The Multidisciplinary Team
Multidisciplinary teams (MDTs) perform the most complex tasks in healthcare, requiring high teamwork skills aside from medical knowledge. In the case of John Smith, the numerous health issues cannot be covered by a single specialist and require a multimodal approach. The proposed MDT includes a physiotherapist, an oncologist, a cancer specialist, a dietitian, and gerontological nurses. This part of the paper will review the specialists’ tasks in upkeeping John’s quality of life.
All included specialists have their role in alleviating John’s suffering in the last weeks of his life. In such a complex team, confusion and delays are common due to mixed decisions made by individual doctors (Li et al., 2020). However, these pitfalls can be avoided via an increased focus on disease staging, treatment cohesion, and continuous evaluations of the patient’s systems (Li et al., 2020). It will be critical for John’s safety to establish a clear philosophy of teamwork in the MDT. Without correct leadership, their efforts may worsen John’s condition since the expertise of each professional must be accounted for during any decisions that affect the patient’s life (Fernando & Hughes, 2019). Otherwise, disharmony will multiply his suffering manyfold and cause distress to his family.
A cancer specialist and an oncologist must continuously monitor and predict John’s cancer progression and report his pain and other symptoms to the rest of the team. Patients with gastrointestinal cancer are heavily burdened by symptoms, requiring constant pain assessments and reduction that might require opioids will be the primary goal of a physiotherapist (Merchant et al., 2019). Moreover, nutritional deficiencies must be assessed by a dietitian since the patient’s food intake greatly affects his final period of life (Cotogni et al., 2021). Due to John’s refusal of hospitalisation, all directions must be reported to his family immediately.
Adult Nurses
Palliative care is a challenging topic to cover, both for medical and ethical reasons. Due to a multitude of severe health issues, John Smith requires nearly constant support from nursing personnel in the form of pain alleviation, timely resolution of issues with the patient’s gastrointestinal tract, food intake, and even breathing. In this part, the tasks of gerontological nurses in cancer and palliative care will be analysed.
Nurses must focus significantly on the patient’s quality of life and diminish the impact of both physical suffering and mental anguish. Their role will expand above reporting the patient’s status and providing treatment to include counselling and educating the patient and his relatives on crisis prevention (Hui, 2019). Without access to screening tools, nurses must be highly knowledgeable in detecting symptoms in an outpatient setting (Temel et al., 2020). There are challenges related to the lacking infrastructure and John’s rapidly deteriorating health, yet, with the help of the rest of the MDT, adult nurses have the ability to improve the patient’s final months greatly.
John’s wish to remain at home will significantly modify nurses’ workload and mode of treatment. They will be met with new requirements, including more challenging symptom assessments and difficulties with detecting the disease trajectory (Hui, 2019). Moreover, their tasks will include continuously checking John’s family’s mental health status since the approaching tragedy can trigger severe emotional reactions that will be disastrous without adequate coping mechanisms (Greer et al., 2020). In return, John has better chances at a higher quality of life while staying at home since his psychological distress will be significantly lower. In conclusion, the tasks of nursing personnel are a direct result of the specialists’ decisions and analyses and must prioritise John’s and his family’s wellbeing.
Reference List
Cotogni, P. et al. (2021) ‘The role of nutritional support for cancer patients in palliative care, Nutrients, 13(2), p. 306.
Fernando, G. and Hughes, S. (2019) ‘Team approaches in palliative care: a review of the literature, International Journal of Palliative Nursing, 25(9), pp. 444–451.
Greer, J.A. et al. (2020) ‘Understanding and addressing the role of coping in palliative care for patients with advanced cancer’, Journal of Clinical Oncology, 38(9), pp. 915–925.
Hui, D. (2019) ‘Palliative Cancer Care in the Outpatient Setting: Which Model Works Best?’, Current Treatment Options in Oncology, 20(2).
Li, X. et al. (2020) ‘Effects of multidisciplinary team on the outcomes of colorectal cancer patients with liver metastases’, Annals of Palliative Medicine, 9(5), pp. 2741–2748.
Merchant, S.J. et al. (2019) ‘Palliative care and symptom burden in the last year of life: A population-based study of patients with gastrointestinal cancer’, Annals of Surgical Oncology, 26(8), pp. 2336–2345.
Taberna, M. et al. (2020) ‘The multidisciplinary team (MDT) approach and quality of care’, Frontiers in Oncology, 10(85).
Temel, J.S. et al. (2020) ‘Multisite, randomised trial of early integrated palliative and oncology care in patients with advanced lung and gastrointestinal cancer: Alliance A221303’, Journal of Palliative Medicine, 23(7), pp. 922–929.