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Pain management in palliative care essay
End of life decision making essay
Pain management in palliative care essay
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Everyone in the world will come to a point in their life that they are approaching death. Some people never see death coming. Every day people are involved in car accidents and never would have thought they wouldn’t make it through the day. However, as people approach old age they start to realize when their bodies are not what they used to be. As people approach the end of their lives different tasks and decisions need to be addressed with their loved ones and family members. Some decisions that have to be made could involve subjects of spiritual, legal, medical, or ethical nature. Some examples include, one wanting to have a priest present in the final days of their lives, or writing out advance directives such as a will. One could also want to have no pain leading to their death and want to request certain medications. The topic of end of life has many different categories that can be discussed. Certain things can make an end of life experience a positive one or negative. Health care professionals, family, or friends have to be involved in someone’s end of life plan for it to be successful. My research will identify and define the topic of pain management and medications and why they are important when caring for the elderly. Then I will explain the implications for patients and their treatment. Finally, I will discuss nursing interventions and issues related to medications and pain management.
In end of life care, a nurses responsibility is to make the patient as comfortable as possible, manage any health complications with appropriate measures, and maintain their overall quality of life. Death could be a long or short process and nurses and other health care providers have to be prepared for anything. Managing a patient’s...
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...ed for the remainder of their life. They need to go through the steps of coming to terms with their fate and they cannot do it alone. Family support is crucial. People have more important things to do than suffer, like spend time with family members, reminisce on old times, and make arrangements for comfort. Patients need to have a support system of some sort.
Being an advocate for the patient is the more important rule of nursing and should be carried out for everyone. When someone’s life is coming to an end, it is the nurse’s job to not let him or her fear death. Their spiritual, emotional, mental, and physical needs need to be met at all times. Nearing the end of life is a scary and tough road, and there are so many ways to make it just a little easier. A little support, a lot of love, and a caring team can make someone’s end of life experience a little easier.
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...
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
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
The American Nurses Association (ANA) thinks that nurses should stay away from doing euthanasia, or assisting in doing euthanasia because it is against the Code of Ethics for Nurses with Interpretive Statements (ANA, 2001; herein referred to as The Code). Overall, nurses are also advised to deliver a quality of care what include respect compassion and dignity to all their patients. For people in end-of-life, nursing care should also focus on the patient’s comfort, when possible the dying patient should be pain free. Nurses have also the obligation to support the patient but also the patient’s family members during these difficult moments. We must work to make sure that patients and family members are well informed about every option that is
Granted, textbooks and nursing classes deal with death, but Marks explains that you do not really understand it until it is right in front of you. Overtime it becomes something that nurse’s become accustom to. To clarify the subject of death never becomes easy, it just becomes bearable. After 31 years of experience Marks explained to me that nurses have to learn how to distance themselves, yet still be caring at the same time; a trait that does not come easily to most. In the same way treating someone with a terminal illness is just as hard. In these cases nurses must step into the role of councillors. They must learn how to comfort their patient, yet not become too attached. As well they must learn how to explain to them what is happening, which can become especially hard when dealing with
The nursing profession is formed upon the Hippocratic practice of "do no harm" and an ethic of moral opposition to ending another human’s life. The Code of Ethics for nurses prohibits intentionally terminating any human life. Nurses are compelled to provide ease of suffering, comfort and ideally a death that is coherent with the values and wishes of the dying patient, however; it is essential that nurses uphold the ethical obligations of the profession and not partake in assisted suicide. (King, 2003)
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
The following are guidelines on things nurses can and cannot do. Nurses can provide care and comfort to the patient and family through all stages of the dying process, explain current law, be present during the patient’s self-administration of the medication, be involved in policy development, explore reasons for the request to name a few (Getter, 2013). Nurse cannot inject or administer the life-ending medication, subject peers, patients, and families to unwarranted or judgmental comments or actions, or abandon/refuse to provide comfort and safety measures to the patient (Getter, 2013). As with any licensure, that individual is responsible for following actions within their scope of practice. It is up to them to know their policies at an institutional and legal
Nurses are both blessed and cursed to be with patients from the very first moments of life until their final breath. With those last breaths, each patient leaves someone behind. How do nurses handle the loss and grief that comes along with patients dying? How do they help the families and loved ones of deceased patients? Each person, no matter their background, must grieve the death of a loved one, but there is no right way to grieve and no two people will have the same reaction to death. It is the duty of nurses to respect the wishes and grieving process of each and every culture; of each and every individual (Verosky, 2006). This paper will address J. William Worden’s four tasks of mourning as well as the nursing implications involved – both when taking care of patients’ families and when coping with the loss of patients themselves.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
In short, euthanasia asks questions that cannot be answered from the perspective of medicine alone. The inappropriateness between assisting voluntary death and the professional ethos of physicians may mean that physicians should not assist death, except it does not necessarily settle the argument of whether anyone ever should. Acceptance for palliative care seems to be growing, but support of assisted suicide is growing also, because end of life issues are kept in the public eye. Additional empirical analysis of this situation is important. Furthermore, this debate could continue to yield insights into the issues around suffering at the end of life.
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...
The purpose of this essay is to analyse various theories on ageing, death, dying, and end of life issues from different perspectives such as: biophysiological theories, psychosocial theories; and taking in consideration the cultural, historical, and religious implications around the aforementioned life stages. One will also discuss important issues relevant to social work practice such as dignity, autonomy, and their relationship with the concept of a successful ageing and a good death. One considers these areas important since they upheld anti-discriminatory practice and may perhaps promote the development of personalised care pathways, as well as fair and justifiable social policies.
We can see that the hospice concept is a bio-psychosocial approach to the dying process, concerned with biological, psychological, and social health. Because of its proponents, Hospice is considered a more humane and sensible approach to terminal illness, combining care, comfort, and support of family and friends as the individual faces death. Their concern for dignity and fo...
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.