Saving Lives: When Multiple Medical Specialists are Required - Essay Sample

Introduction

Doctors, nurses, and all health practitioners face patients with various medical needs daily. Some of the patients exhibit minor health issues, and some are complex to adverse situations. During either of these complications, health workers strive to save lives with the involvement of a few medical professionals. However, in other circumstances, the need to save a life can be dire such that many health practitioners, with different specialisation, are involved. Furthermore, in an unfortunate case, life can be lost. This article intends to examine a critical situation that escalates, leading to death while indicating the causes of health deterioration and recommending proper strategies using Coroner's case.

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Recognition and Response to Deterioration in Complex clients

It has been found that before adverse circumstances such as death, and cardiac arrest, there are observable physiological and clinical irregularities (Commission, 2017). Failures to take note and take necessary actions are errors that can be avoided and can result in devastating events. Furthermore, the recognition of the clinical anomalies is based on changes in vital signs to detect physiological problems (Commission, 2017). Therefore, patients and their families must be involved to rally concerns and be engaged when making critical choices on suitable responses to acute deterioration. This action implies a crucial aspect of successful recognition and response system. The possibility of these actions is achieved through an employing patient and family escalation pathways, sharing the patient's preferences for care, and also the curative, restorative or palliative needs (Gill et al.,2016).

The patient's contribution to their health is paramount during the deterioration and response protocol. Most importantly is the patients' knowledge about their bodies since they can experience symptoms that may be difficult to notice by the nurses. Additionally, communication of the events preceding escalation enables the bedside nurse to raise concerns to the doctors before invoking response programs. Furthermore, trust and expectations is also an aspect that patients develop such that they are confidents about the competency of the clinicians to manage their health status (Guinane, 2018). However, certain circumstances may require careful consideration relating to the patients, such as their traits, which influences a great deal to responses. i.e., those with chronic illness may be aware of the medical culture and can astutely monitor their conditions before reporting as compared with those without medical history. Lack of medical knowledge is a challenge to clinicians as the patient may not be aware of medical terms, thereby failing to communicate the significance of some symptoms (Guinane, 2018).

Case Study Evaluation

Diabetes Mellitus

Diabetes Mellitus is a health problem caused by metabolic disorder defined by the manifestation of chronic hyperglycaemia, and it occurs in several types, which can be immune-mediated or type 1 diabetes, insulin resistance or type 2 diabetes, gestation, genetic defects among others (Baynest, 2015). Type 2 diabetes mellitus (T2DM) is a common disorder characterised by various degrees of v-cells dysfunction and also resistance to insulin. Furthermore, the disorder is associated with overweight and obesity (WHO, 2019). Medical history of diabetes is associated with signs and symptoms of relating to hyperglycaemia; polydipsia, polyphagia, weight loss, fatigue, skin and genital itching, dry mouth, stomatitis, poor wound healing, confusion, erectile dysfunction. Moreover, type 2 is majorly asymptomatic and identified through screening procedures (WADA, 2015).

Management of T2DM

Type 2 Diabetes Mellitus is not a death sentence but a battle of a lifetime. The main objective of diabetes therapy is to maintain the plasma glucose close to normal with utmost care for hypoglycaemia (WADA, 2015). Therefore, insulin is the most preferred glucose-lowering agent as it does not result in an overdose. The agent is available in short, medium, long-acting preparation, and it is administered through the skeletal muscle. During the treatment of T2DM, lifestyle change and higher doses of metformin are recommended. Failure to achieve the objectives, then insulin or sulfonylureas, is applied together. However, self-monitoring is essential in terms of plasma glucose levels and glycosylated haemoglobin (Hb1Ac) (WADA, 2015).

Renal Calculus

Renal calculus or kidney stones is a urological disorder with a crystal concretion inside the kidney and characterised in the worst scenario with increased end-stage renal failure (Petros, 2018). The composition of the renal calculus is mainly calcium salts, uric acids, cysteine, and struvite (Barnela et al.,2016). This disorder has been linked with chronic kidney failure, end-stage renal failure, cardiovascular complications, diabetes, and hypertension (Petros, 2018). Moreover, the symptoms are located on the part of the body in which renal calculus is traced, including kidney, ureter, or urinary bladder (Petros, 2018).

Management of Renal Calculus

Management of kidney stones is individualised care, clinical medications, proper medical history, and various laboratory tests, which is vital in deciding the extent of response (Barnela et al.,2016). Proper medical treatment is considered for clinically stable patients, non-obstructive urinary stones, recurrent stones, and those with systemic illness. Additionally, family history, drug use experience, a similar illness, and the interventions are vital information to clinical management. During its treatment, dietary management such as intake of fluids, specific therapies such as calcium oxalate, uric acid, struvite, and cysteine stones, and also medical expulsion therapy are all applied (Barnela et al.,2016).

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a lung disease in which the patient experiences shortness of breath and fatigue. Patients can be suffering from obstructed bronchitis emphysema, or a combination of both conditions (Anonymous, 2019). Chronic bronchitis results in inflammation of the airways, thereby narrowing breathing tubes and makes it harder for expiration to occur. Furthermore, tobacco is the biggest causative agent, as well as the specks of dust, chemicals, polluted air, and also genetic factors.

Management of COPD

Management of COPD is based on the reduction of the risk of exacerbation and its symptoms. Some of the remedies that are applied include appropriate pharmacotherapy, smoking cessation, rehabilitation of pulmonary, and progress monitoring. Additionally, the patients' category, according to the ABCD, there are recommended treatments besides bronchodilators for any stage of severity (Hartmann, 2020).

Situational Factors That Contributed to Health Deterioration

The case study features a hospitalised patient, James Smith, with the acute and complex disease who, in the course of treatment-experienced clinical deterioration and eventually died. The medical history of the patient contains complex illnesses such as type 2 diabetes mellitus, renal calculus, COPD, suspicion of dementia, and also his age of 67 complicated matters even further. Accordingly, the patient required specialised treatment in an Intensive Care Unit, which can save his life. However, the absence of an advanced facility in the regional private hospital is a situational factor that led to health complications for Mr. Smith.

Moreover, upon admission to the private emergency hospital at 8:15 pm, a lot of tests and documentation were taken from home throughout the time without any medication. From the tests that were being documented, the patient showed a deteriorating health status. The documents showed that at 7:30 pm, he had a blood pressure record of 105/75, pulse rate of 93 and body temperature of 36.8, after 50 minutes, at 8:20 pm, the patient had blood pressure 105/55, the pulse rate at 95, and dropping the temperature at 35.8. The patient was not accorded the medical emergency he deserved because, from the recorded data, his health was fast getting out of hand.

Poor communication skills among the clinicians contributed immensely to health deterioration. It can be during the inter-hospital transfer, where Queensland Ambulance Service paramedics were received the patient from the nurses at 3:55 am. Moreover, the assumption that Mr. Smith was asleep because of suspected dementia was a factor that worsens the situation during his transfers. Another factor was the transfer of Mr. Smith to another private hospital without an emergency response facility despite the deteriorating health. the medical history, which was presented to the paramedics, also had nothing about dementia. Therefore, the assumption of the illness caused resulted in misdiagnosis.

Furthermore, Mr. Smith had a sophisticated health disorder. A combination of diseases such as diabetes, chronic renal failure, and COPD and his advanced age of 67 complicated his health farther. therefore, his deterioration and death is a situational factor associated with his health complications. The treatments offered to Mr. Smith at the public hospital was the best medication thus far; however, it came a little too late.

Best Practice Requirements

The patient's safety is multidimensional and is founded on an ethical and legal framework; it must be taken into considerations (Maliheh et al. 2017). With the respect of legal and ethical aspects, the case involving Mr. Smith, there were no medical errors that warranted legal actions. The patient was attended to from the time he was admitted until his death. However, the principles of medical ethics for the protection of the patient's health and safety were not properly executed owing to how the patient's medical history was disregarded and not accorded the medical emergency he needed. Moreover, the way the clinicians communicated with the paramedics failed to pass the information that can be relied upon by the other team, such as the problem of dementia was an assumption. Furthermore, the death of Mr. Smith was accented by his family members. This case would be an ethical concern if the patient did not indicate that the family members have the right to make such decisions based on his health.

Recommendations and Strategies

Communication strategies were a factor identified as missing with Mr. Smith's case. The importance of communication in healthcare provision is immense, but given that it is an involuntary action, its significance can easily be ignored (Bello, 2017). The importance of communication cuts across the entire medical care from the nurses to the patients and among the nurses. An effective communication skill among the health personnel is critical in providing healthcare, and positive results can be achieved in terms of reduced anxiety, promotes openness, decreased pain and symptoms (Roohangiz et al.,2016). Therefore, proper diagnosis can be made to save lives.

As much as oral communication is widely used and most recommended, written communication is way effective and remains the usual means between the clinicians (Bello, 2017). Through face-to-face communication, the parties can hear and observe the body language of the informant, thereby offering a better understanding. The lead doctors and the clinicians involved in the patient must be present. The medical history of the patient should be indicated on the test documents togethe...