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3. Literature review of palliative care
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Palliative care literature review
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1. The 4-hour shadowing experience at Casa De La Luz Hospice was insightful to the aspects of palliative care. The experience included shadowing the hospice physician and nurse as they calmly interacted with the patients, assessing for abnormalities in ABC, safety, and pain. Additionally, this experience provided examples of therapeutic communication techniques that were appropriate when speaking to patients and families.
2. Interventions that I witnessed and felt were appropriate for the dying process were catheterizing a patient, breathing treatments, and doubling the narcotic dose to a patient. These interventions were appropriate for the dying process, because it allowed for an ease in the efforts to avoid wetting the bed and to maintain
Final Gifts, written by hospice care workers, Maggie Callanan and Patricia Kelly, includes various stories detailing each of their life changing experiences that they encountered with their patients. Hospice care allows the patient to feel comfortable in their final days or months before they move on to their next life. This book contains the information considered necessary to understand and deal with the awareness, needs, and interactions of those who are dying. Not only are there stories told throughout the book, there are also tips for one to help cope with knowing someone is dying and how to make their death a peaceful experience for everyone involved. It is important that everyone involved is at as much peace as the person dying in the
God tells his children, “He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away” (Revelation). Death is one of the most frightening and confusing times a person can go through. Watching a loved one pass away is also one of the hardest trials a person can experience. Many people assume that death is a time of pain and the only thing that they can do is mourn and watch their loved one fade away from the earth. This is wrong. There are ways that people can turn a bad situation to good. Dying doesn’t have to be painful and full of suffering. The County Hospice staff makes sure of this. The Hospice staff not only takes care of passing patients physically, but they also take care of the patients emotionally and spiritually. Hospice staff also plays a key role in helping families during the grieving process.
The boundaries of right to die with dignity are hard to determine. Keeping the terminal patient comfortable is the purpose of comfort care, however there could be a very thin line between what we consider terminal sedation and euthanasia. In theory, comfort care is quite different from euthanasia. Keeping the patient comfortable and letting the nature take its course is at the core of comfort measures (Gamliel, 2012). Yet, the line between keeping comfortable and facilitating death is often blurry. Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering (Gamliel, 2012). The purpose of this paper is to highlight the ethical issue of keeping comfortable vs. hastening death, and the ethical principles involved. Facilitating or hastening death is considered unethical or even illegal.
Charalambous, A. (2010). Good communication in end of life care. Journal of Community Nursing, 24(6), 12-14. Retrieved from EBSCOhost.
After reading the different stories in the book “Final Gifts”, I believe I have a better understanding of the nurse’s role in caring for the needs of the dying patient and how their families need to be guided through this experience. The different stories in this book provide insight into the experiences of the dying as well as how their loved ones cope with their loss. The authors Maggie Callahan and Patrician Kelly, experienced hospice nurses who have extensive exposure to dying patients and their families, through their shared stories, paint a picture of what the dying want. To many, death is a difficult concept.
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...
Palliative care is medical or comfort care that reduces the severity of a disease or slows its progress, but does not provide a cure (Dreeben, 2007). Different people have different needs when life is ending. Working with the incurable may sound depressing but death is a certainty and what we do each day for these patients as physical therapist assistants, matters. Providing care effectively and appropriately has a huge impact on the patient, therefore acquiring the ability to comfort and care for a patient at such a critical stage in life, is an amazin...
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
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,
(2007). The 'Standard' of the 'Standard'. A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. The New England Journal of Medicine, 356(5), 469-478. Patton, D. (2004).
The patient defines who family is and who can take part in bedside shift report”(Hunt, 2014). In 2015 the joint commission implemented a set of safety goals to improve patient quality of care (Atta, 2015). The bedside shift report benefits the patient because they are able to listen to the nurses discuss the care plan of care for the day (Meisel & Smith, 2015). The patient feels as if they play an active roll in their own care and they see how the nurses work together as a
The nursing discipline embodies a whole range of skills and abilities that are aimed at maximizing one’s wellness by minimizing harm. As one of the most trusted professions, we literally are some’s last hope and last chance to thrive in life; however, in some cases we may be the last person they see on earth. Many individuals dream of slipping away in a peaceful death, but many others leave this world abruptly at unexpected times. I feel that is a crucial part to pay attention to individuals during their most critical and even for some their last moments and that is why I have peaked an interest in the critical care field. It is hard to care for someone who many others have given up on and how critical care nurses go above and beyond the call
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.
60). December 1, 2017 will forever be a day that changed my life. It was my first official day at placement. I arrived on the floor dressed and prepared for a day of learning. Once all the patient care assistants (PCAs), registered practical nurses (RPNs), and registered nurses (RNs) gathered, the head RN began to deliver the daily report. I listened carefully for my patient’s name and discovered that they were making great progress. The head RN finished by mentioning that there was a palliative patient on the floor. New to the nursing field, I was unaccustomed to the word palliative, however I quickly learned when I passed by the patient’s room and noticed the patient’s friends and family filling the room with tears. I continued on with my day, making my patient top priority. I was later informed that the palliative patient had passed away. The feeling of grief grew upon me, regardless of even knowing the patient. Our instructor offered the students the chance to see the patient’s body. Having grown up on a farm, I figured the sight of a deceased person would not alarm me. As we entered the dark room, it felt as if we were hit by the cold. The deceased remained covered head to toe by a white blanket. The students gathered quietly around the deceased. There was a moment of silence, where respect was given to the dead. Shortly after
The nurse stated during the interview that “holding the hand of the patient just diagnosed with a terminal illness” (Appendix A) is difficult and requires a variety of techniques to face the situation. There are many ways to approach a dying patient, and one study identified four themes that help nurses in creating a “’curtain of protection’ to mitigate the grieving process and allow them to provide supportive nursing care” (Gerow et al., 2010). Of the four approached, there is one that appears to make the greatest impact on the nurse; the fact that initial patient deaths are formative. In this case, a study found that “significant death experiences early in a nurse’s career set the foundation for how the nurse began caring for future dying patients” (Gerow et al., 2010), which was further explained as the fact that those who had enough support and mentorship early on in their nursing practice were more likely to not be emotionally damaged by the event, and were able to better approach similar situations in the future. I plan on implementing this strategy in the future by surrounding myself with colleagues and mentors within my practice that I am comfortable confiding in whenever I happen to be struggling. A strong support network is key for maintaining proper emotional health, which is important for a nurse to have when working with vulnerable patients and providing competent