All nursing care is important but some believe only one type of care is vital in the somber end stages of life. When a patient is in final stages of their life they look to healthcare providers to comfort them whether it be with words, or medication. At the end of a patient’s life, teamwork and collaboration from the nurse, healthcare provider, and insurance is vital to the patient’s care. Most patients suffer from low income and are financially incapable of paying for end of life care from a hospice organization due to strict Medicare rules. Medicare has made their qualifications for reimbursement for hospice difficult for care on the death bed. Due to new requirements for Medicare, many studies have been performed to conclude if hospice care that includes pain medication, benefits patients in these final moments.
Pain is neither objective nor seen or felt by anybody other than the person that is experiencing it. Pain is subjective, therefore there is no way to distinguish whether or not someone is hurting and the only and best measurement of pain is that what the patient says it is. In settings such as end of life care, patients present with many different disease processes and ultimately are there because they have an average of six months to live. Along with this stage in their lives, palliative care patients can encounter a myriad of symptoms, which can result in these patients experiencing tremendous physical and psychological suffering (Creedon & O’Regan, 2010, p. [ 257]). For patients requiring palliative care, pain is the most incapacitating of symptoms and in return unrelieved pain is the primary symptom that is feared most by these patients. So why has pain management not become the top priority when it comes to end of life care, considering this area is growing at an extraordinary rate as a result of an increasingly ageing population?
Without doubt, there are two variables that should be considered when evaluating the benefit of shared governance in long term/nursing home settings. First, obtaining consent from the nursing assistant to volunteer for the leadership role for the duration of one year, and the nursing assistant employment status at the time of consent. Second, the effectiveness of the shared governance project to reduce falls, weight loss, in-house acquired pressure injury, and nosocomial infection rates for the sake of the resident’s comorbidity.
On February 14th I spent a day doing something I never thought I would do in a million years, I went to hospice. I always thought I would hate hospice, but I actually didn’t mind it too much, it isn’t a job I see myself doing in the future but it is a job that I understand why people do it and why they enjoy it. During this observation I was touched by how much these nurses really seem to care for each of the patients that they have.
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,
The following are guidelines on things nurses can and cannot do. Nurses can provide care and comfort to the patient and family through all stages of the dying process, explain current law, be present during the patient’s self-administration of the medication, be involved in policy development, explore reasons for the request to name a few (Getter, 2013). Nurse cannot inject or administer the life-ending medication, subject peers, patients, and families to unwarranted or judgmental comments or actions, or abandon/refuse to provide comfort and safety measures to the patient (Getter, 2013). As with any licensure, that individual is responsible for following actions within their scope of practice. It is up to them to know their policies at an institutional and legal
Most nurses are drawn into the debate when they are treating terminally ill patients. They believe that even though it is the doctor that prescribes the lethal substances or withdrawals them from their treatment it is them, the nurses that stay with the patients until the end. Some nurses choose to help with assisting a terminally ill patient if requested knowing the legal and professional repercussions and some choose not to. There are developed guidelines stating that nurses have the right to refuse to assist a patient who has requested death assistance if it goes against their moral principles, but with that their oppositions must be stated ahead of time. Nurses on both ends are required to understand their rights and their patients’ rights (Ersek
Lynn, J. (2008). Improving care for the end of life: A sourcebook for health care managers and clinicians. Oxford: Oxford University Press.
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
End of life pain management is an important function of hospice organizations. Families and patients alike are comforted by the fact that, at the end, there are resources which allow for a comfortable death. Much of the quality of hospice care is determined by patient family members. In 2005, the Brown Medical school conducted research with regard to t...
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
Palliative care is a type of expert medical care designed to improve all aspects of a patient’s life and address all of said patient’s medical, physical, emotional and social needs, among others. It is typically used to help terminally ill and disabled patients, those often more prone to consider PAS. It is specialized to each patient and the kind of specific treatment his or her illness requires, and is designed to help patients live as long as possible and improve their quality of life. David Jeffrey, author of Physician-Assisted Suicide: A Palliative Care Perspective, states, “Over 90% of doctors working within palliative care oppose euthanasia and PAS” (Jeffrey 6). Palliative care doctors are those most exposed to PAS, and who have the most experience in dealing with it. The most informed experts on PAS oppose it, because such an exceptional alternative—palliative care—is available. With recent improvements in palliative care, the legalization of PAS is unnecessary and irrelevant now more than ever. The Annual Summary of The World Health Organization Expert Committee states, “With the development of modern methods of palliative care, legalization of euthanasia is unnecessary. Now that a practical alternative to death in pain exists, there should be concentrated efforts to implement programs of palliative care, rather than yielding to pressure for legal
Intro- Collaboration with the interdisciplinary team plays a big part in the care of a patient.
Palliative care involves the holistic care to maintain and improve the quality of life of the patient and family during hospitalisation until the terminal stage. Palliation of care refers to the multidisciplinary approach of providing comfort and support for the terminally ill patient and family, thus has an important role in maintaining and improving the quality of life of the whole family. Chronic illness such as cancer gives a physiologic and emotional burden for the patient and family. Education and counselling of the possible options as well as treatments for pain and other symptoms that could help alleviate anxiety, suffering and discomfort. Palliative care provides assistance for the family as a channel for communication between the
McGowan, C. M. (2011). Legal issues. Legal aspects of end-of-life care. Critical Care Nurse, 31(5), 64-69. doi:10.4037/ccn2011550
Death is the termination of lie and its related clinical signs and has been defined in several ways. Death has various stages, signs, and actors affect it that has physiological and ethical responses. It is the nurse’s responsibility to facilitate coping to the dying and the family members, friends and significant other of that person dying.