Supportive and Palliative Care- Barriers and Facilitators

3535 Words15 Pages
A reflection on the facilitators and barriers to the provision of optimal supportive and palliative care in the clinical setting.
This essay shall critically engage with the issue surrounding supportive and palliative care. We shall begin with evaluating the philosophies, history and definitions within the supportive and palliative care, including concepts such as; quality of life, health and wellbeing, communication and the conflicts between the medical and nursing models. Following this introduction to the key areas, we shall then evaluate some facilitators and barriers as they are perceived in practice. This evaluation will engage with reflections on practise in my own experience, and vignettes are offered as a means to facilitate the discussion about the complex nature of supportive and palliative (S&PC) care and the disparities found between theory and practice. First person pronouns shall be used so as not to disguise my personal evaluation (Webb, 1992). This essay shall particularly focus on the role of the individual in SP&C in comparison to the priorities of organisations, nurses and patients- specifically asking if courage is a vital but under acknowledged part of optimum supportive and palliative care. This discussion on courage in SP&C will lead to recommendations for the development of supportive and palliative care.

Supportive and Palliative Care is an evolving discipline (Craft et al, 2010; Clarke, 2007) that originated with nurses and nursing (Clarke, 2007)and has now become a medical speciality in its own right (Capewell, et al., 2006). The modern hospice movement began in the 1950’s and 60’s with the nurse Cicerly Saunders who articulated the connection between physical and mental suffering found at the end of life for people with pain from cancer (Clarke, 2007). For Saunders, palliative care was a holistic response to (as one
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