Description: On ahome visit I met Miss CB- a 64 year- old lady.
She recently had an ileostomy togive for severe constipation which she has been suffering with for 4 years. Shefelt the reason for having severe constipation was due to a hysterectomy shehad 17 years ago. She believes that the surgeon in charge made a mistake in theoperation. She underwent a couple of treatments for her severe constipationbefore making a permanent stoma the final decision. The main reason she madeher informed decision to have a stoma is to avoid the impacts on daily life oftaking medications. Despite the newly improved quality of life, she feels “guttedand embarrassed” having a stoma bag.
It doesn’t restrict her in ways of living howeverdietary changes were required which involved the inclusion of leafy vegetablesand plenty of fruit. She perceivesherself as not “normal” with a bag. Furthermore, she feels uncomfortable changingit in public toilets. Feelings: I wastaken aback when she was certain that the cause of her severe constipation wasdue to a mistake conducted by the surgeon in charge of her hysterectomy. Thetime gap between the two is so long for an understood connection to be present.It came across to me by her body language that since health practioners couldn’tfind a conclusive aetiology for her newfound ill-state, she found a personal causeherself for it to make sense in her mind. I felt sympathetic towards the new unexpected changes she observedin her social interactions with her grandchildren which disappointed her. This helped gain a perspective that socialexchanges between familial members can have a huge importance to an individual.
I was concerned that she was sociallyisolated and couldn’t engage with the community due to the stigma associatedwith the smell and the visibility of the bag. This could have adverse effects forher mental health because she feels she is “different”. I was moved to learn theshifting dynamics of having social interactions on her physical wellbeing and mentalhealth due to the daily struggles of living with a chronic disease. Reflection: It changedmy personal perception to witness a different personal patient narrative onliving with a chronic disease. I understood her feelings and I felt I couldrelate because I personally would feel the same if I had to undergo anileostomy. I learnt a great deal about the patient’s condition from her viewpointand she told me how helpful the doctors and nurses have been in assisting herto make her quality of life better to cope with everyday tasks.
More notably she explored the ideas of compliance that I haven’tthought of before such as taking medication all the time which was overwhelmingfor her. It made me realise as a future healthcareprofessional the importance of presenting all treatment options for the patientto make an informed decision as different people have varied views on what theyfeel is best for them. I approached the GP later regarding the association forhaving severe constipation and she believed there is no connection for there isno evidence to say otherwise. However, she let Miss CB carry on thinking thisbecause she would think her symptom iscaused by a serious disease and worry unnecessarily. This wouldn’t be sensible forher mental health since she’s had episodes of depression and anxiety during herdivorce. Conclusion: This consultationwith the patient highlighted the importance of reassurance. Reassurance is saidto be the elimination of uncertainties and fears (Traeger et al.
2017). It is commonfor patients trying to find within themselves a reason for reassurance eitherin their treatment or in the aetiology. Concerns aboutthe presence of a serious illness is a usual phenomenon among patientsand in cases where the disease is idiopathic, patients like to make sense of itthemselves (Cooper 1996). Therefore, as a healthcare professional we should be awareof communication tactics that are effective in varied scenarios where comfortis needed. A study was conducted to investigate the ways general practitionersshould use to reassure their patients. It was discovered that the integral methodwas by influencing the patient’s emotions by promoting a sense of security, safetyand trust (Giroldi et al.
2014). This has been considered to supportive itself to thepatient, due to being given information that they can comprehend. In cases whentreating idiopathic diseases patientsadhere and comply better if healthcare practioners acknowledge their presence withrespect (Sabo etal.
2000). Action plan: If asituation arose in the future where I would need to reassure the patient forthem to respond better to the treatment, I would feel more confident toimplicate the methods researched above in consultations. It is important thatthe patient is understood, and their opinions are valued for them to make aninformed decision that they feel is right for them. Some of these articles mentioned addressing the mental healthof the patient so their adherence to treatment is improved.
Therefore I wouldlike to read how social cohesion and isolation impacts on an individual (Cornwell and Waite 2009). Sometimes the psychological sideto living with a chronic disease can be overlooked therefore I would like toread how from a healthcare professional perspective can we address it from thisarticle (Turner and Kelly 2000). I would like to achieve thesetwo objectives by two months.