Providing End-of-Life Care Introduction End-of-life care can be defined as the care of a patient from the moment healthcare team members have doubts about the purpose of life-sustaining treatment until the care for family after death of the patient (Noome, 2016). Caring for patients with life-threatening illnesses is extraordinarily challenging. When caring for a patient in their last days, nurses may encounter legal aspects of care that they may not be familiar with. The main objectives of this paper is to identify and discuss legal aspects of end-of-life care, compromised autonomy of the patient, and nurse perspectives on end-of-life care The Legal Aspects of End-of-Life Care McGowan’s (2011) article highlights legal implications associated …show more content…
Of the healthcare team, nurses spend the most time with the patient at the bedside, resulting in sufficient knowledge of the patient and their family. Information about the clinical and psychological condition of the patient, information provided, and signals given by the family are mostly gathered by the nurse. The ICU nurses involved in the study emphasized the urgency to be present in multidisciplinary meetings on a regular basis to share their knowledge with other professionals. Because nurses have specific information about the patient and his or her family, nurses can communicate this information to the rest of the health care team (Noome et al., …show more content…
Communication between the patient, family, clinicians, and nurses is important in inquiring the needs and wants of the patient and family. Noome et al. (2016) recognized that ICU nurses described their role during end-of-life care as a professional who communicates information to patients and family on treatments, procedures, and prognosis while providing comfort. Effective communication about advanced directives and disputes over end-of-life care decisions may lead to acceptable compromise and solution between all parties involved (Blackler, 2016). Clear communication and understanding is needed in order to provide high quality care. Another topic discussed between the articles involved, is the importance of surrogate decision makers and advocacy for the substituted judgement standard in situations where the patient does not have the capacity to make his or her own decisions. Both McGowan (2016) and Blacker (2016) agree that the proxy should confirm the incompetent patient’s actual interests and preferences when making a decision on their behalf. In these situations nurses should acknowledge the difficult nature of the situation and help the proxy analyze the patient’s interests from the interests of the proxy and/or
Communication is the foundation of interdisciplinary patient care for those working with hospice and palliative care populations (Wittenberg-Lyles, Oliver, Demiris, Petty, & Day, 2008). Shared communication between the nurse, patient, and caregiver is fundamental in decreasing caregiver stress and improving both the bereavement process experienced by the family as well as the symptom management issues experienced by the patient (Ellington, Reblin, Clayton, Berry, & Mooney, 2012). Two types of shared communication methods often found in hospice include face-to-face verbal and non-verbal communication.
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.
.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).
Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.
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
In reviewing the two studies I found, it is very clear there is a difference in quantitative and qualitative studies. To start, Lee et al. (2017) conducted a qualitative study in which the problem statement recognizes that end of life care (EOLC) in dementia patients is less than optimal when compared to cancer patients. The researchers aimed to determine what service managers and frontline staff at different facilities felt were the key aspects in improving EOLC in dementia patients (Lee et al., 2017). As a result, the researchers purpose was to contribute to the current evidence base on good EOLC and interventions to increase quality of care of end of life dementia patients.
My perceptions have changed dramatically since the Clinical 1 rotation. I have noticed that the minute I walk into my patient’s room, I start to collect data. I notice if they are breathing normal, what their skin looks like, what their cognition level is, and what equipment they have in their room. I have started to connect the “puzzle pieces” of the patient’s health, rather than just feeling like I have a bunch of random information. My perception of people has continued to stay the same from Clinical 1. I continue to have an interest in learning about patients and believe that they also have something to teach us. I have learned so much from the patients and it is fun for me to get to know different
In nursing, the goal of care is usually to restore the patient back to the highest level of health possible. In some cases, however, the goals of care change when a curative approach is no longer appropriate. The new goals of care could simply be palliation and pain control rather than a restoration back to full health. This type of care is called palliative care. Palliative care is not the same as end-of-life care, but the two go hand-in-hand at times. The goal of end-of-life care is a “good” death, good being defined by the patient. Palliation is part of that “good” death. Both palliative care and end-of-life
****In this article nurses had raised some extended questions, “what is the nursing role in treating patients than physician-assisted suicide?” First, we need to define physician-assisted suicide “the provision to a patient by a medical health professional of the means of ending his or her own life” (Dilemma,2010). As we all know that the patient has the right to deny any kind of treatment at the patient’s proposal so we cannot view it as physician-assisted suicide but other than a respectful manner to the patient’s nobility and one’s own choice. Nurses encounter problems when caring for their terminally ill patient who request for a physician-assisted suicide. The Code of Ethics for Nurses, is a standard principle for nurses to abide by. When the end-of-life questions arises for nurses, “The Code of Ethics for Nurses” is to guide their practice so no
Judge Neil Gorsuch, President Donald Trump’s nominee for the Associate Justice of the U.S Supreme Court, is soon up for a vote to join their rankings. The article proceeds to mention a book that Judge Gorsuch wrote in 2006 and his stand-point on the matter of End-of-Life Care where he is against the idea. The article switches to the perspective of Dan Diaz, the husband of a patient who needed medical aid in dying after being diagnosed with a terminal brain tumor. Diaz says that if Gorsuch would have been in his position at the time of his wife’s situation he would have a different outlook towards medical aid in
End of Life Care Planning is a controversial topic that is huge dilemma in healthcare. The average Medicare expenditures per person over the last two years of life was $102, 939.00 (Harter, 2015). One quarter of traditional Medicare spending for health care is for services provided to Medicare beneficiaries in their last year of life (The Henry J. Kaiser Family Foundation, 2016). Nurses deal with ethical dilemmas when caring for patients at the end of life. Nurses are responsible in minimizing unwanted treatment and patient suffering, which can sometimes be interfered by what family members want and the patient wishes (American Nurses Association [ANA], 2012). This paper will go over why end of life care planning should and should be covered as a covered expense.
I t is important that end of life care is delivered in respect of patients Autonomy, Beneficence, and in a Truthful way. In what follows I argue that we as nurses need to fulfill obligation to support and assist the dying patient and his family’s right to self-determination as it relates to end of life care. I believe that we have made headway but still have much to achieve. Education and research in these areas by and for health care workers and the general population would do much to improve the quality of end of life care.
“The final moments of one’s life are difficult for everyone involved-the patient, loved ones, and even the healthcare provider” (Klein, 2005). If a patient’s final wishes regarding his/her care are undefined or not clear, then the situation could be worse or uncomfortable. During what should be a time of caring, mourning and supporting one another can quickly become overshadowed by ethical and legal battles. However, this can be prevented and avoided by the execution of advanced directives.
An ethical dilemma is a difficult situation that usually involves a conflict between moral obligations, in which to obey one would result in disobeying another (Murphy, 1997). Sedation is an ethical dilemma in palliative care because on one side it helps to relieve suffering for patients who are terminally ill and almost at the end of their lives. However, at the same time, sedation is making the patient deprived of certain bioethical principles such as autonomy, the main issue with palliative sedation is that it prohibits the patient from changing his or her decision, once sedation is commenced and informed consent also becomes complex (Cooney, 2005). The writer is in the favour of palliative sedation because it is an effective symptom controlled strategy for the patients who are nearly at the end of their lives. Moreover, it is believed that by providing sedation to a patient induce unconsciousness, which makes the patient completely unaware of the external world and tend to reduce the suffering by considering ethical and moral principles. However, some people think palliative sedation as euthanasia, which cause death because of making the patient deprive of nutrition and hydration while giving sedation. Ethical principles are going to be discussed in this essay such as autonomy, beneficence, non- maleficence and justice. Moreover, this essay also going to put light on current research
An individual patient solution may include actions of a clinician such as a trial of therapy (Schlairet, 2013). Providers may propose a trial of therapy for an impaired patient that may offer greater clarity as to whether or not the patient is end stage or has a likely positive outcome. An agreement to neither intensify nor expand critical care interventions should accompany the trial if the patient’s condition weakens.