MN502: Theoretical Foundations Of Advanced Nursing

Karlsson, M. B.-F. (2015). A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care. International Journal for Human Caring, 40-48.

This video produced originally in 1981 follows three terminally ill patients during the end of their life, being cared for by family, at home. It is also the intimate portrayal of the family’s response to the fear, anger, and the overwhelming responsibility of caring for a loved one at home. I found this film powerful because I had a similar experience in my own life. My father cared for my mother at home for the last two months of her life. I remember the wide range of emotions in a manner that allowed me to process and understand the complexity of this kind of intimacy during death. Hopefully as I progress in this career journey I will be better able to make that connection with a family in similar circumstances, help those left grieving “make room” and move forward with a sense of meaning and

3 Outline how the factors relating to views on death and dying can impact on practice

In all my experiences as a nurse, I’ve realized the importance of communication, providing holistic care to an individual and empowering them with the knowledge to manage their health. When an illness strikes a person, it affects not just his body, but also his mind and spirit. The art of communication is invaluable to patient interaction and establishing a therapeutic nurse-patient relationship, that facilitate coping mechanisms for patients, moreover it prepared myself as a nurse to meet their individual needs. Furthermore, there is at the moment an insurmountable demand for survivorship care as a result of the advancement in technology and medicine, which made living beyond life expectancy possible for increasingly more people. Living after cancer treatment is not free of complications as there are acute and chronic side effects of treatment that requires constant monitoring and attention, and this information spurred me to shift my focus from palliative to survivorship care. The knowledge that I have attained now and my background in patient navigation will help me as a future oncology nurse practitioner, to manage the complex needs of cancer survivorship. I will be able to support my patient’s transition into their new way of life as effective transition management can translate into less hospitalization, lower health care cost and less physical, emotional, spiritual, social and financial stress to patients and their support system. Hope comes in many forms other than with the cure, it comes with control, relief, comfort; to a dying patient, it could mean living another day with their loved ones and

As nurses we have the responsibility to give unbiased education on all of the options available for end of life care (Meier, et al., 1998).

My personal philosophy of nursing seeks to incorporate the art of conveying nursing science holistically with care and human dignity. The four nursing metaparadigm concepts are described in relation to nursing as a science and an art and provide the base upon which my view of nursing and my personal philosophy are derived. As a nursing student at UIC, I am well aware of the fact that the best outcome for any patient may not be improvement in health, but rather, a dignified death during the end of life care. End of life care includes a significant quality in care and human dignity.

It brought to my awareness both the limitation and the capacity of medicine. Although there was no medical intervention that could cure the diseases of those terminal patients, their quality of life was improved  by an outstanding team of doctors, nurses and volunteers. This awareness helped reconcile myself to the fact that certain things, such as death and terminal illness, can not be avoided or changed. By viewing death as a natural part of life, I will be able to offer my dying patients the best care possible while also understanding my limitation as a physician and a human being.

This important documentary does not come close to doing justice to Gawande 's video: Being Mortal. The book is rich with excellent examples of doctors, nurses and family members doing their level best assisting others to live the fullest and richest lives possible right up until and including the very end of their lives. As Dr. Atul Gawande would say, the point isn 't to strive for a good death but rather to have the best possible life that is congruent with one 's own values; and to make medical decisions and choices accordingly. By living each day in harmony with one 's goals and values, one is likely to have a good death. Modern medical advances have lengthened the human life span, such that it is now longer than it has been at any point in human history. These advances happened alongside the

Atul Gawande’s book, “Being Mortal: Medicine and What Matters in the End,” explores different themes such as, aging, death, and the mishandling of both aging and death by the medical profession’s. This book also addresses what it means to live well near the end of life. It is not just to survive, not just to be safe, not just to stay alive as long as the medical technology allows, but, according to the author it is about what living truly means to an individual. The author describes that the idea of “Being Mortal” developed as he watched his elderly father go through a steep decline in his health and the eventual death. He soon realized that during his medical education and training he was never taught how to help his patients with managing

it is imperative that nurses maintain a current knowledge of evidence-based practice to best care for their patients, families, communities, and the health care system itself.

The purpose of experiencing a hospice clinical was to give me the opportunity to observe and participate in the care of my patients who are receiving hospice care in their home. My first encounter occurred in Jenks, Oklahoma at the patient’s personal home. Upon entering the house, we were greeted by his wife and one of their sons. Before we spoke with the patient we had a pre-conference in the patient’s living room with his wife. My nurse asked how the patient’s wife was doing and the wife stated that she needs more help with his care. She feels like her husband needs some form of an assistive device for walking, getting in and out of bed, an assistive device for urinating, and a chaplain. In response to this statement the nurse asked her if she would like a walker,

Now I am old enough to know that death is not the end, but it is the beginning of a new life. We have to submit our lives to God and ask him for the strength to move forward. Worldview about life after death will largely determine how the patient and families welcome death. Now, as a Christian nurse, I can see death in the light of the resurrection of Jesus Christ (GCU, 2015). If I can help the family members to go through this traumatic experience and the grieving process, my Christian calling as nurse will be

Palliative care continues to evolve in providing better end-of-life care and so does nursing care. Thus, nursing practice is enhanced to satisfy the demand of the palliative care. A nurse provides complex care and fulfils the needs of the patients. Nursing involves in caring work, which focus on patient experiencing agony in palliative and haematological cancer care. Nurses worked in a taxing environment, that can be highly stressful, and often they experience physical, psychological and spiritual exhaustion. This nature of work can have devastating effects on the health and wellbeing of a nurse. There are three concepts related to adverse consequences of caring work: these are compassion fatigue, burnout and vicarious traumatization.

Alligood (2014) states that Boykin and Schoenhofer’s Theory of Nursing as Caring is an exception to this rule because “rather than providing empirical variables from which hypotheses and testable predications are made, the theory of nursing as caring qualitatively transforms practice” (p. 362). Alligood (2014) argues that the Theory of Nursing as Caring is focused on unique human interaction that cannot and should not be objectified and is therefore impossible to be founded in the empirical way of

My values of nursing shape my practice as a nurse and are affected by my views on health. In my eyes, health is not solely related to medical illness and disease. I believe that health encompasses various aspects within all