A Research Study Of Nurses ' Beliefs And Practice

This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

1.1 Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

Although nurses have their experience to guide their practice, as the health professional most involved with the client at the end of life, there is a need for review of current assessment tools and management strategies to ensure the care given is evidence based and best practice.

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

Sometimes the transition from critical care to end-of-life care is instantaneous, and the urgency associated with end-of life decisions for these children creates challenges for the nurses providing this care. Therefore nurses whose day-to-day practice focuses on saving lives, a sudden or even gradual change in a child's situation to end-of-life care can cause a disconnect between what nurses routinely do in the ICU setting and what they are now expected to do. Fewer studies could be located that has examined the effects of educational program on nurses provide end of life

It is the nurse’s responsibility to remove their personal beliefs when providing care to the patient. If the nurse is persistent in their own beliefs and values there can be a disruption in the successful transition to palliative care. Nurses may feel that they are failing at their job when a patient chooses to go into palliative treatment. The nurse may question their performance as a nurse and have uncertainty regarding whether or not they could of done something more for that

A study conducted in Spain, to explore this exact issue, was preformed in 2012. The results were very compelling and showed a lack of education and resources to professional nurses needed to properly handle patients requesting more information on PAS. The study performed consisted of 35 questions to distinguish basic knowledge in this area, attitudes towards this topic, and their personal experience with these types of conversations with patients. Of the 390 returned surveys, 59% of participants were able to appropriately identify a case of euthanasia, while 64% were able to appropriately identify a case of PAS. Majority of those surveyed felt a stronger sense to support legalizing euthanasia versus PAS (Tamayo - Velazques, Simon-Lorda, Cruz-Piqueras, 2012). While this study was not conducted in the United Sates, it is clear that education of professional nurses on the topic of PAS and euthanasia is imperative as this practice gains more momentum. There is a need to develop a resource and education program for professional nurses that encounter questions regarding hospice, palliative care, and other end of life

Death is inevitable at some point everyone must face it. Whether it is the death of a family member, friend, or a family pet, people are forced to deal with the death. Nurses however have more frequent encounters with death than the average person does. When a patient dies in a healthcare setting his or her nurse is obligated to deal with that as well. They must find ways to cope with the increased amount of death that

Acute hospitals play a significant role in end of life care, it is the place where most people die. Evidence suggests that end of life care in hospitals needs improvement. The purpose of this paper was to investigate patient and family experiences of hospital death, the weaknesses within the hospital setting and possible solutions to improve. A literature search identified common themes, these included:

In relation to the purpose of this study, the driving force behind the research are three questions. What are nurses experience following patient’s death? What are their actions and coping strategies following patient death? Would better learning opportunities and supportive practice environments be provided once there is an understanding of nurses’ grief and coping process, if yes, was it beneficial. The researchers proceeded with a broad question which allowed the focus to be sharpened and delineated later in the

Many nurses are regularly confronted with the hopelessness and exhaustion of patients and their families making it difficult for them to find balance between the preservation of life and the enablement of a dignified death. Nurses must acknowledge their own feelings of sorrow, fear, dismay and helplessness and recognize the impact of these emotions in clinical decision making. These distressing pressures may cause a nurse to contemplate intentionally assist in ending a patient's life as a humane and compassionate answer, however; the conventional goals and standards of the nursing profession mitigate against it.

Knowing that there may be a point the patient can no longer make the decisions about their care allows for the patient, family members and healthcare providers to begin the conversations early about plans and choices for the future. Whitlatch (2013) discusses how critical it is to discuss values and preference for care with both the patient and the caregiver throughout the disease progression, to ensure a person-centered plan of care addresses everyone involved. As a hospice nurse, it can be difficult to have discussions about after life care with a patient who is still living, but to ensure that the nurse provides holistic care for the patient this conversation must take place. Many times, when talking about death and after life, religion and faith can have direct impacts on the plan of care. A specific example for family involvement in the plan of care and where faith had a role in care was with hospice patients that were Catholic.

I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.