Why Is End Of Life Care Important
Clinical decision making and end of life care
The purpose of this essay is to discuss important aspects of clinical intervention in Australia health care settings and end of life care. A vast number of the population in Australia is ageing and numerous people suffer form chronic illnesses, they have more chances to die in the near future. As a consequence the focus of the end of life care resources is concentrated in the elderly and chronic sufferers. Resources such as financial, human and technological are put in place to provide the best care possible for this population. As human resources nurses play an important role in the management of patients in terminal stages.
In a clinical reflection by a nurse student (Bail, 2007) she …show more content…
stated the importance of communication and engagement from the nurses towards the patients as a vital task in the decision making process. Is a reality that nurses are overwhelmed by the nature of their job, looking after an ill population in most cases, however is this same nature the one that makes the relationship between nurses and patients so unique. The drive of nurses is to care for the person as a whole, physically, phsicologicaly and mentally. However due to external factors such as long work hours, stress, poor working conditions, tiredness, etc., the nurses job is affected and they can not engage a proper communication with the patient which is imperative in any case and mostly approaching the end of life.
Emotional support is vital when talking about death, and the nurse are an influential component in providing this support to patients and families at that terminal stage.
However this emotional support has been underestimated, as an example, clinical pathways are applied across the world in the past 10 years (Phillips et al., 2011), although they are widely implemented, they do not include emotional or psychosocial support. In order to improve the care of the terminal ill person is important to provide all the necessary elements to establish a better relationship between nurses and patients, fundamental aspects are communication, knowledge, and …show more content…
trust.
Part of the initiatives about end of life care in Australia is the Respecting Patient Choices, (Austin Health., 2010), is an Australian Care Model that encourage people to make their own choices about health care earlier in case of an unexpected future outcome that results in the impossibility of make decisions. The program is based in Advance Care Planning which means that the patient will evaluate a serial of stages, regarding potential medical care in case of an accident or an unfortunate medical condition. The importance of Advance Planning is to stop the suffering of a human being and give them the best end of life possible and at the same time to provide another human being with quality of life whit the organ donation.
Another initiative is the home transfer at the end of life, ruling out for the patient the stay at the intensive care unit in a hospital (Tellett et all., 2012). Transfer at home aims to improve the quality of life and to respect the choice of the patient about the best way to end life. In this technological modern era is very common for terminal ill patients to be treated in the hospital setting at the intensive care units that provides all the best treatments possible however at times while is the clinicians best practice is not the choice of the patient to remain in the hospital at the end of his life, the majority of individuals have the desire to die at home.
Death and birth are part of life and at the same time are reflexions about the human nature, the function of nurses providing care in this phase is very complex as death is often random and unexpected (Tellet et all., 2012).
Nursing care towards the end of life has an important role and its principal aim is to fin de adequate treatment physical, emotional and social as a holistic care. The nurse goal is to provide the best conditions and quality of life to the patient and its family. As well as deliver elements trough communication to adjust them to a new reality, which is the certainty to the proximity to death. Part of communication includes a multidisciplinary health team, such as palliative care, psychology, social workers, general practitioners, nurses, etc.
Facing end of life is not an easy task for anyone, and the essence of nurses is to care for the human being as a whole, their function is to maximize the use of the resources with the aim to look after the patient and at the same time make it and active actor that manages their own individual decisions. The effect of a deadly health condition has impacts in the patient and its surroundings, affecting the person in all spheres, physical, psychological, social and economic. This requires the person to cope not merely with the disease but with the additional
situations.
Base of a good clinical decision is the communication and good relationship nurse-patient, the nurse have the duty to humanize the contact between the health professional and the patient and family. Communication is an active process that identifies and prioritizes necessities and promotes an adequate care plan with the purpose of the best treatment possible. Nursing care and communication at the end of life must be evidence based, respecting patient beliefs, cultural background, and helping the patient to maintain its dignity at all times. Communicating the best possible options and letting the patient o the family make its final decision about the treatment.
To establish a good decision making frame for the patient at the end of life, the health professional must be open for communication, include the patient, carer and family, to discuss about the best treatment options, or the alternative possibility if the patient takes the decision of withdraw the treatment. This is particularly important when the patient has awareness about what is happening around and it is able to make an output about the situation, and yet even if they are not aware is still important for them to be informed and included in the decision process.
End of life care planes must include activities that encourages the independency of the person as much as possible, this contributes to self-stem and alleviates depression and sadness, is also crucial to involve the family and carer in this final stage educating them in relation to skin care, nutrition, hygiene, complications, physical and psychological changes, and medication treatment. Is basic for a care plan to include interdisciplinary involvement that facilitates a good end of life approach and meets the needs of the dying person, nutritional supplies, good symptom control, palliative care, education for the family, psychological support.
Nursing care at the final stage of life is based in communication, establishing a relationship patient-nurse-family, initiating paths for them to express their own doubts, anxiety’s and emotions. Every single person has its own reaction about end of life, influenced for its own environment and personal experiences. Caring for a patient at the end of life is an ethic, moral and knowledge based practice that involves the nurse own values and emotions. An ill person should be considered as human being, and for its care; communication is a priority, an essential therapeutic skill for every member of the professional health team as well as the family and carers, with all respect allowing the dying process a natural course for a dignifying end of life.
Communication, information processing and relationship building, contributes to the quality of the clinical decision making process (Torke et all., 2011). As a part of the decision making is the consent process, is a complex process that includes all the health team professionals, and maybe informed or implied (Cole., 2012). This process is designed to protect the patient autonomy and their ability to make own choices, which at the end of life may include the refusal or approval of possible medical treatment. A person has the entitlement of making decisions about their wellbeing without intervention of others.
REFERENCES
Austin Health. (2010). Respecting Patient Choices (Booklet). Victoria, Australia.
Bail, K. S. (2007). Engaging nurses in patient care: Clinical reflection by a student nurse. Contemporary Nurse, 25, 156-162.
Clayman, M. L., Makoul, G., Harper, M. M., Koby, D. G., Williams, A. R. (2012). Development of a shared decision making coding system for analysis of patient-healthcare provider encounters. Patient Education and Counseling, 88, 367-372.
Cole, C. A., (2012). Implied consent and nursing practice: Ethical or convenient?. Nursing Ethics, 19(4), 550-557.
Jeong, S. Y., Higgins, I., McMillan, M. (2010). The essentials of Advance Care Planning for end-of-life care for older people. Journal of Clinical Nursing, 19, 389-397.
Lind, R., Lorem, G. F., Norvedt, P., Hervoy, O. (2011). Family members’ experiences of “wait and see” as a communication strategy in the end-of-life decision. Intensive Care Medicine, 37(7), 1143-1150.
Moreau, A., Carol, L., Dedianne, M. C., Dupraz, C., Perdrix, C., Lainé, X., Souweine, G. (2012). What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews. Patient Education and counseling, 87, 206-211.
Phillips, J. L., Halcomb, E. J., Davidson, P. M. (2011). End-of-Life Care Pathways in Acute and Hospice Care: An integrative Review. Journal of Pain and Symptom Management, 41(5), 940-955.
Schlairet, M. (2009). End of Life Nursing Care: Statewide survey of nurses education needs and effects of education. Journal of Professional Nursing, 25(3), 170-177.
Tellett, L., Pyle, L., Coombs, M. (2012). End of life in intensive care: Is transfer home an alternative?. Intensive and critical care nursing, 28(4), 234-241.
Torke, A. M., Petronio, S., Sachs, G. A., Helft, P. R., Purnell, C. (2012). A conceptual model of the role of communication in surrogate decision making for hospitalized adults. Patient Education and Counseling 87, 54-61.
Watts, T. (2012). Initiating end-of-life care pathways: a discussion paper. Journal of advanced nursing, 68(10), 2359-2370.
Youll, J. W. (1989). The bridge beyond: strengthening nursing practice in attitudes towards death, dying, and the terminally ill, and helping the spouses of critically ill patients. Intensive care nursing, 5, 88-94.
The purpose of this essay is to discuss important aspects of clinical intervention in Australia health care settings and end of life care. A vast number of the population in Australia is ageing and numerous people suffer form chronic illnesses, they have more chances to die in the near future. As a consequence the focus of the end of life care resources is concentrated in the elderly and chronic sufferers. Resources such as financial, human and technological are put in place to provide the best care possible for this population. As human resources nurses play an important role in the management of patients in terminal stages.
In a clinical reflection by a nurse student (Bail, 2007) she …show more content…
stated the importance of communication and engagement from the nurses towards the patients as a vital task in the decision making process. Is a reality that nurses are overwhelmed by the nature of their job, looking after an ill population in most cases, however is this same nature the one that makes the relationship between nurses and patients so unique. The drive of nurses is to care for the person as a whole, physically, phsicologicaly and mentally. However due to external factors such as long work hours, stress, poor working conditions, tiredness, etc., the nurses job is affected and they can not engage a proper communication with the patient which is imperative in any case and mostly approaching the end of life.
Emotional support is vital when talking about death, and the nurse are an influential component in providing this support to patients and families at that terminal stage.
However this emotional support has been underestimated, as an example, clinical pathways are applied across the world in the past 10 years (Phillips et al., 2011), although they are widely implemented, they do not include emotional or psychosocial support. In order to improve the care of the terminal ill person is important to provide all the necessary elements to establish a better relationship between nurses and patients, fundamental aspects are communication, knowledge, and …show more content…
trust.
Part of the initiatives about end of life care in Australia is the Respecting Patient Choices, (Austin Health., 2010), is an Australian Care Model that encourage people to make their own choices about health care earlier in case of an unexpected future outcome that results in the impossibility of make decisions. The program is based in Advance Care Planning which means that the patient will evaluate a serial of stages, regarding potential medical care in case of an accident or an unfortunate medical condition. The importance of Advance Planning is to stop the suffering of a human being and give them the best end of life possible and at the same time to provide another human being with quality of life whit the organ donation.
Another initiative is the home transfer at the end of life, ruling out for the patient the stay at the intensive care unit in a hospital (Tellett et all., 2012). Transfer at home aims to improve the quality of life and to respect the choice of the patient about the best way to end life. In this technological modern era is very common for terminal ill patients to be treated in the hospital setting at the intensive care units that provides all the best treatments possible however at times while is the clinicians best practice is not the choice of the patient to remain in the hospital at the end of his life, the majority of individuals have the desire to die at home.
Death and birth are part of life and at the same time are reflexions about the human nature, the function of nurses providing care in this phase is very complex as death is often random and unexpected (Tellet et all., 2012).
Nursing care towards the end of life has an important role and its principal aim is to fin de adequate treatment physical, emotional and social as a holistic care. The nurse goal is to provide the best conditions and quality of life to the patient and its family. As well as deliver elements trough communication to adjust them to a new reality, which is the certainty to the proximity to death. Part of communication includes a multidisciplinary health team, such as palliative care, psychology, social workers, general practitioners, nurses, etc.
Facing end of life is not an easy task for anyone, and the essence of nurses is to care for the human being as a whole, their function is to maximize the use of the resources with the aim to look after the patient and at the same time make it and active actor that manages their own individual decisions. The effect of a deadly health condition has impacts in the patient and its surroundings, affecting the person in all spheres, physical, psychological, social and economic. This requires the person to cope not merely with the disease but with the additional
situations.
Base of a good clinical decision is the communication and good relationship nurse-patient, the nurse have the duty to humanize the contact between the health professional and the patient and family. Communication is an active process that identifies and prioritizes necessities and promotes an adequate care plan with the purpose of the best treatment possible. Nursing care and communication at the end of life must be evidence based, respecting patient beliefs, cultural background, and helping the patient to maintain its dignity at all times. Communicating the best possible options and letting the patient o the family make its final decision about the treatment.
To establish a good decision making frame for the patient at the end of life, the health professional must be open for communication, include the patient, carer and family, to discuss about the best treatment options, or the alternative possibility if the patient takes the decision of withdraw the treatment. This is particularly important when the patient has awareness about what is happening around and it is able to make an output about the situation, and yet even if they are not aware is still important for them to be informed and included in the decision process.
End of life care planes must include activities that encourages the independency of the person as much as possible, this contributes to self-stem and alleviates depression and sadness, is also crucial to involve the family and carer in this final stage educating them in relation to skin care, nutrition, hygiene, complications, physical and psychological changes, and medication treatment. Is basic for a care plan to include interdisciplinary involvement that facilitates a good end of life approach and meets the needs of the dying person, nutritional supplies, good symptom control, palliative care, education for the family, psychological support.
Nursing care at the final stage of life is based in communication, establishing a relationship patient-nurse-family, initiating paths for them to express their own doubts, anxiety’s and emotions. Every single person has its own reaction about end of life, influenced for its own environment and personal experiences. Caring for a patient at the end of life is an ethic, moral and knowledge based practice that involves the nurse own values and emotions. An ill person should be considered as human being, and for its care; communication is a priority, an essential therapeutic skill for every member of the professional health team as well as the family and carers, with all respect allowing the dying process a natural course for a dignifying end of life.
Communication, information processing and relationship building, contributes to the quality of the clinical decision making process (Torke et all., 2011). As a part of the decision making is the consent process, is a complex process that includes all the health team professionals, and maybe informed or implied (Cole., 2012). This process is designed to protect the patient autonomy and their ability to make own choices, which at the end of life may include the refusal or approval of possible medical treatment. A person has the entitlement of making decisions about their wellbeing without intervention of others.
REFERENCES
Austin Health. (2010). Respecting Patient Choices (Booklet). Victoria, Australia.
Bail, K. S. (2007). Engaging nurses in patient care: Clinical reflection by a student nurse. Contemporary Nurse, 25, 156-162.
Clayman, M. L., Makoul, G., Harper, M. M., Koby, D. G., Williams, A. R. (2012). Development of a shared decision making coding system for analysis of patient-healthcare provider encounters. Patient Education and Counseling, 88, 367-372.
Cole, C. A., (2012). Implied consent and nursing practice: Ethical or convenient?. Nursing Ethics, 19(4), 550-557.
Jeong, S. Y., Higgins, I., McMillan, M. (2010). The essentials of Advance Care Planning for end-of-life care for older people. Journal of Clinical Nursing, 19, 389-397.
Lind, R., Lorem, G. F., Norvedt, P., Hervoy, O. (2011). Family members’ experiences of “wait and see” as a communication strategy in the end-of-life decision. Intensive Care Medicine, 37(7), 1143-1150.
Moreau, A., Carol, L., Dedianne, M. C., Dupraz, C., Perdrix, C., Lainé, X., Souweine, G. (2012). What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews. Patient Education and counseling, 87, 206-211.
Phillips, J. L., Halcomb, E. J., Davidson, P. M. (2011). End-of-Life Care Pathways in Acute and Hospice Care: An integrative Review. Journal of Pain and Symptom Management, 41(5), 940-955.
Schlairet, M. (2009). End of Life Nursing Care: Statewide survey of nurses education needs and effects of education. Journal of Professional Nursing, 25(3), 170-177.
Tellett, L., Pyle, L., Coombs, M. (2012). End of life in intensive care: Is transfer home an alternative?. Intensive and critical care nursing, 28(4), 234-241.
Torke, A. M., Petronio, S., Sachs, G. A., Helft, P. R., Purnell, C. (2012). A conceptual model of the role of communication in surrogate decision making for hospitalized adults. Patient Education and Counseling 87, 54-61.
Watts, T. (2012). Initiating end-of-life care pathways: a discussion paper. Journal of advanced nursing, 68(10), 2359-2370.
Youll, J. W. (1989). The bridge beyond: strengthening nursing practice in attitudes towards death, dying, and the terminally ill, and helping the spouses of critically ill patients. Intensive care nursing, 5, 88-94.