...Dying in a Hospital Setting Elizabeth Allegro Aspen University Abstract Acute hospitals play a significant role in end of life care, it is the place where most people die. Evidence suggests that end of life care in hospitals needs improvement. The purpose of this paper was to investigate patient and family experiences of hospital death, the weaknesses within the hospital setting and possible solutions to improve. A literature search identified common themes, these included: * Hospitals are seen as a place of treatment and cure; death may be viewed as a failure. * Good communication between physician and patient is vital for a patient to make an informed choice regarding their care. * Patients may not receive palliative care if end of life is diagnosed too late. * A lack of resources such as short staffing contributes to suboptimal end of life care. Dying in a Hospital Setting Most Americans die in hospitals; many suffer unnecessarily due to the lack of knowledge about end of life care. Some patients receive aggressive treatments up until the time of death. Patients often suffer in vain attempts to prolong life instead of receiving compassionate, comfort care. Death is part of life, sooner or later everyone will face death. It would be easier if one was prepared for it. Communication is important to prepare for death. There is often an expectation of a cure when a patient is hospitalized;...
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...Providing Good Care to Dying Patients: Paper 2 Jaime Holtgrewe Chamberlain College of Nursing NR 449 Evidence Based Practice February 2013 Clinical Question In my group, the focus of research is based on the following clinical question: What are the best practices for end of life care? Within the group, research is driven to focus on enhancing care for end of life patient, including collaboration with physicians and surrogate decision makers or a power of attorney (POA), as well as pain management policies. However, all aspects of care for end of life patients are taken into consideration when determining which facet is most important. The group’s research consists of quantitative and qualitative articles focusing on transitioning to hospice programs, new measures of care, acceptance of death and experience of caregivers for the dying patient. According to the Journal of Health Politics, Policy & Law (2008), three of every four Americans do not fear death as much as they fear being in pain at the time of death. End-of-life care can be a challenge requiring the full range of a family physician's skills. Significant pain is common but is often undertreated despite available medications and technology. Physicians must overcome their own fears about using narcotics and allay similar fears in patients, families and communities. Drugs such as corticosteroids, antidepressants and anticonvulsants can also help to alleviate pain. A considerable amount of research has compiled over...
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...University Introduction to Nursing Research NRS-433V Angie Lawson May 01, 2016 Legal and Ethical aspects of Assisted Suicide Only five states in the US have legalized physician assisted death. California is the latest to legalize this and it will be available here in less than a month. There are many legal and ethical questions that nurses have. Some feel like this is murder or against their religious beliefs and others feel like people should have the right to die with dignity. The Oregon death with dignity act was passed more than 20 years ago in 1994, though legal challenges delayed enactment until 1997. Washington followed in 2008, since this time, Montana and Vermont has passed laws supporting physician assisted death. California has passed legislation and will begin next month (Ganzini, L., 2016). The process is very similar in each of these states. They allow a competent adult resident of that state to obtain a prescription from a physician for a lethal dose of medication, for the purposes of causing death through self administration. The law does not allow lethal injection or allow individuals to acquire a lethal prescription through advanced directive to be used when mentally incapable in the future. There are also limits as to when the prescription can be written. Two physicians, one of whom writes the prescription, must confirm that the patient has a terminal illness (likely to cause death within six months), is competent...
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...Experiments of Death and Dying of Patients and Love Ones Walter A. Jones ITT Technical Institute Abstract Aims and Objectives of this research paper is to find out how different people like nurses, medical staffs, and family members experiences the death and dying between patient(s) and love one(s). Background with this paper is that there are many people dying and that are patient(s) and close one(s) and the research is conducting what experiences that these people have after their death that been left behind. Design of this research is to have a qualitative group interviews with the nurses and medical staffs that want to talk about and public group interviews with love ones and also if they don’t want to do the group interview they can do a questionnaire survey to be anonymous. Methods of this research had taken place in the lunch room of the hospital for nurses and any other medical staff that want to do the group interviews or questionnaires survey over the course of twelve months and the same with the general people that observation had taken placed in a public library. Conclusion of this research is that the nurses and medical staff have a difficult time to recuperating from a dying patient(s) or death that occurs. It also relives that the general public that also took place in the research are more impacted on losing their love one(s) or the person that they care about for the people that volunteer in the research. Experiments of Death and Dying of Patients and...
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...The Colorado End of Life Options Act Jasmine Shaw Denver College of Nursing Abstract This paper is intended to provide an overview regarding the Colorado End of Life Options Act. This paper includes information regarding what it is, who qualifies to use it, and what the entirety of the process looks like. The ultimate goal of this paper, however, is to provide enough information regarding the Colorado End of Life Options Act to ensure that a general understanding of the basic requirements/qualifications, processes, individuals involved, and dilemmas surrounding physician assisted suicide is obtained. Keywords: Colorado, End of Life Options, Physician assisted suicide The Colorado End of Life Options Act The concept of physician...
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...NAME: SALONI KUMARI SEM: 2 ; SECTION: A ROLL NO. : 405 ABSTRACT: DEATH PENALTY “An eye for an eye will make the whole world blind” * MAHATMA GANDHI SHOULD THE DEATH PENALTY BE ABOLISHED? According to oxford dictionary death penalty is the legally authorized killing of someone as punishment for crime. It is the death sentence awarded for capital offences like crimes involving planned murder, multiple murder, repeated crimes, rape and murder etc. where in criminal provisions consider such person as gross danger to the existence in the society and provide death punishment. So, the purpose of this research paper is to highlight, how death penalty infringes individual’s Right to equality before Law and Right to life and personal liberty under Article 14 and 21 of the constitution as death penalty is one of the most barbaric way to deal with the murder and morally there is nothing that makes us better if we kill those who kill. And, whether the judiciary system removes the chances of punishing innocent completely? Apart from these, do the criminals deserves such an easy death, Is it not important for the criminals to suffer more than the person they attacked as dying at once by death penalty is very easy but dying every day in the jail for the completion of life imprisonment is very tough. But whether the abolishment of death penalty would amount to a rational decision, as the abolition of death penalty completely would amount to repeated crimes or can give a second chance...
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...concept that is often ignored despite the fact that everyone will die some day. It is because death is a part of life that people are familiar with comfort care given at the end of life. Comfort care is offered when someone is dying, and when the end is predictable. Comfort care is an essential part of nursing care at the end of life. It is care that helps or soothes a person who is dying. The goal is to prevent or relieve suffering as much as possible while respecting the dying person’s wishes (NIH, 2012). The goal of comfort care in nursing is the immediate state of being strengthened by having the needs for relief, ease, and transcendence addressed in the four contexts of holistic human experience: physical, psychospiritual, sociocultural, and environmental (Kolcaba, 2010). I have worked in the oncology field of nursing for 16 years and have seen several patients go through the end-of-life process. I have seen the better outcome of the dyeing process take place, this is when all four holistic human aspects are met, but sadly I have also seen a few complete the process without having one or more of the holistic context met. I must emphasize that delivering exceptional nursing comfort care to the patients who are in their final days or even hours prior to death, is just as vitally important as delivering critical care to the acutely or critically ill patients. The purpose of this paper is to evaluate and describe the concept of comfort care at end-of-life, thus allowing me...
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...How the death of a patient can impact on nurses: A literature review During 2012 there were 499,331 deaths registered in England and Wales, a rise of 3.1% compared with 2011. Almost half of these occurred in National Health Service Hospitals. (Office for National Statistics, 2012). These figures indicate a substantial amount of individuals dying in a hospital setting each year, therefore a large proportion of patients will be receiving some form of care prior to and at death (Blackwell 2010 p.1). Numerous research studies have been carried out by theorists identifying the impact of bereavement on different individuals. The earliest thorough study of grief and loss developed from Freud with his classic paper ‘Mourning and Melancholia’ (Freud 1917 cited in Payne et al 1999). Freud believed that for the bereaved to detach from the deceased one must work through their grief by reviewing memories and thoughts of the deceased (Ellman 2010). Other theorists have recently identified death and the importance of understanding it. 'Death is a natural progression from life. Most nurses will be exposed to the physical and emotional effects of this experience as they care for a dying patient. The nurse is taught how to provide support for the patient and family as they proceed through the stages of grief. Often, however the nurse may not realise his or her own need to grieve'. (Brosche 2003 p. 173). Although nurses try to remain professional whilst at work...
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...NEVADA LEGISLATIVE COUNSEL BUREAU OFFICE OF RESEARCH BACKGROUND PAPER 1977 No. 8 RIGHT TO DIE I The name Karen Ann Quinlan brings to mind the plight of many apparently terminally ill patients who are kept alive by lifesustaining mechanical procedures. On March 31, 1976, the New Jersey Supreme Court spoke to the issue raised by Miss Quinlan's specific plight and said, based on Karen's right to privacy, that "The present life support systems may be withdr?~m * * * without any civil or criminal liability therefore on the part of any participants." Ironically, Miss Quinlan lives on; so does the question of the role of machines and medication in sustaining vital functions and the propriety of stopping or withholding such treatment from patients. The dilemma doctors, patients, relatives and the legal community face in cases like Karen's is largely due to medical progress in the development of ever more sophisticated means of life support. Several years ago, a patient died when his heart stopped and "extraordinary" treaL"Uent consisted of an injection of adrenaline. However, with respirators, heartlung machines, organ transplants and similar measures, patients who would have died in the past can now be kept alive, at least technically, for weeks, months and even years. The slogan "death with dignity" implies a rejection of the paraphernalia by which a terminal patient is kept alive, usually at great cost to his family and in isolation from it. Such "intensive care," so the argument...
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...wellbeing of those facing death. Indeed, health promotion is a core component of the nurse’s role. Originating in the UK, EoLC pathways have been adopted around the world.Their broad aim is to optimise the quality of the dying process, enabling people to ‘die well’ across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory. Key words: End-of-life care l Care pathways l Terminal care l Health promotion Michael Allen is Staff Nurse, Chemotherapy Day Unit, Singleton Hospital, Abertawe Bro- Morgannwg University Hospital Board, Swansea, Wales; Tessa Watts is Senior Lecturer, Swansea University, Swansea, SA2 8PP, Wales Correspondence to: Tessa Watts t.watts@swansea.ac.uk End-of-life care (EoLC), a core component of palliative care, is concerned with pre- venting and easing suffering experienced by people facing death. As life draws to its...
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...Women in Psychology Introduction Before recent times, many doctors, or physicians did not want to treat people with terminal illnesses. People with terminal illnesses were often considered as a humiliation to doctors or physicians, as the doctors and physicians were frequently thought of as failures because they could not treat or cure those individuals with life-threatening illnesses. Many times the doctors or physicians justification as to why patients with incurable illnesses were dying was that there was nothing more that could be done, and that there were countless demands that required the doctors or physicians time. The doctor’s unsympathetic and heartless ways towards the terminally ill was ostracized by a doctor from Switzerland by the name of Elizabeth Kubler-Ross. Thus, she decided to spend time with the patients who were terminally ill to both comfort and study them. This paper will discuss the background of Elizabeth-Kubler-Ross, her theoretical perspective as well as her contributions to the field of psychology. (Chapman, A, 2006). Background Elizabeth Kubler-Ross was born in Zurich, Switzerland, on the 8th day of July in 1926. She was a sister of triplets and a sister to a brother. Elizabeth desperately searched for uniqueness. It was hard enough being a triplet but having a sister who looked exactly the same as her was taking an even bigger toll on her. Since then need to be unique was so bothersome for Elizabeth she would often escape to one of her...
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...JAN DISCUSSION PAPER JOURNAL OF ADVANCED NURSING The use of theory in qualitative approaches to research: application in end-of-life studies Hung-Lan Wu & Deborah L. Volker Accepted for publication 24 July 2009 Correspondence to D.L. Volker: e-mail: dvolker@mail.nur.utexas.edu Hung-Lan Wu PhD RN Nursing Instructor Meiho Institute of Technology, Pingtung, Taiwan Deborah L. Volker PhD RN AOCN Associate Professor The University of Texas at Austin School of Nursing, Austin, Texas, USA W U H . L . & V O L K E R D . L . ( 2 0 0 9 ) The use of theory in qualitative approaches to research: application in end-of-life studies. Journal of Advanced Nursing 65(12), 2719–2732. doi: 10.1111/j.1365-2648.2009.05157.x Abstract Title. The use of theory in qualitative approaches to research: application in end-of-life studies. Aim. This paper is a report of an analysis of the use of theory in qualitative approaches to research as exemplified in qualitative end-of-life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end-of-life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions...
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...Salinas Professor King English 1302 May 3,2012 Literary Research Paper In the late 1800’s there was a great legend made in the history of poetry. Emily Dickinson, a famous American Poet who resided in Amherst Massachusetts, was born to a successful family who was thought of highly by many members of the community. Although, her reluctance to meet and greet people and her reputation of keeping to herself, made people think of her as strange and anti-social. Dickinson studied at the Amherst Academy in Massachusetts. However, even though Dickinson did not have many relationships with friends or people, this did not stop her from making the best out of her career. As a private prolific poet, Dickson was blessed with great success dealing with her poetry. She has had about one thousand eight hundred of her poems published in her life time, including After great pain, a formal feeling comes, and I heard a Fly buzz-when I died-; two poems which Dickinson is popular for today. These two poems strongly illustrate a theme of death and dying, to assist the reader understand and analyze the depth of this theme; Dickinson uses strong symbolism, tone, and figurative language throughout her works. Dickinson’s symbolism throughout these two poems is strong and magnificent. In After great pain, a formal feeling comes the author uses many objects to symbolize feelings having to relate with the major theme of death and dying. “The nerves sit ceremonious, like Tombs” (line 2). Dickinson...
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...experiencing stressful situations related to symptom management and death. The aim of this paper is to critically examine the current stress nurses face caring for Palliative Care patients. Four Nursing Journals and one Psycho-Oncology were reviewed. There was strong evidence to support that nurse’s experience stress caring for Palliative care patients. Common concerns in the first study were caring for a dying patient; personal level, comfort of the patient, and mediating between patient and family. The second study reported physical and emotional health consequences for nurses who provide hospice and palliative care over extended periods of time. The third study of nursesreported job satisfaction, stressors, coping strategies, and support. The fourth study nurses had 10 themes that conceptualize their work that may enable palliative care workers to remain resilient and effectively buffer or moderate stressful effects. The fifth study reported routinization of care, lack of nursing staff’s availability for emotional engagement, frequent interruptions, quiet afternoons, upbeat and positive culture, and a matter of fact attitude surrounding death and dying ,were all the behaviors that “being with” could not create. Although the report showed nurses able to cope by not “being with” the overall impact is stress related to caring for Palliative care patients. Although the common theme was education and support further research is the key to effective stress management and self- development...
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...NETTAH NDUNGU Texas Tech University Health Science Center School of Nursing Hospice Hospice is a comprehensive, medically directed, team oriented program of care that emphasizes pain control and symptom management rather than curative treatment. It directs acceptance of death as a natural part of life and addresses the psychological and spiritual needs of the patient and family. This paper will outline the history of hospice, the effect it has on healthcare today, why it is important to nursing, how nursing is impacted by the availability of hospice services, and finally, what nursing has done to affect change related to hospice. History of Hospice Hospice was first applied to specialized care for dying patients by Dr. Dame Cicely Saunders, who started working with the terminally ill in 1948 (NHCPO, 2015). Dr. Saunders later created the first modern hospice – St. Christopher’s Hospice in a residential suburb in London. Her approach was later introduced to healthcare professionals and chaplains in the U.S in 1963 during a lecture at Yale University. In 1969 Elizabeth Kubler-Ross contributed to the idea of hospice centered care in her book: On Death and Dying which highlighted the five stages of dying and a plea for home care as opposed to treatment in an institutional setting. In 1978, the United States’ Department of Health, Education and Welfare Task Force acknowledged the hospice concept as a means of providing more humane care for America’s terminally ill, while asking...
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