Reflective Essay on the Effects of Alemtuzumab on Patients (Essay Sample)

Reflective essay on the effects of Alemtuzumab on patients
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Reflective essay on the effects of Alemtuzumab on patients
Introduction
Gibbs model of reflection is a common model for reflection. It includes six phases of reflection. They include description, feelings, evaluation, analysis, conclusion, and action plan. The description phase explains the situation that has occurred, the feeling stage reflects on your thinking’s and feelings, the evaluation phase majors on the bad and good about the experience, the analysis is on what sense can you create out of the situation, concluding phase is on what other things you could have done, and the action plan is the actions you have in place if there is a re-occurrence ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM-1", "itemData" : { "URL" : "/services/upgrade/study-skills/reflective-gibbs.html", "abstract" : "Gibbs\u2019 reflective cycle encourages you to think systematically about the phases of an experience or activity, and you should use all the headings to structure your reflection. See how we have used Gibbs' reflective cycle in our Health Visitor example . Forgotten the Health Visitor example?", "author" : [ { "dropping-particle" : "", "family" : "Oxford Brooks University", "given" : "", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" } ], "container-title" : "Oxford Brookes University", "id" : "ITEM-1", "issued" : { "date-parts" : [ [ "2013" ] ] }, "title" : "The reflective cycle (Gibbs, 1988)", "type" : "webpage" }, "uris" : [ "/documents/?uuid=293dcb49-59da-470f-b70d-dee1dccea88d" ] } ], "mendeley" : { "formattedCitation" : "(Oxford Brooks University 2013)", "plainTextFormattedCitation" : "(Oxford Brooks University 2013)", "previouslyFormattedCitation" : "(Oxford Brooks University 2013)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation-style-language/schema/raw/master/csl-citation.json" }(Oxford Brooks University 2013). Alemtuzumab is a drug that is used in certain conditioning regimes for islet cell, kidney, and bone marrow transplantation. It is a monoclonal antibody that binds proteins present on the surface of mature lymphocytes and after administering Alemtuzumab to the patient it destroys these lymphocytes bearing proteins. It is also referred to as Campath and sometimes it may have adverse effects on the patients using it ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM-1", "itemData" : { "DOI" : "10.2165/00003495-200363120-00003", "ISSN" : "00126667", "PMID" : "12790693", "abstract" : "Alemtuzumab is an unconjugated, humanised, monoclonal antibody directed against the cell surface antigen CD52 on lymphocytes and monocytes. In noncomparative phase I/II studies in patients with B-cell chronic lymphocytic leukaemia (B-CLL) relapsed after or refractory to alkylating agents and fludarabine, intravenous (IV) administration of alemtuzumab 30 mg/day three times weekly for up to 12 weeks was associated with overall objective response (OR) rates of 21-59%. Combining alemtuzumab with fludarabine resulted in ORs >80%. In noncomparative studies in patients with previously untreated B-CLL, subcutaneous (SC) administration of alemtuzumab alone, or IV in combination with fludarabine, was highly effective, achieving OR rates of around 90%. IV alemtuzumab was active in patients with chemotherapy-resistant/relapsed T-cell prolymphocytic leukaemia, with reported OR rates of 24-76%. Alemtuzumab has been incorporated in novel conditioning regimens designed to facilitate stem cell transplantation in haematological malignancies. Adverse events with alemtuzumab are predictable and manageable. 'First-dose' flulike symptoms, frequently seen after IV infusion, can be managed by (pre)medication and minimised by dose escalation (or SC injection). Anti-infective prophylaxis is mandatory. Cytopenias are transient, although red blood cell and platelet support may be required.", "author" : [ { "dropping-particle" : "", "family" : "Frampton", "given" : "James E.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Wagstaff", "given" : "Antona J.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" } ], "container-title" : "Drugs", "id" : "ITEM-1", "issue" : "12", "issued" : { "date-parts" : [ [ "2003" ] ] }, "page" : "1229-1243", "title" : "Alemtuzumab", "type" : "article", "volume" : "63" }, "uris" : [ "/documents/?uuid=2bfae59d-fea0-4817-885a-89d80dba0ed9" ] } ], "mendeley" : { "formattedCitation" : "(Frampton & Wagstaff 2003)", "plainTextFormattedCitation" : "(Frampton & Wagstaff 2003)", "previouslyFormattedCitation" : "(Frampton & Wagstaff 2003)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation-style-language/schema/raw/master/csl-citation.json" }(Frampton & Wagstaff 2003).
Description
In this case, the situation is about a 44-year-old patient who is undergoing a bone marrow transplant in Glasgow hospital. The chemotherapy regime administered to her comprised of Melphalan, Fludarabine, and Alemtuzumab. On the first day of Campath administration, I provided the patient with patent education and every procedure was well explained to the patient. Additionally, I also made sure the possible side effects are well known to the patient. The conditioning regime, Alemtuzumab was administered to the patient according to protocol and everything was in place including the patient alarm system. In the last injection, the patient informed me about an itching and burning feeling to the skin and after checking it was clear the patient had reacted from the chemotherapy. She had developed rashes in numerous parts of the body. I brought the injection on hold, and I reassured the patient as I looked at vital signs and examined baseline observations. I was summoned and educated and since then actions were carried out as per local protocol.
Feelings
I remember that after noticing how the Miss x skin had been affected, I had a feeling that was mixed up with stress, fear, uneasiness, and nervousness. Miss x condition surprised me at how she had developed numerous rashes all over her body. Nothing in my practice had equipped me for such an experience, at least in situations like this, in which we as nurses were so clearly employed to care for the patient. I felt as if I was the one to blame for doing something wrong to the patient, and I had a feeling of ineffectiveness which made me feel as if I did not have proper medical experience. I felt younger and less experienced than I should be at my point of training. I have this urge of caring for sick people, but through this happening, I lost confidence in helping patients get better, giving them advice and also helping my fellow colleagues.
Evaluation
Later, this short incident prompted debates and doubts about numerous significant aspects of my nursing profession to me. Setting apart the encounters, I had already informed Miss X on the effects of the drugs before administering it to her, and I explained each and every procedure of administering the drug to her. The information I gave her helped to prevent adverse conditions as the patient responded immediately and informed me of the effects the drug was causing to her skin. Also the information I gave might not be that good since it may have triggered the patient to keep quiet of the effects the drugs was doing on her. This is because she is aware her life depends entirely on the treatment. In this case, the patient waited for a long time after the drug has caused so much effects on her skin. She waited until the last minute and told me, if I had a bad relationship with the patient, then she could not have informed even me in the first place and the condition could have worsened. I had a good relationship with the patient and she decided to open up on how the drug was affecting her skin. The quick reaction of the situation from me to check for any vital signs that the drug may have caused helped calm the situation and I stopped the infusion. Lastly, the reassurance I gave the patient that all will be fine prevented the patient from fearing and gave her confidence.
Analysis
To examine the whole situation through additional contemplation, I am noticing how important a good patient and nurse relationship is to the health of a patient. I tend to see the situation in a different manner. When I first started administering Alemtuzumab to the patient, I felt like I was doing my job well and I was free to discuss any other issues apart from medical ones with the patient so as to create a bond. Now I realize, it is not just about treating, there are many other aspects that matter in ensuring that the patient is recovering well. This situation made me feel comfortable, I felt good that the patient was free to come out and say the treatment was affecting her before things could get worse. Also, it made me think about the good relationship with other people and how it may affect their lives. The whole situation was enhanced by this good relationship factor. The reassurance the patient received from me that she will be fine showed that I care for her health that I am willing to do anything to make sure she is fine. This helped give the patient some confidence and at least made me feel relieved of the situation. The education I gave to the patient on the effects of the drugs and how the drug works might have made the patient feel that without the drug she is not going to survive, and this made the situation worse since she decided on keeping quiet. Chemotherapy using Alemtuzumab is given more so when other drugs have refused to work. This drug is used as the last solution and patients desperately need it to survive. Due to these the patient will still accept its adverse effects even if they are bad so as to be able to surv...