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This Ana Position Statement Delineates Roles, Responsibilities, Opportunities, And Guides The Nurse Regarding How He/she Can Help Patients And Families Understand, Cope With, And Prepare For A Patient’s Impending Death.
The Nurse Should Ensure Maximum Comfort For The Patients And Their Families Through The Identification Of Symptoms, Identifying The Available Strategies Within Their Scope Of Practice To Manage Medication, Take More Steps To Reduce Their Symptoms, And Working With Other Professionals.
It Is The Role Of Nurses To Ensure That Patients Receive Quality And Comprehensive Care During Their Final Stages Of Life.
This Includes Recognizing Impending Death And Being Able To Communicate This To The Families. As Part Of Holistic Intervention, Nurses Should Collaborate With Other Health Professionals In Maximizing The Relief Of Symptoms And Promoting Comfort And Welfare For The Patient And Family.
It Is The Role Of Nurses And Other Health Care Professionals To Devise The Decision-making Processes For This Service User, Which Take On Board Patients’ Wishes, Physiological Realities, And Also An Understanding Of What Can And Cannot Be Achieved Medically.
Models Most Likely To Be Useful In Deciding The Woman’s Goals Of Care Now Would Be Those That Offer A Framework For Discussion Of The Nature Of The Appropriate Care To Be Offered. This Often Includes Consultation With Decision-making Experts, Such As A Palliative Care Team Or Ethics Committee.
Much Is Now Known About How To Improve Care At The End Of Life From The Experiences And Lessons Learned Over The Past Two Decades. There Are Numerous Opportunities For Nurses And Other Health Caregivers To Continue Improving Care For Patients And Their Families.
An Iom Study Said, “At This Time, The U.s. Health Care System Is Ill Designed To Meet The Needs Of Patients Nearing The End Of Life And Their Families.” It Was Designed To Provide Immediate Treatment To Cure Illnesses; It Wasn’t Designed For The Kind Of Comfort Care Most People Want When Their Lives Are About To Come To An End.
“The Financial Incentives Built Into The Programs That Most Often Serve People With Advanced Serious Illnesses—medicare And Medicaid— Are Not Well Coordinated, And The Result Is Fragmented Care That Increases Risks To Patients And Creates Avoidable Burdens On Them And Their Families” (Institute Of Medicine, 2014, P. 330).
Following Are Some Practice, Education, Research, And Administration Recommendations For Improvements That Can Be Helped To Be Implemented By Nurses In Order To Get Over Some Of These Barriers.
For Patients And Their Families, The Immediate Reality Of A Patient’s Death Is Usually Rather Traumatic. Whether A Patient Will Eventually Benefit From A Certain Therapy Is A Common Consideration When Deciding On The Best Course Of Care For Them Towards The End Of Their Life.
The Quality Of Life May Be Impacted By These Decisions. When Patients And Their Families Are Faced With Tough Choices And Need To Adjust To Hard Truths, Nurses Are Usually In A Position To Provide Help.
When Potentially Life-prolonging Treatments (Such As Ventilator Support, Dialysis, Vasopressors Or Inotropes, Chemotherapy, Antibiotics, Etc.) Are Stopped, It Is Not Unusual For A Patient To Pass Away.
There Is No Moral, Legal, Or Ethical Distinction Between Never Beginning Treatment And Ending It. Never Should A Provider Begin A Treatment That They Are Unwilling To Finish.
Decisions About End-of-life Care Often Take Quality Of Life Into Account. In Addition To Promoting Comfort And Relieving Pain And Other Symptoms, Nurses Also Have A Duty To Help Patients, Their Families, And Other Individuals Who Are Close To The Patient.
In This Position Statement, “Family” Refers To Anyone The Patient Claims It Is, Regardless Of Whether They Are Related By Blood Or Love.
It Is Never Morally Acceptable For A Nurse To Act By Omission Or Deed, Including But Not Limited To, Medicine Delivery, With The Aim Of Terminating A Patient’s Life, Even Though Nurses Should Make Every Attempt To Offer Active Symptom Management Near The End Of Life.
Making Decisions For A Patient’s Last Years Should Take Place Across Years Rather Than Simply In The Hours Or Days Prior To The Patient’s Death. In The Period Leading Up To A Patient’s Death As Well As Throughout The Decision-making Process, Nurses May Be A Valuable Resource And Source Of Support For Both Patients And Families.
In Discussions On End-of-life Care And Choices, Nurses Are Often In An Excellent Position To Make A Contribution. This Includes Focusing On Patients’ Wishes And Establishing Procedures That Uphold Patients’ Autonomy.
There Are Situations In Which The Patient’s Preferences Are Not Reflected In The Family’s Choices, Or Even Disagree With Them.
In Such Situations, The Nurse’s Main Duty Is To Tend To The Patient’s Needs And Respect Their Autonomy While Also Supporting The Patient’s Family As They Attempt To Come To Terms With The Patient’s Imminent Death. Evidence-based Criteria For Exceptional End-of-life Care Should Include Both National And International Standards Of Care.
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