Kendell Smith – Reflection

Thank you so much for all you taught me over the last 3 days! I have learnt so much and I know it will carry over into my emergency nursing, it already has!!

First shift back in the Emergency Department (ED) and I have a home based palliative care patient referred in for nausea, we did bloods and scans and IVT, analgesia and anti-emetics. The patient had cholecystitis which we managed with IV medications and IV fluids, all while making sure the patient remained comfortable!

So yay ED for treating a palliative patient well.

Another patient on the same shift came in actively dying from the nursing home. The patient was seen by the palliative care team at the nursing home and a syringe driver had been commenced, the patient then had decreased level of consciousness at the facility and the son wanted them to call an ambulance.

Unfortunately the son wasn’t told about the dying process or symptoms etc and that this was an expected outcome that her consciousness would drop etc. Because of my PEPA placement I was able to confidently discuss the end of life process with the patient’s son, what symptoms to expect and the management etc. The son was then happy for transfer back to the nursing home and for comfort care only. Therefore thanks to PEPA I have already started improving palliative care in the ED!!

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