Name : Sandeep Grewal Date Submitted : 18" November, 2014 Practical Nursing Theory 3 Movie : The Doctor Professor : Ann Senezuk Humber Collegeio (“The Doctor” is a movie of a doctor character named Jack, who was successful and brilliant heart transplant surgeon, He was so busy in his work that he lost his compassion for his work and treat patient ‘as a disease rather than human being: He became d’emotionless machine who could not give time to his family. His life changed dramatically, when he was diagnosed with laryngeal eancer. When he went through the same agony that the patient feces, it effected him mentally and physically to change his present behavior. When he go'through the medical system upon fighting with terrifying cancer, he realize: that uncompassionate caregiverhave major impact on peoples life who are trying to cope with painful and vague circumstances of life. Jack comes through physical effects like fatigue, swallowing difficulty, coughing up blood matter, while treating the cancer. At the same time), Sen ect -tosin the challenge of cancer 6ften evident in psychosocial dysfunction that are fear of losing voice, opti impaired social interaction, and stress overload, Jack's mostly concern is to lose his voice. As a result, multidisciplinary and collaborative health care professionals team which involve caregiver providers, nurses, physician, speech pathologists and psychotherapists work together to assist a modified holistic care for the patient. Physical effects of Jack’s health challenge _ 3 domi i Fatigue is one of & predominance physical impairmentof cancer as it occurred because of the affect of the extensive multiple medical treatments on the body. According to Eva Grunfeld, fatigue is multidimensional symptom which is caused due to disease progress, intensive medical treatment and environmental stress. Patient is advised to pace his activity with % 2: Patient is encouraged to get schedule'rest and avoid sudden or stress to prevent muscle wassupport and share the feeling as it can ease the burden of fatigue. It help in finding coping technique. Impaired swallowing is common and visible side effect of laryngeal cancer which ean Jead to throat tumor and narrow the passage of airway. ifmatasa Veronika (2008), states that woking — impaired swallowing leads to hoarseness of voice stay longer without or with treatment. Patients usually are at the risk of aspiration, dehydration and malnutrition if not treated because of constant blockage and inability to swallow correctly. Coughing up blood is another common symptom of laryngeal cancer. It is serious airway disorder which erupt the soft epithelial lining due to progression of the disease. The cancer cells. ——7 1" stimulate coughing because of unfamiliar mass over the throat (Age to Veronika (2003), the oot a . a progression of the disease leads to irritating and dry cough with a smelly odor, which ulcerate the laryngeal wall 19 bleed. That's the reason of cough will be accompanied by blood stained or purulent bloody sputum, Psychosocial effects of Jack's health challenge Fear of losing voice : Cancer is devastating for many people and its psychological and social effect is evident. As for Jack, fear of losing Voice is the biggest psychosocial effect of the disease. It is very hard for him to adjust practically and emotional with the fear of losing Voice. The effect of the disease is so devastating and terrifying a patient cat a their feeling and need without veice Impaired Social Interaction: Social interaction refers to an individual's ability to interact normally with various structures in society. Simultaneously, cancer patient experiences significant psychosocial problem and sustained self-isolation from society with family members and in workplaces. Eva’ Grunfeld et al. (2013), People think cancer patient is a stigma in theitlife, so they isolated them from society and stop interacting with them. Similarly, Jack's coddling colleagues stopped riecessitate him in their decision making and group interacticn. Moreover, jack started to isolate himself from being involved in the quality social interaction, he had before. Stress overload occur mostly because of unexpected illness, exceptionally packed schedule, and fragmentary issues at work or home, Multiple stressors become so overwhelming, ae ‘that could contribute to developing other complications. Additionally, stress overload is a response, which contribute to develop other physically, emotionally and behaviorally problem. Priority holistic nursing eare plan People take voices for granted. V + is essential to interact and communicate with people. Its allow them to work in many professions. The profession of physician and surgeon is one of the field in which without voice communication, they are unable to convey sensitive and complex information to their colleagues or patient. The loss of voice has an adverse consequence on their ability to continue their jobs. That is the reason nurses should use holistic care as a base for patients who are in danger of losing their voices. Doctor like jack is one of them. He knows the consequences of losing his voice. Without it he can’t continue his profession effectively. According {o Veronika (2003), quality of life characterized by the individual's position, perspective, purpose and expectation in life and that can be pursued by good communication techniques (Page). Absence of this quality, create the stress and unhappiness in their life that cause the Jack to worry about, That's why jack told his friends about his fear of losing the voice.Voice is essential to interact with people and make them understand own feeling. Voice people a unique opportunity to engage and interact with others. Nursing Specific interventions Active Listening : Nurses have specitic role:to identify problenvby active listening and bod building nurse-patient rapport. It allonspatient to open up their fears about disease. According to \nuree® Glotom Somat Fr art (Cherith etal (2013), active listening and eye net during petient-nunse eocimniication tells the patient that he nurse is interested in conversation (page-7). Nurses could provide emotional support by facilitate time to talk with patients. It encourage patients to talk about the fear and inconvenient in their lives. Yoga ard Meditation : The aims of yoga and meditation is returning a person’s full ‘wellbeing by restorative total body care. Yoga and meditation helps to avoid negative mood like depression, ange fear and anxiety. yoga help in physical relaxation and meditation help them in mental and spiritual strength to counter fear and panic. According to David(20C5), meditation and yoga promotes physical and mental energy and helps to focus lean the problems that are spiritual in nature(page.2), Nurse should encourage the patient to do yoga, meditation or any other exereise which help to strengthen the muscle tone. It helps the patient to concentrate that how they can help themselves Family Support : Family contribute to motivatés and supports positive emotional development that help patient to conquer the'fear. Family support helps to face the fear and stress. Ace toCherith et al.(2013) family support has a crucial and significance effect on.» patient’s psychological strength in order to cope with disease process(#Be6). Nurses must ‘encourage significant family members to engage in drawing patient’s care plan, which strengthenthem psychologically in order to manage with disease process. It is encouraged to involve family in teaching sessions and continual support of the patient Inter-professional collaborative care « Patient need'to know about the level of disease, treatment options, symptoms, adverse effects and prognosis. Family physician is the first person who notifying the patient regarding the diagnosis, give psychological support, helping them in making decision about treatment, identifying, and managing complications of cancer therapies. As for Jack. family physician may be providing hope conveyed through information that subsidizes Jack's fear of losing his voice. Ag ‘Veronika(2003)| states that family physician teats adverse effects of cancer physically and psychologically (paged); That’s the reason, continual involvement of the family physician is necessary to improve throat cancer patient's care. Correspondingly, psychotherapist could provide an important care for cancer patients. Psychotherapy and social worker are beneficial with the combination of medical treatment to treat the emotioa of a patient, who shares a common bond of fear and emotional distress while facing similar problems. Social workescan support patient through counselling and refer them to other social activities. Moreover, psychotherapeutic and social worker support could be effective in improving outcomes. According to Cherith etal. (2013)z;psychotherapist gave patients with a new social network in which members shires connection of facing similar problem.(page-8) ‘Throat cancer treatments such as chemotherapy, surgery, and radiation have side effects. Side effects of chemotherapy or radiation including difficulty chewing, difficulty swallowing and communicating will require the patient to contact speech pathologist. Because of cancer, if thelarynx is surgically removed, speech pathologist teaches them a effective way t» communicate. ‘The speech pathologist collaborates with the patient physi an and surgeon for giving back a better method of communication. Also, speech pathologists aim to return the individual functional ability with minimal impairment, According to Veronika(2003), speech pathologist may prepare the patient for future functional problem such as complete loss of their voices (page 10). Common problem of throat cancer patients is to loss of voice. It can significantly influence the patient’s quality of life, if not detected and treated properly. Community resources Other than a hospital care, Community groups in GTA such as, Wellspring Cancer Support gives group therapy for patients. Group therapy provides them a platform to come together and support each other to resolve their issues come-aeross from social isolation. Group therapy provides them a way to share their feeling and learn from each other. Ir group therapy, ‘many patient’efther survived the cancer or manage to live while managing their disease. More yoo theta, over group support provides patient to gain self-esteem, cope with their fear and manage the disease progress. It provides a prolonged social network and role models for co2ing with various phase of life complications. Simultaneously, Gilda’s Club Greater Toronto Support Group Gilda) give patients a community support to help them through coping with their disease. This, community support organization's helps to provide advance care for patient and their families by extemporize their specific needs. Gilda focus on developing strength and comfort in a compassionate environment by providing cost free counseling. Referencesdy 4 ‘Cherith, J. S., Kate, S., Lynn, D., & George, K. (2013). Psychosocial Interventions for Patients ur ~ With Head and Neck cancer. The Oral cancer foundation, Part 1-2. \ Eva, G., Timothy J. W., Louise Z., Andrew, R. W., Barbara, M., and William, K. E. (2013). Cancer care workers in Ont prevalence of burnout, job stress and job satisfaction vol. 163 no. 2 \\, David,S.S-khalsa.(2005). Patient Perspectives: Kundalini Yoga Meditation Techniques for Psychooncology and as Patential Therapies for Cancer. Integrative Cancer Therapies. DOI: 4(1):87-100 Veronika, F., Richard, C., Marta, K. and Michael, Q. (2003). Cancer Rehabilitetion. Particularly with aspects on physical impairments 35: 153-162 ernaad we \ond vere, Gah unk eg Grunts, Esure Turin eS PeecRevew ——MyGrades Discuss NOW VIEVANG: Howe > NURS Welcome to your new class homepage! 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