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Refractory suffering: The impact of team dynamics on the interdisciplinary palliative care team

Published online by Cambridge University Press:  25 February 2011

Kate Swetenham*
Affiliation:
Southern Adelaide Palliative Services, Daw Park, South Australia, Australia
Meg Hegarty
Affiliation:
Flinders University, Bedford Park, South Australia, Australia
Katrina Breaden
Affiliation:
Flinders University, Bedford Park, South Australia, Australia
Carol Grbich
Affiliation:
Flinders University, Bedford Park, South Australia, Australia
*
Address correspondence and reprint requests to: Kate Swetenham, Southern Adelaide Palliative Services, 700 Goodwood Road, Daw Park SA, 5041, Australia. E-mail kate.swetenham@health.sa.gov.au

Abstract

Objective:

This qualitative study aimed to describe the skill sets that experienced palliative care clinicians possess when managing refractory suffering.

Method:

Thirteen tape recorded semi-structured interviews and four online questionnaires were completed by participants with at least two years clinical palliative care experience. The research team undertook cross sectional thematic analysis of the transcribed interviews.

Results:

In the face of refractory suffering, team cohesion was identified as a key requirement to support the interdisciplinary team. However, team cohesion was found to be undermined by philosophical differences between team members, a paradigm shift concerning cure versus care and individual opinions regarding the chosen approach and levels of respect between the individual disciplines involved in the care of a person with a life limiting illness.

Significance of results:

The findings of this study highlight the precarious nature of the interdisciplinary team when significant challenges are faced. As a result of witnessing refractory suffering the division and fracturing of teams can easily occur; often team members are completely unaware of its cause. The findings of this study contribute to the limited literature on the nature of refractory suffering from the perspective of the interdisciplinary team.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Abel, E.K. (1986). The hospice movement: Institutionalizing innovation. International Journal of Health Services, 16, 7185.CrossRefGoogle ScholarPubMed
Beel, A.C., Hawranik, P.G., McClement, S., et al. (2006). Palliative sedation: nurses' perceptions. International Journal of Palliative Nursing, 12, 510518.CrossRefGoogle ScholarPubMed
Bloch, S. & Singh, B.S. (2001). Foundations of Clinical Psychiatry (2nd ed.). Melbourne: Melbourne University Press.Google Scholar
Blondeau, D. (2005). Physicians' and pharmacists' attitudes towards the use of sedation at the end of life: Influence of prognosis and type of suffering. Journal of Palliative Care, 21, 238245.Google Scholar
Bruce, S., Hendrix, C. & Gentry, J. (2006). Palliative sedation in end of life care. Journal of Hospice and Palliative Nursing, 8, 320327.CrossRefGoogle Scholar
Cutcliffe, J. & McFeely, S. (2001). Practice nurses and their lived experience of clinical supervision. British Journal of Nursing, 10, 312323.CrossRefGoogle ScholarPubMed
Dush, D.M. (1993). High-tech aggressive palliative care: in the service of quality of life. Journal of Palliative Care, 9, 3741.Google ScholarPubMed
Gist, G. & Devilly, G.J. (2002). Post-trauma debriefing: The road too frequently travelled. The Lancet, 360, 741742 R.CrossRefGoogle ScholarPubMed
Graham, I.W., Andrewes, T. & Clark, L. (2005). Mutual suffering: A nurse's story of caring for the living as they are dying. International Journal of Nursing Practice, 11, 277285.CrossRefGoogle ScholarPubMed
Junger, S., Pestinger, M., Eksner, F., et al. (2007). Criteria for successful multiprofessional cooperation in palliative care teams. Palliative Medicine, 21, 347354.CrossRefGoogle ScholarPubMed
Kyba, F.C. (2002). Legal and ethical issues in end-of-life care. Critical Care Nursing Clinics of North America, 14, 141155.CrossRefGoogle ScholarPubMed
Liamputtong, P. (2010). Research Methods in Health: Foundation for Evidence-Based Practice/Pranee Liamputtong. Oxford: Oxford University Press.Google Scholar
Maeve, K. (1998). Weaving a fabric of moral meaning: How nurses live with suffering and death. Journal of Advanced Nursing, 27, 11361142.CrossRefGoogle Scholar
Mealiea, L. & Baltazar, R. (2005). A Strategic Guide for Building Effective Teams. Public Personnel Management, 34, 141160.CrossRefGoogle Scholar
Mickan, S.M.Y. & Rodger, S.A. (2005). Effective health care teams: A model for six characteristics developed from shared perceptions. Journal of Interprofessional Care, 19, 358370.CrossRefGoogle ScholarPubMed
Morita, T., Akechi, T., Sugawara, Y., et al. (2002). Practices and attitudes of Japanese oncologists and palliative care physicians concerning terminal sedation: A nationwide survey. Journal of Clinical Oncology, 20:758764.CrossRefGoogle ScholarPubMed
Morita, T., Miyashita, M., Kimura, R., et al. (2004). Emotional burden of nurses in palliative sedation therapy. Palliative Medicine, 18, 550557.CrossRefGoogle ScholarPubMed
Parker–Oliver, D., Bronstein, R. & Kurzejeski, L. (2005). Examining variables related to successful collaboration on the hospice team. Health & Social Work, 30, 279286.CrossRefGoogle ScholarPubMed
Sinclair, A.H. & Hamill, C. (2007). Does vicarious traumatisation affect oncology nurses? A literature review. European Journal of Oncology Nursing, 11, 348356.CrossRefGoogle ScholarPubMed
Teasdale, K., Brocklehurst, N. & Thom, N. (2001). Clinical supervision and support for nurses: an evaluation study. Journal of Advanced Nursing, 33, 216224.CrossRefGoogle ScholarPubMed
Palliative Care Expert Group. (2005). Therapeutic Guidelines: Palliative Care. Version 2. Melbourne: Therapeutic Guidelines Ltd.Google Scholar
Weissman, D.E. (2006). Palliative care education. What works, what doesn't. Presented at the EFPPEC Interprofessional Symposium on Palliative and End-of-life care Education, Ontario, Canada.Google Scholar
White, K., Wilkes, L., Cooper, K., et al. (2004). The impact of unrelieved suffering on palliative care nurses. International Journal of Palliative Care, 10, 438444.Google ScholarPubMed
Yamey, G. (2000). Psychologists question ‘debriefing’ for traumatised employees. British Medical Journal, 320, 140.CrossRefGoogle ScholarPubMed
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