Abstract
Collaborative efforts to solving problems in multidisciplinary approach is a process that is accompanied with multiple problems that need to be critically reviewed so that a conclusive decision that is long lasting can be arrived at. In the case of Riverbed city home care planning for the cancer patient, several conflicting issues were arrived at that involves both the involved multidisciplinary professionals as well as the family members. In this case, the involved parties in the home care plan have to discuss the presented issues and look for several alternative solutions for each question where a single lasting solution for each of the issues can be drawn from. This paper therefore, focuses on some assessments made on each of the issues were raised in the first meeting in an attempt to come up with alternatives solutions for the issues. The paper also tries to look at some of the expected results after the solutions to the various issues are arrived at including the ways in which the involved multidisciplinary professionals will be able to work together in the home of a patient with strict religious background.
The process of decision making in a collaborative work involving a multidisciplinary team will first require the team getting acquitted with the environment where they will be exercising their varied duties. This involves finding out the social setting of the family where the group have already identified the religious ties of the family that restricts the practitioners carry out certain health procedures according to what the family’s religious teachings allow them to do. This involves the suggestion that it could be preferable if the chaplain understood Jewish teachings which is the family’s religion and also the feeding of the patient whereby the wife prefers to feed him kosher and soup until his last days, a situation which contradicts with the patient’s ability to eat as a result of his illness.
In order to ensure the needs of the family in terms of religion are met, there are three options involved. There an option to either the group works only with the professional chaplain who does not favor any religion in his mentoring work, or they involve both the profession chaplain and family priest who understand the Jewish teachings as that is what the family would want. Alternatively work with only the Jewish priest without involving the previously suggested chaplain who according to the nurse is a profession in his work.
The initial suggestion is more applicable in this case since the chaplain is already experienced in homecare practices and has a record of mentoring and encouraging the patients and their families in a spiritual manner that does not rely on any religion. If the team involve the family priest, they are likely to incur problems in the process as the priest has no relevance idea on how the program works and also his religious stand is likely to conflict with the medical and social work practices in one way or the other.
The second major concern is the use of medicine that involves the family member’s view that the medicine that was used in the hospital to ease the patient’s pain (morphine) should not be used during the homecare plan and she has doubts on whether the nurse will comply with her request. According to the patient’s wife, the medicine makes the patient sleep all the time and as such, he has no time to interact with his family during this last time of his life.
In addition, the medicine, according to the family will speed up the death process which in contrary, is supposed to occur in a natural way. On the other hand, the patient’s son is concerned that their father should not be allowed to suffer from any sort of pain and therefore, there must be use of painkillers that will not completely knock him off all the time. This means that since the family wishes need to be put in concern, the multidisciplinary team has to come up with a painkiller other than morphine that should enable the patient have time to interact with the family. One of the suggested painkillers (Tylenol) can be used as it is a strong painkiller and also the family has trust on its use. Also the issue of trust on the nurse administering painkillers and other medications, one of the family members can be allowed to be around during the time when the patient is taking medication just to ensure they are the right ones. Also Compassionate Choice has suggested an opinion of supplying all the medicines under the doctor’s prescription and this option can be adopted whereby the family members can review the prescription before and after delivery of the necessary medicine.
Provision of support group in taking care of the patient is also another issue as the patient’s wife is concerned that she may not be able to take care of the patient the same way he had been cared for at the hospital. This issue needs vibrant volunteers who have already been identified from Compassionate Caring Hospice and willing to work with the new patient as soon as possible. The home caregivers are however, not likely to work over the weekend since the patient’s insurance cover is not enough to cover for the services. To this effect, the other members of the family can take part in taking care of the patient which in addition, will create more time they have to spend with their dad. Alternatively, the plan can include a volunteer worker in community service to assist although this could be uncomfortable to the family receiving help from irregular community service personnel who they are not used to. Hence the first alternative is applicable in solving the caregiving issue.
The expected results of the best alternatives obtained from this critical decision making process includes an effective working plan which harmonizes the expectations of both the family and the involved multidisciplinary work (Piat, 2004). As the plan requires a collaboration from both the professionals, family members and other directly involved parties such as the religious leaders, these decisions ensures that the need of every party is equally represented and they are comfortable with the implementation process. The main objective of this decision making process was to come up with the expected duties of all persons and procedures that are reasonable to all the parties involved and executing the proposed solutions to the issues helps in achieving the objectives.
The main critical solution from this decision-making process suggests the use of Tylenol painkillers under supervision of the family, involving the professional chaplain in provision of spiritual and moral counseling to the family and effective use of the volunteers to assist in taking care of the patient at home. Other issues include ensuring the family understands the nature of the illness and the complications involved with eating. The issue of painkiller could have been solved by the nurse or the doctor only as a way of granting the family’s wish of conversing with the patient who is likely to leave them any time. The decision however, had to involve all the involved parties as a way of earning their trust and assurance.
This decision making process involving hourglass model has proved to be successful strategy to coming up with the lasting solutions to critical issues raised by various stakeholders in the homecare plan. This model has proved successful in other articles. The approach focuses on the main aim of finding any issue that may jeopardize the collaborative working process (Brownman, 2004). As a result, adopting the agreed solutions is the best way to create a working environment where all the involved parties, both the professionals and other family and non-family members work whilst knowing their roles and boundaries. This way, the conflict of interest are avoided as all the involved personnel works with an aim of saving life and keeping the patient as comfortable as possible during his last days of living. A successful collaborative involves a working environment where the interest of all the parties are addressed but most importantly the family receiving direct impact of the home care program are at ease with all the processes enacted in the plan. These are the same expectations that were met in other articles concerning multidisciplinary practices and therefore, the solutions have a high probability of succeeding in this homecare plan involving collaborative work from various multidisciplinary professionals.
References
Piat, M., Perreault, M., & Ioannou, D. (2004, Winter 2004). Stakeholder Perspectives on Psychiatric Foster Homes: Residents, Families, Caregivers and Professionals. Psychiatric Rehabilitation Journal, 27.3, 228-234. Retrieved from http://search.proquest.com.
Browman, T., Ramona, M., & M, J. (2004, March/April 2004). Emergency Department: Improving Patients Satisfaction. Nursing Economics, 22.2, 71-4, 55. Retrieved from http://search.proquest.com
