...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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...caring for palliative care patients?” Regina Nelson Governors State University Abstract Palliative Care Nurses are at risk of experiencing stressful situations related to symptom management and death. The aim of this paper is to critically examine the current stress nurses face caring for Palliative Care patients. Four Nursing Journals and one Psycho-Oncology were reviewed. There was strong evidence to support that nurse’s experience stress caring for Palliative care patients. Common concerns in the first study were caring for a dying patient; personal level, comfort of the patient, and mediating between patient and family. The second study reported physical and emotional health consequences for nurses who provide hospice and palliative care over extended periods of time. The third study of nursesreported job satisfaction, stressors, coping strategies, and support. The fourth study nurses had 10 themes that conceptualize their work that may enable palliative care workers to remain resilient and effectively buffer or moderate stressful effects. The fifth study reported routinization of care, lack of nursing staff’s availability for emotional engagement, frequent interruptions, quiet afternoons, upbeat and positive culture, and a matter of fact attitude surrounding death and dying ,were all the behaviors that “being with” could not create. Although the report showed nurses able to cope by not “being with” the overall impact is stress related to caring for Palliative care patients...
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...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 concerns would be my next order of business. Insufficient health care insurance or financial resources can cause excessive worry and concern for...
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...Running head: Knocking on Death’s Door Knocking on Death’s Door: Methadone for Palliative Care Wendy M. Walker NURS 407 February 23, 2015 Abstract “Terminally ill.” “Six months to live.” “Hospice and Palliative Care.” These are just a few of the phrases that will completely turn a person’s life upside down. Effective and appropriate symptom management at the end of a hospice patient’s journey is vital. Health care professionals have a duty to provide ethical and compassionate care to patients. Ensuring that they spend their last days on earth comfortable and free of symptoms is not only the decent thing to do, but it also is very rewarding to a health care professional. With the correct combination of appropriate medications, a hospice patient can pass away peacefully, in the privacy of their own home, surrounded by loved ones. Knocking on Death’s Door: Methadone for Palliative Care Patients on hospice care often experience pain from their terminal diagnosis, as well as a plethora of other symptoms limiting the peace and comfort they deserve during their final months, weeks, days, or hours. Hospice diagnoses include but aren’t limited to; cancer, end stage cardiac disease, COPD, Alzheimer’s Disease, Parkinson’s Disease, ALS, end stage renal disease, and cirrhosis of the liver. Passing away at home can be a beautiful, peaceful, and spiritual experience for the patient and family as long as symptoms are under control and the patient is comfortable. ...
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...HCS/552 Health Care Economics July 09, 2012 Amy Stoles Abstract The United States has a great consumer demand for health care services. The supply of these services or products, such as new medications or medical equipment, is affected by many factors. Factors such as the situation of a financial aspect, patient education and the quality of the services or products being distributed. Care of the Dying “Hospice care is palliative care given to individuals who are terminally ill, with an expected survival of six months or less. The focus of hospice care is on meeting the physical, emotional, and spiritual needs of the dying individual, while fostering the highest quality of life possible.” (Rastegari RN, B.S.N., 2002, para.). In the way that our world is becoming, we are seeing many individuals coming down with diseases that are either not curable or that it has ran its’ course in the body and that there is nothing that can be done to prolong life. This is when this type of service is needed and many of individuals, especially the minorities and the American Indians. Many people do not understand what Hospice is all about. When they do find out about it, then they wish that it was known about sooner. The sole purpose of using this service is to help reduce both the physical pain and the emotional suffering of the patient during their final stages of the illness that they are dying from. According to "Evercare Hospice And Palliative Care" (2012) Hospice is not a physical...
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...Hospice Care in the United States Catherine Harmer HCS.212 Feb.23, 2013 Prof. Mark Miller Hospice Care in the United States Hospice care is one of the best services the health care industry has to offer, and is available to all walks of life. When the patient has reached end of life, hospice provides support to the loved ones as well. “Hospice focuses on caring, not curing and, in most cases; care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations” (NHPCO, 2011, par.2). Hospice care has evolved over many years and has a lot to offer: Patients are kept as comfortable as humanly possible. For loved ones, finding peace or comfort is likely more achievable when helping their loved ones let go, making the course of grieving and acceptance much less difficult. Caregivers, employees, and volunteers are faced day-to-day with the reality that life as we know it does expire; it is only fitting then, that greater patience and appreciation of self, family, and life in general become more characteristic of the providers than might be otherwise. This facet of health care, one might fear, would require tremendous resilience. On the other hand however, facilitating a...
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...As a nurse, do you want to work in a Hospice and Palliative Care Unit? Expound your answer. A nurse should be emotionally stable and accept human suffering as a part of their career. Honestly, I am not an emotionally strong person, so if I was given a chance to work in the Hospice and Palliative Care Unit, I will grab the opportunity because this can be a benefit for me. It will help me enhance my skills especially in controlling my emotions so that I can handle situations no matter how painful or difficult it is. And It is not just about how much salary you will receive but it is about the effort that you will invest in caring people who is not related to you. This is one of those careers which will require so much passion to your work, the degree of caring and love to your patients. As we know that a person admitted in the Hospice unit, will gone sooner or later. As a nurse, we care to listen, touch, clean, teach, pray, share, and do all you can within your knowledge and skill to help this patient, family and friends walk this journey with peace, dignity and comfort. As a family member, what are you going to do if you found out that one of your love one is terminally ill? I already have experienced this kind of situation. We found out that our grandmother was diagnosed with COPD. Of course, to feel so worry about her condition is just an understatement but to feel afraid about losing her anytime keeps running on our mind. Of how long she will be on our sides...
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...Hospice care The term was from the medieval times when it referred to a place of shelter and rest for weary or ill travelers on a long journey. The name was first applied to specialized care for dying patients by physician Dame Cicely Saunders, who began her work with the terminally ill in 1948 and eventually went on to create the first modern hospice—St. Christopher’s Hospice—in a residential suburb of London. Sanders idea of specialized care for the dying to the United States during a 1963 visit with Yale University brought on the thought of helping the ones that couldn’t help them self and more and day were limited. To help them go in peace. It been an ongoing thing since the 1963 and still used to day Hospice is a type of care and a philosophy of care that focuses on the palliation of a terminally ill or seriously ill patient's symptoms. These symptoms can be physical, emotional, or psychosocial in nature. Hospice care focuses on bringing comfort, self-respect, and tranquility to people in the final years of life. Patients’ symptoms and pain are controlled, goals of care are discussed and emotional needs are supported. Hospice believes that the end of life is not a medical experience, it is a human experience that benefits from expert medical and holistic support that hospice offers. The concept of hospice has been evolving since the 11th century. Then, and for centuries thereafter, hospices were places of hospitality for the sick, wounded, or dying, as well as those...
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...American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care Elizabeth Joy Gifford University of San Francisco, lgiffman1@aol.com Follow this and additional works at: http://repository.usfca.edu/dnp Part of the Nursing Commons Recommended Citation Gifford, Elizabeth Joy, "The Experience of African American Hospice Patient/Family with Board Certified Music Therapy as a Component of their Plan of Care" (2009). Doctor of Nursing Practice (DNP) Projects. Paper 14. This Project is brought to you for free and open access by the Theses and Dissertations at USF Scholarship Repository. It has been accepted for inclusion in Doctor of Nursing Practice (DNP) Projects by an authorized administrator of USF Scholarship Repository. For more information, please contact zjlu@usfca.edu. COMPREHENSIVE EXAM 2 Section I: Introduction Statement of the Problem Although 60% of African Americans in the United States have stated that they would want hospice care when they are dying (AARP, 2003), they only comprise 8% of all hospice enrollees (NHPCO, 2007), despite the fact that they represent 13% of the total population in this country (U.S. Census Bureau, 2008). In fact, hospice care in this nation has always been underutilized by African Americans (Connor, Elwert, Spence, & Christakis, 2008). In the San Francisco Bay Area, among Medicare-certified hospice agencies that submit data to the State of California, only 2% of all the hospice enrollees...
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...Dementia and Palliative Care Thomas Edison State College Introduction According to the Palliative Medicine article “global prevalence of dementia is almost 36 million people and the numbers are expected to double every 20 years (Ryan, Gardiner, Bellamy, Gott & Ingleton, 2011). With this in mind, in seems dementia is just as prevalent as cancer but these patients do not seem to receive the same end of life care or palliative care. The World Health Organization defines palliative care as An approach that improves quality of life in patients and families facing problems associated with life threatening illness, through prevention and relief of suffering by means of early identification, impeccable assessment and treatment of pain and the problems with physical, psychosocial and spiritual. ("Who definition of," 2013) The two article summaries that follow will help healthcare staff understand the great need for palliative care in dementia, from the diagnosis to death. Annotated Bibliography Ryan, T., Gardiner, C., Bellamy, G., Gott, M., & Ingleton, C. (2011). Barriers and facilitators to the receipt of palliative care for people with dementia: The views of medical and nursing staff. Palliative Medicine, 26(7), 879-886. doi: 10.1177/0269216311423443 Tony Ryan and colleagues discuss how “people with dementia often receive too little care whereas end of life care is often characterized by too much” (Ryan, Gardiner, Bellamy, Gott &...
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...JAN DISCUSSION PAPER JOURNAL OF ADVANCED NURSING The use of theory in qualitative approaches to research: application in end-of-life studies Hung-Lan Wu & Deborah L. Volker Accepted for publication 24 July 2009 Correspondence to D.L. Volker: e-mail: dvolker@mail.nur.utexas.edu Hung-Lan Wu PhD RN Nursing Instructor Meiho Institute of Technology, Pingtung, Taiwan Deborah L. Volker PhD RN AOCN Associate Professor The University of Texas at Austin School of Nursing, Austin, Texas, USA W U H . L . & V O L K E R D . L . ( 2 0 0 9 ) The use of theory in qualitative approaches to research: application in end-of-life studies. Journal of Advanced Nursing 65(12), 2719–2732. doi: 10.1111/j.1365-2648.2009.05157.x Abstract Title. The use of theory in qualitative approaches to research: application in end-of-life studies. Aim. This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end-of-life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end-of-life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions...
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...utilitarianism and deontology. Rather than focusing on the consequences of the act we wish to evaluate or the rule that guides the action, we look at the character of the person performing the act."(Mosser, 2010) Each having the same outcome but still different, physician assisted suicide is when a physician gives the patient means to commit suicide but not administering it personally.Euthanasia is a lethal dosage of medicine administered by a physician. (Gula,1999a) This process is called death by mercy but some see it as murder. Death is a natural part of living. Death is something that occurs somewhere every second of the day, it should be from natural cause or accidental never should it be doctor promoted . When people become ill it is the physician they put trust in for the care they need to survive the illness they have become stricken with. This is not always the case, depending on the severity of the illness some have ask physicians to assist in their death. The physician must be responsible and alert the patient of their choices when a life threatening illness occurs. Physician assisted suicide demonstrates ethical egoism, even though it satisfies ones desire it is not always the...
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...Enhancing end-of-life care (EoLC) is a core component of international governments’ health policies. Across the globe, nurses make significant contributions to EoLC and, at this delicate time, have the power to positively influence the health and wellbeing of those facing death. Indeed, health promotion is a core component of the nurse’s role. Originating in the UK, EoLC pathways have been adopted around the world.Their broad aim is to optimise the quality of the dying process, enabling people to ‘die well’ across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory. Key words: End-of-life care l Care pathways l Terminal care l Health promotion Michael Allen is Staff Nurse, Chemotherapy Day Unit, Singleton Hospital, Abertawe Bro- Morgannwg University Hospital Board, Swansea, Wales; Tessa Watts is Senior Lecturer, Swansea University,...
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...or omission of a dependent human being for his alleged benefit. (If death is not intended, it is not an act of euthanasia) ARGUMENTS FOR EUTHANASIA: It provides away to relieve extreme pain It provides a way of relief when a person’s quality of life is low Frees up medical funds to help people It is another case of freedom of choice ARGUMENTS AGAINST EUTHANASIA: Euthanasia devalues human life Euthanasia can become a means of health care cost containment Physicians and other medical care people should not be involved in directly causing death There is a “slippery slope” effect that has occurred where euthanasia has been first been legalized for only the terminally and later laws are changed to allow it for other people or to be done non-voluntarily. Opposition overcomes 48 point deficit to defeat assisted suicide - Ballot Question 2 in Massachusetts 1 1 0 Google BOSTON, Nov. 7, 2012 /PRNewswire/ -- In a stunning upset, the voters of Massachusetts soundly defeated Ballot Question 2 on Election Day. Dealing a significant setback to the expansion of the assisted suicide movement throughout the United States by Compassion & Choices (the organization formerly known as the Hemlock Society), a diverse coalition of disability rights organizations, medical associations, nurses' groups, community leaders and faith-based organizations united in this effort. "Tonight was a huge victory for those of us in the disability rights community that have worked...
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...practice, with emphasis on primary care in relation to the goals mentioned in the IOM report and the impact on the nurse’s role as a leader. The IOM report has two key points in relation to education: “Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.” (p. 5) and “Nurses should practice to the full extent of their education and training.” (p. 5). The focus of this education should be on the patients, in all settings, and the unique needs of each of these individuals. The Affordable Care Act (ACA) of 2010, focuses on creating a system that is more patient centered. To do this, there needs to be a complete transformation of the healthcare system as it currently stands. The roles of healthcare professionals will have to be reviewed and redefined; and with newly developed initiatives and programs to create the necessary improvements. As mentioned in this report, “If the system is to capitalize on this opportunity, however, the constraints of outdated policies, regulations, and cultural barriers, including those related to scope of practice, will have to be lifted.” (p. 5). This calls for advanced education and training, along with leadership. Health care is ever-changing and for patient-centered care to excel, competencies, advanced education and training need to be on-going. Education should also be multi-disciplinary and include physicians and other health care staff to ensure unity and conformity...
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