P10#1 and P10#2
18 hours ago
RE: Discussion - Week 10
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Desry,
Good post. You had mentioned the ethical issues that occur during end of life care. This hits close to home for me and my place of work. Currently working on a Med Surg floor I am surprised by how many cancer patients I care for. Since we are a smaller hospital, most of our cancer patients are care for under one physician. Unfortunately this physician is notorious for promising false hope. When I first started I doubted this thinking this would go against not only ethical standards, but moral right as well. However, I have had multiple patients talk with me about this hope that has been promised to them and their families while the patient is clearly needing hospice or palliative care services. "For the nearly 80 percent of those who live their final days in hospitals, nursing homes, and at home in hospice care, decisions continually need to be made about what treatment to administer, what treatment to cease or withhold, what treatment to continue, and what treatment to taper off," (Cerminara & Meisel, N.D). It is troubling as a nurse to see my patient getting worse and trying to advocate for their care to in turn get scrutinized. I think that because some of this advancing technologies patients and families want everything done to slow the progression of an illness. Do not get me wrong, these advances in medicine have done wonders. A part of me just can not help but think it has also hindered views on a peaceful passing.Cerminara and Meisel wrote "only a small proportion of Americans have written advance directives, such as a living will, but their usefulness has long been questioned by the physicians who must draw guidance from them." Perhaps this is a major reason for such prolonged intrusive care. There needs to be better education about advance directives and discussion on the importance of setting one up before our patients get sick. I think it would be a great advantage for primary care physicians and nurses to have this discussion. That way the patient has that trusting relationship with that nurse of doctor instead of learning about advance directives from a stranger they just met in a hospital.
I think another great way to help with end of life is to train and educate nurses and other health care team members how to approach the situation and communicate with patients and family. There have been times where patients request that their family is not told about their prognosis and this can cause challenges in care for the nurse or provider. Jocelyn (2017) writes about some challenges that educators are faced when implementing end of life education. Jocelyn (2017) writes "Despite the shift in the approach to preparing nurses to care for dying patients, many challenges exist for nurse educators. One of the most significant is how to include end-of-life content in an overloaded curriculum. Another problem is the lack of consistency in how end-of-life content is taught." As our population continues to age, end of life care needs to be taken into consideration and viewed just as important as preventive medicine.
References
Cerminara, K., & Meisel, A. (N.D.) End-of-life-care. The Hastings Center. Retrieved
from https://www.thehastingscenter.org/briefingbook/end-of-life-care/
Jocelyn, D. (2017). End-of-life nursing care and education:end-of-life nursing education past and
present. Journal of Christian Nursing. 34(1). Retrieved from
https://journals.lww.com/journalofchristiannursing/Fulltext/2017/01000/End_of_Life_Nursing_Care_and_Educatio n_.12.aspx
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