Question:
In Australia, most people who die receive care in the acute setting for end-of-life.
The aim of acute hospitals, which are primarily aimed at treating and releasing cured patients, is to diagnose and treat them.
Recognizing a patient in need of end-of–life care and providing terminal care are often delayed in this setting.
There are many issues that affect nurses and people who care for them at the end.
These issues include
Pain management
Patients and families are supported.
information and support offered to patients and families
Recognizing death, and
Understanding the treatment process.
Write an essay explaining the care requirements for end-oflife care in an acute care setting.
Write about the challenges faced by nurses who deliver this care.
Answer to Question: NURS 300 Professional Transitions In Nursing
Care for dying patients: The role of nurses at acute hospitals
Australia is considered to be a death-denying’ nation.
There have been a lot of efforts to improve the health care system and policies in Australia.
Around 70% of all diseases diagnosed in Australian hospitals are chronic.
Patients who are suffering from a chronic illness need medical attention. This makes their final days more comfortable.
Palliative services are offered to patients who are terminally ill to provide comfort care.
In a hospital environment that is task-oriented, patients are treated with the sole purpose of relieving their suffering.
In such settings, safety of end of life care is a concern as dying patients often aren’t given the necessary attention.
Most nurses are responsible for safe end of life care in clinical settings.
However, patients suffer tremendous pain in their final days because of a number of factors, such as poor communication between patients and their family, late detection of protracted illnesses, and poor pain management (Rosenstein (2011)).
It is not possible to consider psycho-societal needs or holistic pain management for those who are dying.
According to surveys and available literature, it is clear that even with the advances in medical technology and all types of resources, there are still flaws.
We will be highlighting the difficulties nurses face while caring for dying patients at acute hospitals.
It will allow us to see the real issues and what we can do to address them.
The existing care-giving practices might be raised.
To provide the best care possible for a dying person, it is essential to become intimately acquainted with them and their family members.
Although nurses gave individual care to dying patients, they tended to focus on meeting their physical needs. They often neglected their emotional needs.
The new environment in the hospital, chronic pain, loneliness and separation from spouse can all make it easy for patients to feel afraid.
At this stage, it is crucial to engage with the patient and listen to his concerns.
Families and patients may have special questions or needs that change as they progress through illness. Such needs can be addressed throughout the caretaking process (Van dersteen et. al., 2014.
One situation could be that a nurse is required to provide care for a dying patient while simultaneously caring for another patient.
This scenario is very common in all acute care hospitals.
Nursing staff are less capable of meeting the patient demand due to time and work constraints.
Negative reactions, mental disorders, and frustrations can lead to non-cooperation by patients. This is why nurses are required to manage all difficult situations.
If a terminal illness is diagnosed early, it gives the doctor and nurse community more time for treatment.
While the patient eventually dies, early diagnosis of terminal illness and proper assessment reduces the suffering and pain the patient suffers in his final days.
Unfortunately, medicines cannot significantly reduce suffering.
An accurate analysis of the patient’s pain-pattern and thorough assessment by nurses of his suffering under different conditions can lead to better care (Dansie & Turk (2013)).
It is important for doctors and other healthcare professionals that a timely diagnosis is made so they can keep trying new treatments without giving up.
It reduces the likelihood of over-treatment and prolonged medications that can cause unnecessary pain, harassment, fear, or stress for patients and their families (Hickman & Douglas (2010)).
Enduring pain for patients with terminal illnesses must be managed with extreme care.
It helps reduce stress levels in patients.
The goal of pain management is to give maximum pain relief and minimize side effects.
Wei and colleagues (2016) recognize that pain can be more than just physical.
A nurse’s ability to accurately assess pain and manage pain for patients is improved by having knowledge of this topic.
Even though many nurses expressed interest in helping dying patients with their spiritual needs, it is not something they do.
Spiritual needs become more significant towards the end (Garcia & KOENIG 2013).
Some patients may desire to make amends with loved ones who offer spiritual comfort.
Fulfilling the wishes of the patients’ last wishes can also bring them comfort.
These can all be assisted by a nurse.
Families need to prepare for the future and plan what to do after the death.
A second issue is the non-disclosure information about terminal illnesses (Bloomer et. al., 2011).
A majority of terminal patients desire to die at home surrounded by loved ones and friends.
They are very rare to see their wishes fulfilled (Fischer, et al. (2013).
In order to learn such wishes, nurses should be able take the patient to the nurse in confidence.
It reduces the pain of death, and it advocates for the patient’s preferred setting for a dignified and peaceful death.
A nurse is able to offer comfort and support to the family, as well as grief and bereavement support throughout the dying process.
An emergency care plan must be prepared by the nurse and the interdisciplinary team in consultation with the patient’s loved ones.
Since nurses are able to communicate the most with patients and their family members, they must make sure the care plan is appropriate and current.
Only nurses can meet these challenges. They are uniquely placed to improve the care of patients who are terminally ill by lowering costs and by successfully navigating the amendments to the health care legislation that finally prepares the future for the healthcare industry (Berglund und al. 2012).
The ever-present challenges of increasing workload and time limits mean that health care staff must do their best to provide quality healthcare in acute hospitals.
The environment in hospitals should be safer and more conducive to providing safe and effective death care.
A nurse must be skilled enough to help a patient who is nearing the end of his life.
All health care personnel, including doctors and nurses, must collaborate to establish a standard model of care for these patients.
It is essential to provide effective care by providing quiet spaces, understanding the patient’s mental condition and planning for their care.
As a nurse, you must pledge to provide safety and comfort for your patient all of your life.
Nursing care at the end of life will be more meaningful if nurses are more mindful about these issues.
Nursing staff must receive special education and training to ensure comfort for dying patients.References:
Australian Commission on Safety and Quality in Health Care. (2013).
Background paper on Safety and Quality in End-of Life Care in Acute Hospitals.
Sydney: ACSQHCBerglund, M., Westin, L., Svanstrom, R., & Sundler, A. J. (2012).
Hospital patients’ experiences with suffering caused by hospital care. International Journal of Qualitative Studies on Health and Well-Being, 7, 10.3402/qhw.v7i0.18688.Bloomer, M., Moss, C., & Cross, W. (2011). End-of-life care in acute hospitals: An integrative literature review.
Journal of Nursing and Healthcare of Chronic Patients, 3(3), 173-173.Dansie, E. J., & Turk, D. C. (2013).
Assessment of chronic pain patients.
BJA: British Journal of Anaesthesia.Fischer, S., Min, S., Cervantes, L., & Kutner J. (2013).
Which place would you like to spend your final days?
Patients admitted to hospital have a low level of concordance in their preferred and actual death sites.
Journal of Hospital Medicine (8(4),178–183Garcia, K., & KOENIG, H. G. (2013).
Re-examining the Definitions of Spirituality in Nursing Research.
Journal of Advanced Nursing. 69(12), 2622–2634.Hickman, R. L., & Douglas, S. L. (2010).
Impact of chronic critical illness on the psychological outcomes of family members.
AACN Advanced Critical Care. 21(1), 80–91.Rosenstein, D.L. (2011).
Patient with cancer, depression and end-of–life care.
Dialogues on Clinical Neuroscience 13, 1: 101-108.Van der Steen, J.T., Radbruch, L., Hertogh, C.M.P.M., E de Boer, M., Hughes, J.C., Larkin, P., Francke, A.L., Junger, S., Gove, D., Firth, P., Koopmans, R.T.C.M., & Volicer, L. (2014).
White paper to define optimal palliative Care for older people with dementia: A Delphi Study and recommendations from European Association for Palliative Care.
Palliative Medicine. 8(3). 197-209.Wei, D., Liu, X.Y., Chen, Y.Y., Zhou, X., & Hu, H.P. (2016).
An Integrative Review on the Effectiveness of Physical and Psychological, Social, Spiritual, and Social Interventions for Breast Cancer Survivors.
Asia-Pacific Journal of Oncology Nursing. 3(3): 226-232