...care advocate is the most important role a nurse serves as a health care provider. Nurses serve to support the patient, sometimes having to put their own personal beliefs and values to the side. Although this is ingrained in us as nurses, sometimes health care providers allow their emotions to alter their perspective when dealing with death and dying. For twenty-four years I have served as a critical care nurse, and as an ICU nurse, I have been trained to help patients and families through this time of illness to provide care to help them heal and get better. Despite all that we do to treat patients, sometimes their illnesses are such that they do not get better and a decision is made to pursue comfort care. Since we are trained to help patients and families heal, this can be difficult to handle. Regardless of my personal feelings or beliefs, I always encourage my patients and their families to make the decisions that are best for them with the information they have been given. Our job as patient care advocates is crucial, especially when dealing with end of life and quality of life issues. The National Institute of Health defines hospice as “end of life care provided by health professionals and volunteers.” This type of care gives attention to pain control while trying to keep the patient as alert as possible. A referral to hospice is placed when a patient has been given less than six months to live. The goal of hospice is to maintain dignity and comfort while making...
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...Nursing Nurses face various ethical and legal issues in the medical setting. As professionals, nurses must be aware of these legal and ethical issues when they occur. Nurses have a legal and ethical obligation to respond to these issues. Being a professional nurse requires a nurse to assess the pros and cons of different situations, but also to withhold their personal beliefs and listen and respect the beliefs and traditions of others. Legally Nursing implications require nurses to maintain licensure, obey state and federal laws and to remain within their scope of practice. Within these legal and ethical issues the American Association Code of Nursing ethics, personal and societal values, legal aspects and legal responsibilities all affect decisions. Two different cases will be discussed and explored; an advance directive case involving a woman by the name of Marianne, and a malpractice case involving a nurse and the involved healthcare organization. The American Nurses Association Code of Nursing Ethics can influence the final decision made in the case study involving Marianne’s family by designating a surrogate. According to "American Nurses Association" (2011), “The nurse supports patients self-determination by participating in discussions with surrogates, providing guidance, referral to other resources as necessary, and identifying and addressing problems in the decision-making process” (1.4). In the case study involving malpractice, the nurse being called upon...
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...Come Join the Hospice and Palliative Nurses’ Association Houston chapter! Why Join HPNA Houston Chapter? • Free monthly subscription to CHPNA TODAY, a nursing journal with up-to-date articles and the most cutting edge research in hospice and palliative nursing • Speakers teach us how to apply research findings in clinical practice! • Bi-annual workshops and CEU’s • Fellowship with like minded professionals and networking opportunities • Houston chapter sponsors a bi-monthly newsletter for all things local in Hospice and Palliative Care! • Free study materials for CHPN certification! • Free Tote bag, T-shit and professional pin! Requirements for Membership: • Must be RN or LVN practicing in Hospice and/or Palliative Care setting for 18 months+ (special circumstances considered) • $120 yearly member ship fee, waived for members 55 years and up! American Cancer Society says, “HPNA is leading the charge for evidence based practice in a bourgeoning specialty.” Ruth M RN says, “ I have been a hospice nurse for 10 years, and yet I learn something new about this field and how to deliver care nearly every week!” Come see for yourself! This Monday November 15th HPNA Houston chapter is hosting an Ice Cream Social with keynote guest speaker Dr. John Wessley. Topic: “Caregiver Fatigue: Caring for yourself and Others, an RN’s perspective” Monthly meetings held the third Friday of the month 7:00p-8:30p In the M.D. Anderson...
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...staff nurses and hospice nurses collaborate on the administration of morphine. The rationale for this question is nurses are to medically provide comfort to the dying but not assist with a rapid increase of death. Appendix B on page 28 asked the following questions: 1. What is the problem and why is it important? The problem that exist is morphine being issued to hospice patients and the medication suppresses respirations. 2. What is the current practice? The current practice is hospice patients are being ordered morphine as a standard of practice by hospice nurses and staff nurses are the practitioners who have to implement the orders. 3. What is the focus of the problem? The focus of the problem are clinical, educational. and administrative 4. How was the problem identified? Safety/Risk Management Quality Concerns Unsatisfactory Patient, Staff, or Organizational Outcomes 5. What is the scope of the problem? The scope of the problem is institution. 6. What is PICO components? P - Patient, Population, Problem - Hospice patient receiving medication as standard. The medication is noted to reduce respirations. I - Intervention - Collaborate with hospice nurses to order morphine as a individualized medication and not automatically used for protocol C - Comparison with other interventions, if applicable Research to be done to do comparison, O - Outcomes that include metrics for evaluation - The outcome of hospice staff...
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...one fade away. But there are programs out there to help not just the dying person but also the families of the dying person. Palliative care and Hospice care are two of the programs in the U.S that are tailored to medical care, pain management, and emotional and spiritual support for the patient and family. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so. Palliative care focuses on relieving symptoms that are related to chronic illnesses, such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s and other dementias, AIDS, Amyotrophic Lateral Sclerosis and other neurological diseases. World Health Organization defines Palliative care as “improving the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement” (“WHO”, 2013). Palliative care is accessed at any point during the course of a chronic illness regardless of life expectancy. It is typically provided through regular physician and nursing visits in an inpatient consultation service in a hospital setting. Palliative care is provided by a team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Some treatments and medications may be...
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...Running head: HAT Task 2 1 HAT Task 2 Anita Worley Community Health Practice March 27, 2013 Western Governor’s University A. Personal Perceptions As a Registered Nurse for thirteen years in an acute care hospital setting, I have tended to many dying patients. It is my personal belief that quality of life and health promotion are imperative to the care of the terminally ill patient. Personally, I am a big fan of palliative care nursing. The World Health Organization (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” B. Strategies Improving Mrs. Thomas’ quality of life would comprise of assisting her with her increased level of pain, limited amount of emotional support, and financial concerns. Firstly, Mrs. Thomas’ physical comfort needs addressed immediately. As evidenced by the patient spending large amounts of her day crying in bed, her pain is not under control. As her nurse, I would listen to her fears about addiction, but discuss quality of life versus drug addiction. I would explain how once her pain is tolerable, she will be able to assume a more productive, engaged role in her own life. Secondly, addressing Mr. and Mrs. Thomas’ financial...
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...Grand Canyon University: NRS-433V Introduction to Nursing Research May 20, 2012 Research Critique, Part 1 Advanced Care Planning (ACP) is a huge part of healthcare. Dying is a part of life, but that doesn’t make the subject any less scary. Just because healthcare professionals handle end of life issues on a regular basis, doesn’t mean that they are immune to the sensitivities of the topic. End-of-life decision making is the process that healthcare providers, patients, and patients’ families go through when considering what treatments will or will not be used to treat a life-threatening illness. (Thelen, 2005) Many nurses who deal with death and decision making burn out. Hospice staff, because of their work with the terminally ill, are considered a high-risk group for burnout. Often, the reason behind the decision to leave or take a sabbatical from hospice work is that the staff member reached the limits of his or her capacity to care and “couldn’t take it anymore.” (Keidel, 2002) A qualitative study done, on anticipating emotion, related to ACP, was chosen to be critiqued, due to this highly sensitive topic in the healthcare industry. The subject this study was critiqued on, were, the problem statement, purpose and research question, literature review, and conceptual/theoretical framework. The clinical problem, addressed, is that end of life discussions between healthcare professionals and clients have many areas of hindrance, due to the sensitiveness of the discussions...
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...Franciscan Hospice and Palliative Care Cindra Jones BSHS301 September 29, 2012 Christopher Bingham FRANCISCAN HOSPICE AND PALLIATIVE CARE I chose Franciscan Hospice and Palliative Care because I am interested in the valuable service they provide to the community. I wanted to know exactly what they do and how it is paid for so I made an appointment to talk to someone at the Franciscan Hospice and Palliative Care facility. Hospice is care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than a cure. The word “hospice” comes from the Latin “hospitum” meaning guesthouse. It was originally a place of shelter for sick and weary travelers. Palliative care is the treatment and relief of mental and physical pain for those with a life threatening illness. This treatment uses several types of therapy to make a person comfortable and free of pain. I was very fortunate to meet Pam Ketzner, the hospice educator and registered nurse at the Franciscan Hospice and Palliative Care facility located in University Place, Washington. Pam is in charge of educating the hospice nursing staff. With new equipment and medications always becoming available, she instructs the nurses on their proper use. She has been a nurse for 35 years. She was a visiting nurse to begin with and then became the head of education so she spends most of her time at the facility. She feels very privileged to be a part of...
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...Review of Literature Essay When a person is placed on hospice, it is generally seen as a comfort measure instead of a curative measure (Villet-Langomarsino 2018). Pain management of the hospice patient is of great importance because it is one of the few things that can be done during the end stage of life when treatment of a disease is no longer desired. Pain is a common symptom in health care and should be one of the easiest to treat due to its popularity, but unfortunately it is not. Since pain is so unique to person, assessment and treatment must be custom tailored to each patient. The problem with pain management is its specificity to each person and disease plus the numerous ways to treat it. Without one specific roadmap of treating...
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...through this difficult time by providing health care, therapy, comfort, dignity, and emotional support. The health care service that I am referring to is hospice care. Hospice care is different from regular health care in that Hospice is a style of caring for people. Hospice care is intended for patients who’s doctor puts their life expectancy no longer than six months. In the following reading I will provide a detailed description of hospice care including the demographics, services and a reason for choosing hospice as my topic. The beginnings of hospice care is debated by many authors. The majority of authors agree that a form of hospice did exist before the 19th century outside of the United States. The foundation of hospice care started to take form in London somewhere about 1948. Hospice care came to the United States in 1963 by a physician Cicely Saunders who spoke of the new style of care given to terminally ill patients. After the first introduction back in 1963 hospice care in the United States has expanded from the first hospice care center in 1974 to “today there are more than 4,700 hospice programs in the United States.* Hospice programs cared for 965,000 people enrolled in Medicare in 2006,** and nearly 1.4 million people in the United States in 2007* ("What Is Hospice(about Hospice)", 2012). The Hospice team works in different ways than a normal medical team would. The...
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...Hospice Care HCS 212 December 12, 2012 Hospice Care Hospice is a very special type of healthcare that offers comfort and support for patients and families that are facing a terminal illness. The focus is put on making a patient comfortable with a quality of life instead of a cure. The main goal is for a patient to have comfort and free of pain, with the hope that they will live each day as fully as possible, allowing people to live the remainder of their life with comfort and dignity. Hospice services are available for people that can no longer benefit from curative treatments, and are different from other types of care. You may require more help than you are used to which can be both good and bad. The life expectancy for these individuals is normally six months or less, but sometimes they do live past six months. These patients are encouraged to try and live as much of a normal life as possible and to the fullest as possible as well, they do not have to confined to a bed or stay at home 24/7. A multi-disciplinary team of physicians, nurses, pharmacists, social workers, dietician’s, hospice certified nursing assistants, clergy, therapist and bereavement counselors as well as volunteers who all work together as team to address the physical, mental, emotional, spiritual, and social needs of each and every family member. This care is provided in their own home no matter what age...
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...Children in Hospice Katrina Williams RES/110 April 26, 2012 Professor James Lazos Children in Hospice Research suggests that every year there are between 100,000 to 150,000 children born in the United States with a genetic disorder or defect. This represents approximately 20% of infant deaths each year. However, many of these children live to age well beyond the expectation, and some are enrolled in hospice. According to Armstrong-Daily and Zarbock (2001), “The concept of hospice today is applied to patients who are traveling through the final stages of their lives-in effect seeking shelter and comfort.” Hence, the main focus of this program is to prepare families for the death of a loved one. Although accepting these services is optional, families suddenly faced with the harsh reality that adulthood or even adolescence is not in their child’s future are in need of support services that offer much more than the comfort of a shoulder to cry on. There is an urgent need for organizations that strive to assist parents in helping the child to reach his or her full potential while encouraging loved ones to celebrate and cherish the time spent without the constant reminder that death is near. Caring for a child with a disability can be challenging. Immediately upon the child’s initial discharge from the hospital, life changes drastically. Parents are instantly bombarded with phone call from social workers, medical supply companies, and nursing staff for updates about...
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...R.M Community Health Task 2 When caring for the terminally ill patient, one must examine their feeling in order to provide care. It is important for the nurse not to judge the patient or family for decisions made, only to support and advocate for the patient and family during this time. As a critical care nurse the author has participated in the care of numerous terminally ill and palliative care patients. Unfortunately every person that lives will eventually die and it is the responsibility of the nurse to help improve the quality of life for the patient and offer support to the family during this dying process. The nurse must respect and honor the patient. To improve the quality of life for Mrs. Thomas, education on disease process and end of life events is of the utmost importance. Hospice is a specialty offers support and services to the terminally ill (“What is hospice,”). Not only does hospice provide services, but also a wealth of education for the patient and family. Along with education, symptom management and spiritual support are also offered to improve Mrs. Thomas’s quality of life. Pain control and symptom management can also improve the quality of life in this case. After adequate education is received, Mrs. Thomas may not be as reluctant to receive pain medication. As pain relief is obtained, the patient may enjoy more of time with her husband and may even return to church for social interaction thus increasing her quality of life. The third...
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...Hospice care The main goal of hospice care is to aid patients to live their last days as alert and pain-free as possible. Hospice care attempts to manage symptoms so that the person's last days may be spent with dignity and a good quality of life. Hospice care treats the person rather than the underlying disease; it focuses on quality of life rather than length. Hospice care is family oriented; it includes the patient and the family in the care and decision making. The care is planned to cover all 24 hours of a day, and all 7 days of the week. Care is given in the home, a hospital, nursing home, or hospice facility. Hospice care is what we resort to when the patient can no longer be helped by a curative approach, and the patient is expected to live less than 6 months. Hospice is palliative care, which means that the approach is to relieve symptoms, but not to cure the disease; its main purpose is the improvement of the patient’s quality of life. The patient, his/her family and the physician decider when hospice care should begin. Hospice care is managed by an interdisciplinary care team. What it means is that the different disciplines interact and work together towards a common goal. Doctors, nurses, CNA’s, social workers, therapists, and volunteers work together to care for the patient and his/her family. All of these people offer their support based on their individual special areas. Together, they give the patient and their loved ones complete palliative care aimed...
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...How effective communication can contribute to health, care and early years workers valuing people as individuals. All of the Migrant Helpline staff are effectively trained and know what to do automatically and so do not unnerve the client or make them feel uncomfortable by making obvious mistakes or faults if trying to communicate them. Migrant Helpline staffs also know efficient background information on each client. This is through referral forms. Referral forms are used to write down all the client details. Case booklets are filled in by all professionals, a detailed admission section and daily notes added from medical note to family details, patient’s concerns etc. case conferences held to set up support for patients going home. All written information must be sensitive and with agreement of the clients, who can see them at any time. . A follow up consultation may be needed, where questions can be answered. Stress and being upset are barriers to good communication, as is confusion and being emotionally distressed. Multi skilled professionals all work together to meet the client needs. Case workers, voluntary organizations, social workers and managements staff meet regularly to discuss and to make new plans. How client confidentiality can be maintained. Most people in caring professions and roles are aware of the need for confidentiality, but we must not assume that the client will know about this, or expect it. Some clients will have heard stories of confidentiality...
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