Western Governors University
Community Health Nursing
May 23, 2013
HAT 1 Task 2
Nurses in a palliative care situation have multiple roles which range from a clinical technician to a shoulder to cry on. They advocate for the friends and family of the dying patient and educate all on positive ways to grieve. The main concerns of these nurses are centered on the promotion of comfort, quality of life and preserving the patient’s dignity. Because each patient approaches death differently, the nurse must alter their care plan accordingly. Personal Perceptions
Connecting is one of the most important themes in establishing an effective nurse-patient relationship (Johnston & Smith, 2006). This connection with the patient gives them someone to talk to, someone to listen to them, someone that wants to know them as a person and someone that doesn’t avoid them. These things are often difficult for family and friends to do during the end of life stages because of their own grief and lack of knowledge of supportive measures. The author’s decision to return to school and become a nurse was the result of having a wonderful nurse that did just this. The author’s 8 year old niece was diagnosed with leukemia and only lived 6 months after the diagnosis. There was nothing that could have changed the final outcome of her niece but the connection that her nurse had with the family changed the way that they dealt with everything. This is something that the author will never forget and inspired her to “pass this forward”. When a nurse has gone through a tragic situation like this, they can remember those large and small things that were done for their loved one and the impact it had. Being able to bring this life experience to the situation allows a nurse to connect on a deeper level. This connection assists with enhancing the quality of life and will ultimately influence the course of the illness in a positive manner. Keeping the patient as free from pain as possible not only is beneficial for the patient, but is comforting to the family members when they don’t have to watch their loved one suffer as much. This was one of the things that the nurse of the author’s niece monitored closely. She educated the family on appropriate pain management and comfort measures to be used when they brought her home to die. If the parents had not felt comfortable in their knowledge of how to do this, they would not have been able to bring her home to be with her family in her last days. This education and advocacy for what was best for the family was driven completely by this nurse. The author relates back to this often and because of this insight, strives to deliver this same compassionate care. Regardless of whether the patient wants to die at home or in a hospital setting, the author keeps them as comfortable as possible and advocates for the patient making as many decisions about their care as possible. Once decisions are made, education and support are the greatest gifts the nurse can give. The nurse needs to help the patient and family understand that there is no right or wrong answer and support them when a decision is made. If a nurse were simply caring for a patient from a clinical standpoint, the patient, family and nurse would miss the opportunity for some very special moments. Strategies
There are several things that a nurse can do to improve the quality of life for Mrs. Thomas. There should be a conversation between Mr. and Mrs. Thomas and the nurse on their expectations and wishes for this final stage. Baohui Zhang had a team of researchers in a Coping with Cancer study that determined patients who were more worried at the beginning had a worse quality of life in the final weeks (Nordqvist, 2012). To effectively assist them with the choices, the nurse must learn about things that were important to the couple prior to the illness. The goal is to try to redesign the processes of the...