should be looking for when developing Frank's care plan?
• What is the pathophysiological response when someone dies from a GBM?
• What should I expect?
• Am I ready to deal with this?
• Where do I get support as an RN if i feel overwhelmed?
• Have I thought enough about my own well being and resilience for this professional soeciality?
• How do I care for a deceased person?
How will I know what to say?
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