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Care at the end of life

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Care at the end of life
Care at the end of life

Leah Brown

HCS/545

October 31, 2013

Valerie Platt

Care at the end of life

It is a fact that humans are born to die. What was once considered a natural part of life has changed to an experience that may be more painful for the patient, family, and caregivers due to the advances in medical care. New procedures have allowed life to be extended longer than ever before. The question is: has the dying experience improved? This paper will include a review of death and dying from the perspectives of the patient and caregivers. An unfortunate case will be discussed, and the organizational structure, culture, and governance that led to this situation will be reviewed. Recommendations for the changes necessary to prevent such cases in the future will be included. Ms. Smith was a 66 -year -old female with breast cancer that had metastasized to her lungs and liver. She had two adult daughters who lived in her home town and one of them had a young child. Mr. Smith was a 70- year-old retired factory worker. Ms. Smith had gone through lengthy chemotherapy and radiation treatments that had left her weak and debilitated. She developed pneumonia and experienced a respiratory arrest. She was placed on a ventilator and was weaned off the ventilator after two weeks.
She remained in the Intensive Care Unit (ICU). Her family stayed with her as much as the ICU visiting hours allowed, but she was often alone and told her family that she was in pain and wanted to die. The nurses were concerned about her pain needs, but were also worried that too much medication could cause another respiratory arrest. Ms. Smith languished in the ICU for two months until she did have another respiratory arrest and died without her family at her side. She and her family had agreed that she would not go back on the ventilator, and the physicians had written a Do Not Resuscitate (DNR)



References: Cantlupe, J. (2013, September). A fresh look at end-of-life care. Health Leaders, 12-22. Gastman, C. (2012, September). Nursing ethics perspective on end-of-life care. Nursing Ethics, 19(5), 603-604. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/1041054841 Gourdji, Iris. McVey, L., & Purden, M. (2009, Spring). A quality end of life from a palliative care patient 's perspective. Journal of Palliative Care, 25(1), 40-50. Izumi, S., Nagae, H., Sakurai, C., & Imamura, E.  (2012, September). Defining end-of-life care from perspectives of nursing ethics. Nursing Ethics, 19(5), 608-616. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/1041054846 Silveira, M., & Forman, J. (2012, May). End-of-Life Care from the perspective of Primary Care Providers. Journal of General Internal Medicine, 27(10), 1287-93. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/1040945319 Singer, P., Martin, D., & Kelner, M. (1999, January). Quality end-of-life: patient perspective. The Journal of the American Medical Association, 28(12), 163-168. Retrieved from http://av4kc7fg4g.search.serialssolutions.com.ezproxy.apollolibrary.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Quality+End-of-Life+Care%3A+Patients%27+Perspectives&rft.jtitle=JAMA%3A+The+Journal+of+the+American+Medical+Association&rft.au=Singer%2C+Peter+A&rft.au=Martin%2C+Douglas+K&rft.au=Kelner%2C+Merrijoy&rft.date=1999-01-13&rft.pub=JAMA&rft.eissn=1538-3598&rft.volume=281&rft.issue=2&rft.spage=163&rft_id=info:doi/10.1001%2Fjama.28 1.2.163&rft_id=info:pmid/9917120&rft.externalDBID=n%2Fa&rft.externalDocID=281%2F2%2F163&paramdict=en-US Volker, D., Kahn, D., & Penticuff, J. (2004, September). Patient control and end-of-life care part II: the patient perspective. Oncology Nursing Forum, 31(5), 954-960. Retrieved from http://av4kc7fg4g.search.serialssolutions.com.ezproxy.apollolibrary.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Patient+Control+and+End-of-Life+Care+Part+II%3A+The+Patient+Perspective&rft.jtitle=Oncology+Nursing+Forum&rft.au=Volker%2C+Deborah&rft.au=Kahn%2C+David&rft.au=Penticuff%2C+Joy&rft.date=2004-09-01&rft.issn=0190-535X&rft.eissn=1538-0688&rft.volume=31&rft.issue=5&rft.spage=954&rft.epage=960&rft_id=info:doi/10.1188%2F04.ONF.954-960&rft.externalDBID=n%2Fa&rft.externalDocID=10_1188_04_ONF_954_960&paramdict=en-US White, D., & Curtis, J. (2005, December). Care near the end-of-life in critically ill patients: a North American experience. Current Opinion in Critical Care, 11(6), 610=615. Retrieved from http://av4kc7fg4g.search.serialssolutions.com.ezproxy.apollolibrary.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Care+near+the+end-of-life+in+critically+ill+patients%3A+a+North+American+perspective&rft.jtitle=Current+Opinion+in+Critical+Care&rft.au=White%2C+Douglas+B&rft.au=Curtis%2C+J+Randall&rft.date=2005-12-01&rft.issn=1070-5295&rft.eissn=1531-7072&rft.volume=11&rft.issue=6&rft.spage=610&rft.epage=615&rft_id=info:doi/10.1097%2F01.ccx.0000184301.76007.70&rft.externalDBID=n%2Fa&rft.externalDocID=10_1097_01_ccx_0000184301_76007_70&paramdict=en-US

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