Sdl4 Activity 1

End of life care is considered to be one of the toughest decisions to be made. The challenge of making decisions, the after care of a ended life, factors that support ending life and guidelines for the withdrawal of life are major themes throughout making this decision. These challenges can often be caused by many other factors. Throughout this literature barriers to providing good end of life care was documented throughout, one of which was the overall environment that nurses provide. Which was also described as the nurse's work load, physical layout of the facility, visitation restrictions, procedures, and

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

Coming from a third world country where there aren’t many opportunities for work and funding for education, proceding to nursing school was a grand opportunity. The privilege to attend a government subsidized school where top students in the region compete to get into the program that allowed only 60 students per year was indeed a blessing. As clinical rotations began, what was once considered a mere opportunity evolved into a true passion for caring as I truly love and enjoy nursing and helping people.

Hospice and palliative care can be easily intertwined; they are both concerned with promoting comfort and relieving patient pain. Hospice and palliative care, however, are different in some aspects. Patients who receive hospice care are nearing the end of their lives and there is no effort to cure their disease; the goal is to provide pain relief, a sense of belonging from family and friends if desired, support through the dying stages, and to assure that the person is able to die with dignity. Palliative care is also focused on reducing discomfort; however, the patient receiving care can be at any stage in their disease. Additionally, palliative care can also be administered during a time when a patient is receiving treatment to cure their illness.

I currently work for Compassion Care Hospice. Compassion Care Hospice is a for profit hospice agencyin Las Vegas Nevada. Owners Denny Barnett, Kelly Thompson, and Joe Schwab opened Compassion Care began in April 2005. Compassion Care Hospice is run and operated by the Aria management company. Compassion care is now one of the leading Hospice in the Las Vegas area, with a census at 140. They areinvolved in providing palliative care,into a system of medical care that emphasizes palliation and psychosocial support of patients diagnosed with a life-limiting illness, through professional nursing or other therapeutic services, such as physical therapy, home health aides, nurse assistants, medical social work, nutritionist services, or personal care

The Joint Commission on Accreditation of Healthcare Organization (JCAHO) National Quality Safety goals stresses the standard of palliative care provided to patients and families using an interdisciplinary approach. JACHO added pain assessment and symptom management standards making pain the fifth vital sign in an effort to improve the standards of care. The Joint Commission has encouraged all staff to seek education, experience and certification in palliative care. In addition the Joint Commission states that the NCP Clinical Practice Guidelines for Quality Palliative Care originated from evidence based national guidelines which are used to deliver care including physical and psychological interventions, focus on imminent death, taking into

Nursing is a very emotional and physically demanding job. Emotionally, since you are dealing with a large number of people who are sick as well as being an emotional support for the family members as well. A great deal of t time you may also need to advocate for your patients. This can take an enormous toll on you without you even realizing it. “NURSES ARE short-handed, understaffed, and overworked. We are only an accidental needlestick or body fluid splash injury away from exposure to deadly diseases. We get aches and pains from lifting and tugging on people bigger than we are. We watch people die. We see families

This writer is now familiar with the work of Keeley,Wolf, Regul, and Jadwin (2015) in The Fox Chase Cancer Center based on comparison among nursing units and their caring behavior.

In many critical care units there are always some patients who receive treatment or interventions to prolong their lives. These interventions include mechanical ventilations, dialysis, inotropes support and so on. According to Huynh (2014), when critical care is used to prolong life without achieving a benefit meaningful to the patient, it is usually considered "futile". He had conducted a survey in five ICUs for three months, there were 123 patients been assessed to receive futile treatment among 1136 patient (Huynh, 2014). Towards the end of life, the physician will have to face the dilemma when to discontinue life sustaining treatments or interventions. The conflict will

Cultural: A persons culture for example Muslims, are against euthanasia and it is forbidden, this can underpin a person choice to die by free will and not suffer and this could case an entire family to be shunned

Being a nurse is one of the hardest jobs, including one of the lowest paying for the workload nurses take on. Nurses go through years of schooling, and many nurses often end up disliking their chosen profession. There seems to always be a shortage of nurses so many nurses are more than often overworked and underpaid. Having another individual’s health hang in your balance can cause mental and physical exhaustion which can eventually lead to nurse burnout. Many nurses that work in high-stress environments and not having the proper training or enough assistance can lead to serious mistakes in patient care. In order for patients to receive the right care, they must have willing and compassionate care by nurses and doctors to treat and heal them.

Hospice/Palliative care for a dying patient needs to be well planned and managed to ensure that all aspects of care giving are taken care of. The plan provides a reference for nurses and other practitioners who are involved in giving care to the patient. This is so as to ensure that they all know what needs to be done and does not. The plan also includes the relatives or family of the patient who need to be involved in the process not only to give emotional support but also physical support to the patient. However, this is just a plan and the nurse’s actions are independent and governed by the scope of practice of the state and specific country as well as the comfort levels of the nurse. The common management needs for a dying patient are comfort,

An option for healthcare in today’s era of medical knowledge and highly increase use of technology has provided some possibilities concerning the medication of patients. Providing care especially palliative care is very challenging in a demanding complex environment of medical and thus requires specialised training and knowledge (Malloy et al 2007). In a study conducted by Duldt-Battey (2003), humanising the communication theory for nursing, the study provides a strategic foundation to assure the fact that communication occurs between nurses and other physicians connected with the healthcare. These typical goals are also outlined in a conductive study of Solomon (2002) that relates to palliative care.

As many people approach their life’s end, close friends and family members are often faced with many decisions and tasks that entails a wide range of choices from the very simple to the super complex. The decisions made may be psychological, practical, legal, existential, spiritual or medical. Some of difficult decision that the family members encounter may be choosing the right care giver help they want and whether to receive the proper care in a standard medical institution or just at home. The dying victim may be involved in the decision making where they must give their preferred degree of family participation, durable powers of their attorney as well as advanced directives (Singer, 1999).

Palliative care is “whole person” care that involves focus on quality of life, or living well, for all family members when they are dealing with a life-limiting illness. It can start long before the end-of-life period, as early as at the diagnosis of a life-limiting illness, and extend beyond death to bereavement. End-of-Life care is a very broad topic and possibly more angles could have been addressed within the chapter. For example Advance Healthcare Directives and its impact on the patient and their quality of life for families who can’t let go of a love one of