Palliative Care in Health Care

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.

In 2003, the American Nurses’ Association published a position statement regarding “Pain Management and Control of Distressing Symptoms in Dying Patients.” The organization states:

In the context of the caring relationship, nurses perform a primary role in the assessment and management of pain and other

distressing symptoms in dying patients. Therefore, nurses must use effective doses of medications prescribed for symptom control

and nurses have a moral obligation to advocate on behalf of the patient when prescribed medication is insufficiently managing pain

and other distressing symptoms. The increasing titration of medication to achieve adequate symptom control is ethically justified.

I would like to expand this idea from what appears to be an end-of-life hospice position to the broader based idea of palliative care. My experience in both the medical-surgical and the intensive care settings have left me with the feeling that this specialty is often overlooked and underutilized in the acute care setting. It is generally believed that palliative care is the same thing as hospice or that a patient must stop aggressive treatment in order to receive it. Many of my colleagues, including physicians, have a preconceived notion that if palliative care is involved, it usually means the patient will be placed on an end-of-life protocol with a morphine drip. This co...

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...eeds of the adult/gerontology population, especially within the context of palliative care. As nursing continues to shift towards an evidence-based approach in health care, I am also interested in participating in the synthesis and dissemination of research-based guidelines in palliative care. UCLA’s advanced practice nursing degree program is nationally recognized and the medical center is known for its care on the adult/geriatric population. My brief tenure at UCLA has been a rewarding experience and an opportunity to continue contributing to this institution as an advanced practice nurse in palliative care would be an honor. My goal to maximize the use of this valuable, but currently underutilized resource within the acute care setting is ultimately about helping patients achieve and maintain a quality of life that is both acceptable to them and their families.