Nursing Role In End Of Life Care

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

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.

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

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

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.

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.

The significance of addressing psychosocial concerns with dying patients is essential to assure a peaceful closure in end-of-life care. The social worker's role is to provide competent, psychosocial intervention with patients and families.

At times the dying patient’s loved ones become the nurse’s patients. As stated in End-of-Life Care: Caring for the Dying Patient and Family of the Dying Patient, “End-of-life (EOL) care of the dying patient and the patient’s family encompasses a variety of interventions that meet the physical needs of the patient and the emotional/psychosocial needs of the patient and the family. The rationale for EOL care is to provide physical comfort for the patient by managing pain and reducing emotional stress, and to promote effective coping and spiritual comfort for the patient and family” (Woten and Schub, 2016). As future nurses, it is critical that we acknowledge the potential we hold, we treasure the gift we have been given and we take our responsibilities

providers to help enhance their communication with aboriginal patients at the end of life. The

According to the National Hospice and Palliative Care organization, in 2011, an estimated 1.651 million patients received services from hospice care, while 1,059,000 patients passed away from this form of care in the same year (NHPCO pdf, 2012). Hospice end of life cares mission/goal is to provide compassionate care for patients and their families who are living with a life limiting illness. This type of medical service gives expert medical care, pain management, and emotional and spiritual support (NHPCO, 2016). End of life care is beneficial for ones well being while they are passing away. Giving someone a peaceful and warm environment to spend their final life moments in. This form of end of life care is something that most people can relate to as many friends and family members have gone through this process. Hospice care is delivered to many patients, residents, and in general people all around the world, having many factors that go into hospice such as the requirements to receive hospice, the care team and the levels of care one receives, all of these factors are extremely important when it comes to the care for one’s life, family member, or friend.

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Caregiver burnout is very serious. Family caregivers face chronic health issues at double the rate of non-caregivers. Family caregivers also suffer from depression at more than twice the rate of non-caregivers. Sadly, most of these caregivers don't recognize the symptoms of their ailments. They simply think they are feeling tired, or that the symptoms are just part of caregiving. Even worse, caregivers are less likely to seek their own medical treatment while caring for a loved one, so their condition goes unnoticed and undiagnosed until it reaches a highly serious state.

Throughout the course of their career, nurses will constantly face the reality of death and dying patients. Disparate from medical physicians, nurses are almost always on duty to treat and hand out medication. Therefore, a situation where it is not possible for their patient to completely heal can ultimately put the nurse in a high amount of stress. Such feelings can lead to discomfort with aiding hospice patients and a decrease in nurses in that area (Peters, et al., 2013). The quality of end of life health care is also jeopardized due to the nurse facing ethical issues and death anxiety (Hold, 2017, p. 13). The impact of a patient death can incite more stress in the health care worker, according to Bickham, "Nurses often experience

Many of the more severe complications of caregiving arise as chronic conditions wear on and progressive conditions reach their advanced stages. Many family members are simply not physically, emotionally, or educationally prepared for they type of care their loved one now needs. They see the need for support and assistance, but they simply don't know where to turn. Others can handle the daily tasks and chores, but the increased medical help that their senior loved one needs can quickly get overwhelming. The downward spiral of stress and anxiety quickly leads to social isolation and depression. One of the reasons this situation is so serious is that depression is linked to cardiac disease, heart attacks, stroke, diabetes, and suicide.

This research article indicates addressing the communication problems in a hospital setting between the doctors, nurses and any other medical team member since effective communication is paramount with end-of-life care. Having effective communication with the patient and patient’s family members will improve the overall satisfaction of care during a loved one’s end-of-life care. In a time of a health crisis, the patient and patient’s family members may not be sure of what is going on or what is to be expected. They may not have enough knowledge about their diagnosis or comprehend the meaning. In the research most family members felt they had unfilled communication needs, had feelings of being a burden, left abandoned, felt a lack of trust