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Providing pain management to the dying patient
The importance of pain management in palliative care nursing easy
Importance of palliative care
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Comfort measures are crucial for the dying patient and their loved ones. Comfort measures, not only, include pain management but also massage, music, position changes, and heat, which are all just as important. Palliative care is an extremely important aspect of nursing. Palliative care “focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses” (http://www.WebMD.com). The ultimate goal of comfort measures and palliative care is to ensure that the patient has a more relaxed and peaceful death (End of Life care: An Ethical Overview, 16). Other important aspects of palliative care consists of hygiene measures, which includes keeping the patient dry and clean, offering food and fluids often, and keeping the patient, along with the family, as comfortable as possible. Some try to argue that drugs, like Morphine, should not be given to the dying because it speeds up the dying process, but I believe that their death is inevitable and it is best to make the patient as comfortable as possible. For many families, the thought of losing their family member is too much to handle but with pain management, at least, the patient gets to die a relatively pain-free death. This can be comforting for the family. Although, there are pain medications that can suppress the respiratory and cardiovascular system, the patient, typically, has a much more peaceful death, as opposed to not having any sort of drug.
Palliative care “focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses” (http://www.WebMD.com). Palliative care is not the same as hospice, since it is not only for the dying. According ...
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... that the nurse or family can do. The goal for palliative care is to make the patient’s passing as comfortable and relaxing, as possible. Medication management should be provided for every patient that is having pain to allow for a more comforting, pain-free, and peaceful death.
Works Cited
Aranella, Cheryl, MD., M.P.H. Use of Opiates to Manage Pain in the Seriously and Terminally Ill Patient. American Hospice Foundation, 2006. Web. 7 November 2011.
Center for Bioethics: University of Minnesota. End of Life Care: An Ethical Overview. 2005. PDF.
Kam, Katherine. What is Palliative Care?. WebMD, 24 January 2011. Web. 7 November 2011.
McGhee, James, and Kathleen Ouimet Perrin. Ethics and Conflict. Massachusets: Jones and Bartlett, 2008. Print.
World Health Organization. Nursing Care of the Sick: A Guide for Nurses Working in Small Rural Hospitals. WHO. Print.
God tells his children, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Revelation). Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away from the earth. This is wrong. There are ways that people can turn a bad situation to good. Dying doesn’t have to be painful and full of suffering. The County Hospice staff makes sure of this. The Hospice staff not only takes care of passing patients physically, but they also take care of the patients emotionally and spiritually. Hospice staff also plays a key role in helping families during the grieving process.
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?
Comfort care or palliative care is when a terminal patient is placed in a quiet room, where no medical interventions are done except morphine. The patients are not placed on any monitors, no vital signs or given prescription medications. Only the presence of families, periodic turning, swabs for dampening the lips, and perhaps restful music is around the patient. Comfort care is meant to allow a dying person a peaceful end, thus, morphine drip is added for pain relief. Stephens (2012), states that it’s the same medications used to control pain and discomfort, could be used to “help” the patient to stop breathing. The concept of terminal sedation assumes death as an outcome of the intervention.
Nye, Howard. PHIL 250 B1, Winter Term 2014 Lecture Notes – Ethics. University of Alberta.
Braddock, Clarence, and Mark Tonelli. "Physician Aid-in-Dying: Ethical Topic in Medicine." Ethics in Medicine. University of Washington, 2009. Web. 3 March 2015.
Currently, in the United States, 12% of states including Vermont, Oregon, and California have legalized the Right to Die. This ongoing debate whether or not to assist in death with patients who have terminal illness has been and is still far from over. Before continuing, the definition of Right to Die is, “an individual who has been certified by a physician as having an illness or physical condition which can be reasonably be expected to result in death in 24 months or less after the date of the certification” (Terminally Ill Law & Legal Definition 1). With this definition, the Right to die ought to be available to any person that is determined terminally ill by a professional, upon this; with the request of Right to Die, euthanasia must be
Palliative care is medical or comfort care that reduces the severity of a disease or slows its progress, but does not provide a cure (Dreeben, 2007). Different people have different needs when life is ending. Working with the incurable may sound depressing but death is a certainty and what we do each day for these patients as physical therapist assistants, matters. Providing care effectively and appropriately has a huge impact on the patient, therefore acquiring the ability to comfort and care for a patient at such a critical stage in life, is an amazin...
...rson cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged. (Catechism)
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
Palliative care is an essential to the creation of a health and wellbeing continuum for Australians living with a chronic illness. It is an approach of care that seeks to improve the life of patients and family experiencing the effects of chronic illness. Palliative care centres on the relief of the symptoms and effects of disease and incorporate the physical, psychological and social dimensions of a person at the end of life. A recent focus for the delivery of palliative care by nurses to Indigenous communities is the consideration that culture can create barriers to the provision of appropriate and beneficial care for the dying or deceased person. This essay explores the palliative nurse caring for Indigenous communities and the need to consider
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...
Compare hospice to palliative care and describe the similarities and differences of the two in terms of community health nursing. (12 pts) Palliative care is used when someone is diagnosed with a serious or chronic illness and they are having side effects from the illness and are nearly at the end of their life, they will need to be referred to palliative care to help them in relieving and preventing the suffering. Palliative care is not limited it can be conservative or aggressive. Hospice care is when a person has a terminal illness that is advanced and there is no more cure or treatment, and are going to die in six months or less they then refer to Hospice care to attend their emotional and spiritual needs and helps to relieve their suffering and improve their quality of life. (12 pts).
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...
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Robert Matz; Daniel P. Sudmasy; Edward D. Pallegrino. "Euthanasia: Morals and Ethics." Archives of Internal Medicine 1999: p1815 Aug. 9, 1999 .