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End of life care in the Intensive Care Unit (ICU) can be very stressful for ICU nurses due their need to rapidly transition from curative care to end of life care, therefore the interventions they choose are very important. The qualitative study “A Study of the Lived Experiences of Registered Nurses who have Provided End-of-Life Care Within an Intensive Care Unit,” by Holms (2014), explores the experiences of ICU nurses who have provided end of life care to dying patients and their families in the ICU. End of life care according to Radbruch and Payne, is “synonymous with palliative care yet it is more specific to acutely unwell patients who require palliative care in the last few hours, days or weeks of their lives” (As cited in Homs, 2014, p. 549). Sadly, patients in the ICU are critically or terminally ill, and most are unable to plan their own end of life care. Therefore, nurses in the ICU are needed to help guide patients and family members through this process. According to Wright, “95% of patients within the ICU may not have the ability to make informed decisions” (As cited in Holms, 2014, p. 549). The discussion of end of life care in the ICU continues to be a very controversial because care is highly inconsistent due to conflicting opinions on what to base the care for the patient.
Overall, this study focused on the feelings of ICU nurses and their ways of being prepared for dealing with death and dying in the ICU. The target population for this study was registered ICU nurses and staff within one ICU who eventually dwindled down to five selected nurses. Holms adapted Burnard’s (1991) 14-Step framework to guide the analysis of these interviews that were eventually broken up into five main themes. These themes were integra...
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... end of life care. The third theme discussed in this study is the intensive care environment. Homs stated that advantages in the ICU include a higher ratio of nurses to patients leading to more available time with the ill patients and their families. The fourth theme discussed in this study is education and training. Nurses learned about end of life care in the ICU through bad experiences or by watching other co-workers make a mistake. The final theme discussed in this study was staff distress. The nurses stated that the feeling of distress was brought upon when they lacked experience or training and there was inconsistent communication. “Lack of support from other staff and managers, differences in the consultants’ End of Life Care decisions and a lack of involvement in the End of Life Care decision-making were the most common areas causing distress” (2014, p. 553).
The purpose of this paper is to critique a qualitative research article in all phases of the report. For this purpose, the article that will be used is “Lamentation and loss: expression of caring by contemporary surgical nurses” written by Carol Enns and David Gregory. This paper will address the problem statement, literature review, conceptual underpinnings and research questions, research design/method, ethical considerations, sampling, data collection, data analysis, confirmability of the findings, interpretation and discussion of findings, additional considerations, and rating the scientific merit of a research report.
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
In today's society, one of the most controversial health-care-related ethical issues is assisted suicide for terminally ill patients. Assisted suicide is not to be confused with ethically justified end-of-life decisions and actions. Nurses have a responsibility to deliver comprehensive and benevol...
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
Hospice care can be provided in a variety of settings – in a hospital, in a facility devoted to
Granted, textbooks and nursing classes deal with death, but Marks explains that you do not really understand it until it is right in front of you. Overtime it becomes something that nurse’s become accustom to. To clarify the subject of death never becomes easy, it just becomes bearable. After 31 years of experience Marks explained to me that nurses have to learn how to distance themselves, yet still be caring at the same time; a trait that does not come easily to most. In the same way treating someone with a terminal illness is just as hard. In these cases nurses must step into the role of councillors. They must learn how to comfort their patient, yet not become too attached. As well they must learn how to explain to them what is happening, which can become especially hard when dealing with
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
Overall the need for a better based end of life care strategy is warranted globally. More of a focus should be given on care and high quality service for patients. As of now too much decision lies with the healthcare professionals and this can lead to faulty decision making because the health care providers are doing what they believe is in our best interest. In reality the patient or ourselves only have the true idea how we would like our final days to be carried out. By developing and carrying out an end of care plan we can take the decision making out of the family and doctors and place it on the patient. By all counts the need for change is apparent within the healthcare industry in regards to end of life care. By considering this unique change a great deal of improvement can be derived from this decision making process.
The nurse becomes the confidant, the guide through the darkness, a source of comfort for those experiencing the trauma of losing a child. To successfully fulfill these nursing roles, in addition to roles that must be fulfilled to meet other patient’s needs, one must acknowledge their own definition of death and educate themselves on cultural and societal norms associated with death and dying. It is important to identify one’s own definition of death and dying but also understand that one’s preference does not define the death experience for others. The individuality and uniqueness of each death experience means that one definition of death may be hard for one to accomplish. It is important to maintain an open mind, nonjudgmental spirit, and impartiality for the cultures and practices of others surrounding death and dying. A culturally competent nurse is not only responsible for acknowledging the cultural norms of others but also respecting and educating themselves about the death rituals of their patient’s culture and providing the family with as many resources to safely and effectively fulfill their cultural practices. Education is empowering for the nurse who is navigating the death and dying process. Education often supplements ones credibility with the dying patient and their family which can ease overall anxiety and further promote ones role as a patient advocate and provider of
My earliest experiences of observing nursing in action occurred during my last two years of high school. My father was diagnosed with cancer during the spring of my junior year and died right before my senior year. During that short time I watched as the nurses cared for him and I could see compassion and empathy in the way they looked at him. It never occurred to me until after I had raised my children that I wanted to be able to help people in the same way those nurses helped my dad. But now when I tell people that I want to be an oncology nurse, people often respond by saying that they would never choose that type of nursing. They say that they could not stand to watch their patients die so frequently. Their reactions, along with this course in death and dying, have made me question how I might be able to bear the challenges of nursing in an area where death of my patients may be common. I believe that oncology will be a positive specialty to work in because of the consistent advances in prevention, early detection, and treatment of cancer. Furthermore, I believe that William Worden’s four tasks of mourning as presented in our text book is a good framework for the oncology nurse to use in order to cope with the repeated losses inherent in this type of nursing (Leming and Dickinson, 2011).
“Persons intentionally choose to become nurses to help patients meet their health needs,” even when the patient is actively dying. (Wu & Volker, 2012) Hospice nursing and palliative care nursing are both considered end of life care. However, hospice nursing is typically given to patients with a terminal illness and who have less than six months to live. Palliative care is typically given to patients with a life threatening illness, and is used to increase the patient’s quality of life. Choosing a nursing career in either hospice or palliative care can be extremely difficult, but will provide an opportunity for great personal growth. At times, an end-of-life caregiver may feel responsible for their patient’s death, or they may feel isolated due to a lack of support. Nurses new to this field should “feel that their unit acknowledges death as a difficult event and that discussion of death is acceptable in the workplace.” (Lewis, 2013) The most rewarding, and also most difficult, part of being a hospice or palliative care nurse is the ability to be a part of your patient and their family’s life, including their loss, grief, and death. (Wu & Volker, 2012)
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.
This paper is an academic critique of an article written by Lautrette, et al. (2007) titled: “A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU” and accurately reflected the content of the article and the research study itself. The abstract explained the article in more detail, while remaining concise. The type of research study, sample size, variables, intervention, measurement method, findings, and conclusion were all mentioned in the abstract.
Pain is a serious issue, one that can limit a person’s ability to function in all facets of life. The purpose of treating pain is to eliminate needless suffering and maintain the highest level of function despite the pain experienced by an individual (Herr, 2010). Pain can be under-recognized and underrated among end-of-life patients. This can be because these patients sometimes have difficulty communicating their pain to their nurses. In some cases, nurses do not have the necessary pain assessment skills needed to effectively manage those population pain.