Evidence-based practice (EBP) in hospice care indicates use of palliative care in collaboration with hospice care. Palliative care goes hand in hand with hospice care, because palliative care is concentrated on providing relief from the pain and symptoms of serious illnesses. The goals of palliative care are to improve quality of life for both the patient and the family. Therefore, principals that are used in the palliative care can be directly related to the hospice care.
The 76th World Health Assembly emphasized strengthening of palliative care as a global focus. In their article Phillips, and Agar, (2016) review the five practices of exemplary leadership in nursing. The authors believe that World Health Assembly vision for palliative
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Critical thinking plays an important part in this process. Appropriate assessment skills, collecting necessary data, planning, implementation, and evaluation are nursing steps that accommodate nurses and their leaders with tools for clinical reasoning. Nursing leaders should also enable other nurses to act by identifying opportunities to promote the development of palliative care nurse specialists and supporting members of their teams to move to the new positions. Nursing Leaders should also model the way of palliative nursing by clarifying values, setting appropriate goals, and being an example. This can also inspire team members to provide competent and compassionate palliative and end-of-life care.
Cultural and Linguistic Competence
Nurses are the hospice team members who spend a lot of time with dying patients and their families. “The World Health Organization has characterized the need for expert, palliative and end-of-life care as a top priority for global health care. The specialty of hospice and palliative care nursing embraced a humanistic caring and holistic approach to patient care.” (Wu, Vilker, 2011).
Wu and Vilker (2011) researched the issue of nurses’ experience in end-of-life care and relevance of the core Humanistic Nursing Theory to nursing humanistic caring and holistic approaches to palliative and hospice
On reading this article and identifying the study, there was a clear insight on how death and dying, and even improved health, impacted those nurses (Conte, 2014). Nurses, who worked closely with their patients, through the perils and suffering, culminating of death and losses, had grief not readily explored to enable that comfort zone (Conte, 2014).
Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help
Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely
Nurses in specialty care continue to change the health care system to meet the needs of patients regardless of the setting. Hospice and palliative care is an area of nursing specialty care that has grown since the 1970s when it began (Cowen and Moorhead, 2011). Leaders in nursing identify change that is needed and discover ways to make the changes possible. The leadership in nursing brought forth attention for patients with terminal illness. Nurses defined hospice and palliative care, developed core principles, practices, provided education and then pushed for the care to be available in multiple settings (Cowen and Moorhead, 2011). The continued growth in this specialty area of nursing is related to the positive outcomes of patients that have
Before I started this class I thought palliative care was only used as end of life care, or for when a curative treatment was unavailable or had failed. As we learned about the different models of care, and how they have changed over the years, it became evident that the use of palliative care has changed drastically over the past several decades. In the 1800s to 1900s, palliative care was only used once the patient had reached the dying stage, and only included the patient in this care, not their families1. Before taking this course, this is what I thought of palliative care as well. Since the late 1900s though, palliative care has been used in a more proactive approach. From the moment an individual receives a life threatening illness, palliative care begins. This includes caring for the family of the patient as well. This care increases as the patient’s illness progresses, and even continues for the family after the death of the patient. Learning this has really made an impact on how I would like to work as a
According to Allen et al. (2012), “millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.” This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling & Quill, 2014) purposely states the misconceptions of palliative care and advocated for seriously ill patients that education must bring under control the misconceptions. Some patients do not receive appropriate symptom management because the palliative care treatment needed is often confused with end-of-life care. However, end-of-life care attempts to relieve pain and suffering when a disease is no longer responsive to curative treatment. Pain and suffering could ultimately be controlled or even eliminated through the proper utilization of palliative care. Patients who are not referred to palliative care in a timely manner is more likely to have poor quality of life, uncontrolled symptom management and increased amounts of visits to the emergency room during the disease process. Patients with life limiting illnesses bear the burden of increased discomfort and increased suffering. Nurses experience clinical practice issues and difficulties in the clinical setting during the delivery of comfort and symptom management. These issues
This might be one reason why some patients choose conventional treatment instead of choosing a hospice program, there is many other factors that may contribute to this decision such as; financial status. This research will help give nurses a stronger knowledge base of characteristics and advantage of hospice care. In addition, nurses will be able to explain the advantages of Hospice programs to more of their patients, thus, they will be able to educate and encourage more families to choose hospice care. Not only will it help the patient live out a comfortable life it will also help the caregivers with
The present-day misconception of palliative care possibly comes from the circumstance that palliative care was used interchangeably with hospice care until the 1980s. (Clark & Seymour, 1999). Clark and Seymour (1999) extensively write on the beginnings and evolution of palliative care. They describe the progression of palliative care as a whole and explain the movement from palliative starting out as supplemental care to terminal patients to the concept division of palliative and hospice care. They describe the differences in each and explain why palliative is its own concept that differentiates from hospice care. In 2002, the World Health Organization defined palliative care as “an approach” that increases the quality of life of
End of life issues involving education on palliative care and hospice; are these issues important to you and your loved ones? The purpose of this paper is to discuss end of life care and how the legislative process affects this important topic. As the American population keeps growing, so does the amount of an aging population. Is the amount of training and education in nursing school sufficient for palliative care and hospice? Do we need to provide more training to the medical field to help support the growing need for end of life care? At some point in our careers we might be faced with helping someone in their final days. Being educated and having the ability to provide appropriate care is part of our scope of practice. (American Nurses Association, 2010, pp.1-2)
This nursing organization has a magnificent amount of power and responsibility in improving the expert care in illnesses and diseases acquired by older adults through advocacy, dissemination of knowledge and the provision of continuation of education (“About GAPNA,” 2016.). Similarly, the Hospice and Palliative Nurses Association’s political position is to enhance expert care in serious illness and to advance nursing competence through education, leadership and research (“Shared Mission,” 2016). It also creates programs and other learning resources to advance competent care in complicated health conditions (“Shared Mission,” 2016). Furthermore, its responsibility extends to utilizing the best practices of hospice and palliative care to support those who are in need (“Shared Mission,”
The purpose of this paper is to address and identify the best possible practice of nurse leaders in the nursing arena. When considering effective leaders in the nursing field nurses must acquire leadership skills in order to meet the steep demands of the positions held as advanced practitioners. The healthcare industry has mainly focused on meeting the continuing education requirements to keep advanced certifications of nurse leaders however an effective leader who is faced with a plethora of complex leadership challenges will focus on enhancing their personal arsenal of leadership techniques through seeking leadership development opportunities catered to the provision of safe and effective care for patients and their staff. Through the
Palliative care is for patients such as Lorna Hetherington who are facing a life threatening illness. Palliative care is defined by the World Health Organisation as an approach that improves the quality of life of patients and their families confronted with the problems of a life threatening illness, through the prevention and relief of suffering by medical interventions and constant assessments as the illness progresses (Brown & Edwards, 2012, p 158). Implementing a palliative approach is not based on a clinical stage or diagnosis but based on the patients needs. As an enrolled nurse providing palliative care, the aim is to improve the quality of life for the patient, which is more than just pain management, rather a holistic approach is implemented.
The purpose of this project is to implement an evidenced-based palliative care educational program in the intensive care unit. The protocol aims at educating registered nurses who work in the intensive care unit to identify those patients that can benefit from early implementation of palliative care. Nurses who have adequate skills and knowledge and are at ease communicating with patients, families, and health care providers about palliative care can significantly help improve the quality of life of these particular patients while in the intensive care unit (ICU) setting (Moir, Roberts, Martz, Perry, & Tivis, 2015). Hinton (1963) pointed out that not only patients dying from cancer experiencing great distress but also patients dying from non-cancer illnesses can benefit greatly from palliative care. A literary review of English health related, peer reviewed literature from 2010 to the present pertaining to studies on palliative care and health care providers’ knowledge about the subject was completed.
I have been a registered nurse at UCLA for 18 months. One particular issue that has captured my attention is the utilization of palliative care in health care. Because nurses are generally at the bedside all the time, they have an important role to play in voicing the importance of its utilization and implementation in the patient’s care.
Key importance of the palliative care approach in nursing is for it to be responsive, rather than