Posted by: Tango | 2009/02/02

Mutterings and moanings!

Dear CS

How are you doing? I do hope you manged to have a ood festive season with some quality time off. I worked straight through and we have had very very challenging patients with complicated symptoms to manage.

What I would like to know is, when does introspection and going over patient cases and ethics become " unhealthy?"  What I mean is, after looking after a terminal / Hospice patient I always go over and over the mangement of that patient, the decisions made and any ethics involved. I do believe that everything is done to preserve and promote quality of life, never to hasten or delay the final process - yet, there are such challenges that I often feel I fail miserably!

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Our expert says:
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HI Tango,
And how, indeed, are you ? Don't berate yourself for being less than perfect. From my experience of hospice care, over many years and more recently, the danger of poor and uncaring care comes not from people who are self-critical, but from those who are not self-critical, and believe their decisions are perfect. The aim, though, is to examine each case that went less well than expected or hoped, see where and how it might have been improved, and to identify from that, lessons to elarn to improve care in future cases. Excsssivel;y wallowing in situations where you felt the challenge was inadequately met, helps nobody.

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