Important Aspects of Communicating with End-of Life Patients and How Nurses Can Facilitate the Process

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

Key people could be family, doctors, carers, religious leaders etc. Each may own distinctive role to play in order for the choices and preferences of the individual to be respected and carried out. [ Every person’s end-of-life trajectory is different and needs differ in intensity and quality over time. End-of-life care must adapt to the varying and changing needs of the individual over time and that it cannot be limited to certain settings or services. The provision of good

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.

This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted

As people approach the end of their lives, they with their families and their caregivers, face many tasks and decisions. They may be psychological, spiritual, or medical in nature, but all end-of-life choices and medical decisions have complex psychological components, ramifications, and consequences that have a significant impact on the suffering patients and their caregivers.

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 article points out how the American Nurses Association (ANA), the Hospice and Palliative Nurse Association (HPNA), and Oncology Nursing Society (ONS) do not support the use of assisted dying. However, due to recent law changes, the organizations are reevaluating their position on dying with dignity. The article talks about the countries and states that have legalized assisted dying and who can qualify to obtain the prescription. It also points out that nurses who live in these countries and states are more likely to be uncomfortable to talk about this subject with their patients. Either way, patients need to be educated and advocated for while following the code of ethics when dealing with the subject of assisted dying. The article also points out how a nurse needs to be a tentative listener to further assess why the option of assisted dying is being considered. A brief case study demonstrates how a good nurse can reveal the true motives behind choosing the assisted dying as an option. Finally, the article talks about different communication techniques and approaches a nurse can use when discussing the subject of

Helping adolescent and young adult palliative care patients communicate their end of life requests is a significant aspect of hospice nursing, yet the conversations can be difficult (Wiener, et al., 2008). The use of age appropriate advance care planning documents is one way to facilitate the death and dying discussion (Wiener, et al., 2008).

and acceptance (pg. 710). It is imperative for nurses involved in end of life care to communicate with the patient who might be in any of these stages, as well as find out which stage the patient their family is in regarding the request.

Modern medicine presents caregivers with many end-of-life options. If possible, it is best to include the patient in this process while they are still fully cognizant or before the patient falls ill. It is important to discuss whether to prolong the patient’s life during terminal illness and where to deliver hospice service. An ideal time for patients to broach this subject with family members is during a private family meeting to talk over or update a living will. Patients and care providers also inform the primary care provider about these details.

Nurses have an obligation to provide timely, humane, comprehensive and compassionate end-of-life care. Nurses can demonstrate their respect, support and lasting commitment to their patients and families by creating compassionate care at end of life without participating in the euthanasia process (Purtillo & Doherty, 2011). Hospice care is an important part of the nursing practice and helping people die with dignity by providing them with the best possible care during their final moments and prevention of pain and making those who are near the end as comfortable as possible. Being able to choose your own end of life plan can prevent

Promoting well-being emphasizes a person’s physical, mental, and social resources and enhances protective factors and conditions that foster health (Ferran, 2005). The most important component in ensuring the quality of life and avoiding challenges that may arise along the way for end-of-life patients is communication. First, a patient should be asked if they want information to be conveyed to family/surrogate instead. Throughout any communications there the following must be expressed: the seriousness of illness; expected course; treatment options, risks, and benefits; and empathy, support and caring. Additionally, family and other relationships should help in decision-making/advance care planning and aid in alleviating pain and distress.

In nursing profession, nurses can never run away with caring for the dying as it is a particularly a difficult role that requires nursing skills. It is also essential for nurses to have an insight on their own personal beliefs about dying and death. Researchers had stated that, nurses who have a positive attitude towards death are more likely to have a positive attitude towards delivering end of life care for dying patients. Being a nurse the writer believes that nurses need to consider their own race and spiritual beliefs as well as of the dying patient as this might affect the nurses objective in caring for a patient whose journey is coming to an end.

The concept of hospice care in the United States has continued to evolve over the past three decades. Initially met with great skepticism and mistrust by the general population and the medical community, hospice services and care are now considered a valuable resource and venue of care for those suffering from a terminal illness and for their families. The choice of hospice services and the approach of palliation of symptoms, comfort care, and the end of life can be difficult for a patient and family. The many issues that surround the concept of hospice care may cause the patient and family feelings of great sadness, grief, anticipatory grief, anger, defeat, loss, and many other complicated and gut wrenching thoughts and emotions (Chi Ho Chan & Fong Tin, 2012). With the support of the hospice care providers the patient and family have the opportunity to spend quality time together and share their thoughts, concerns, reflect on the past, and most importantly to communicate final good-bye’s and potentially seek closure to any remaining unresolved issues.

According to Taylor (pg. 1618) patients generally feel more comfortable discussing their questions and concerns with their nurse, patients feel as though the nurse is more approachable and less intimidating. They spend more time with the nurse and generally direct their concerns towards them. It is imperative that the nurse use tools such as therapeutic communication when answering questions regarding death and showing the patient and family that they are freely open to discussing any concerns that they have regarding care and death (Taylor, pg.1618). It is an essential part of being a well-rounded competent nurse to be equipped with the ability to provide some counseling and death education (Taylor, pg.1618). Therefore, having a sound education including the elements of end of life care is essential. Moreover, it is especially important to develop a solid, trusting relationship between one’s patient and family by allowing the patient to discuss openly their issues and giving oneself by serving as a nonjudgmental listener (Taylor, Pg.1614).