...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...
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...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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...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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...Protection of Human Life in Law and Public Policy: Research Paper Topic Issue Statement: What are the moral, ethical, and legal implications associated with end of life care for individuals suffering from Alzheimer’s and other forms of dementia? Sources: I will use a variety of articles, case law, and relevant statutes and regulations that deal specifically with end-of-life care. Sources I have already located: * Late stage and end-of-life care: Caregiving in the Final Stages of Life * http://www.helpguide.org/elder/alzheimers_disease_dementia_caring_final_stage.htm * A Christian Response to “End-of-Life” Decisions By Bert Thompson, Ph.D and Brad Harrub, Ph.D * http://www.apologeticspress.org/apcontent.aspx?category=7&article=58 * Decision Making at the end of life: Patients with Alzheimer’s or other dementias * http://content.lib.utah.edu/cdm/ref/collection/uspace/id/3461 * Ethics Conflicts in Rural Communities: End-of-Life decision-making * Taken from the Handbook for Rural Health Care Ethics: A Practical Guide for Professionals (PDF Download) * The Euthanasia Debate: Understanding the Issues * From the Christian Research Journal * Euthanasia Arguments-Christian Research Institute * http://www.equip.org/articles/euthanasia-arguments/ * Views on Euthanasia * http://www.equip.org/articles/views-on-euthanasia/ * Active and passive euthanasia * http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_1...
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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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...The Summary Paper Legal/Ethics Issues In The Health Care Business BUS670 Rhunda Mitchell Instructor Little 10/24/11 More than any other industry, it is in the healthcare business that ethics are of utmost importance. This is because, people in this industry deal with such situations and circumstances, everyday, which have a direct bearing on another person's life. In this paper one will discuss the ethical/legal issues which are faced by the healthcare industry as a nurse, and ethical issues in healthcare, pertaining to both management and medical research and give suggestion on how to handle each situation in hand. Ethical/ Legal Issues as A Nurse: Nurses are subject to a wide range of legal, ethical and professional duties which can be very challenging. These duties are generally considered to be to respect a patient’s confidentiality and autonomy and to recognize the duty of care that is owed to all patients. As a nurse their duties have to be always professional, because there are legal implications if these duties are breached. They also must consider when it is okay as a nurse to breach these duties and therefore ethical issues arise. Ethics is a set of moral and practical guideline that influences nursing decisions big and small. One of the main priorities of a nurse is to advocate for their patients a nurse expresses and defends the cause of their patient, nurses are expected to protect their patients’ rights. Patients’ rights can vary from...
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...Legal and Ethical aspects of Assisted Suicide Paula Nehrling Grand Canyon 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...
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...this research paper you are to select a country other than the United States and survey the health care system of that country, identifying and discussing its key features. As part of this project, you’ll research your chosen country’s health status and health care environment, its policies and practices. Due Week 2: The name of the country you’ve chosen as the topic of your project is submitted to the drop box. (See additional instructions under the Week 2 Assignment tab) Due Week 5: An outline of the information and topics to be covered in your paper is due to the dropbox by the end of the week. This assignment is to follow a formal outline format. For a template of a formal outline review the example provided in the Course Project tab or visit: http://www.crlsresearchguide.org/worksheets/outline%20worksheet.htm this is the one I am going now Due Week 7: The completed research paper is due by the end of Week 7 and requires at least three sources beyond the course text and should be 6-8 pages in length. I will need this one in about two weeks. I will be paying for this one later The length of this paper is to be 6-10 pages; bibliography and text citation is required (APA Style). You are required to have references from our course textbook incorporated into your paper (in–text citations/works cited page) and at least three sources beyond the course texts. Have your paper include an introduction, main body and conclusion. For additional information on writing a research paper...
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...one else. According to the Catholic Church there are three moral principles on conserving health and life: sanctity of life, God’s dominion and human stewardship, and the prohibition against killing. Promoting the morality of the right to life, compassionate care and the power of divine love, the Catholic Church tries to offer a hopeful perspective. Radically different views than those of the Catholic Church are expressed by both healthy and terminally ill patients when surveyed. Several national organizations have been founded supporting a persons’ choice, to include the Hemlock Society and the Final Exit Network both with Arizona chapters. One of the main reasons terminally ill patients want the right to choose assisted suicide is to be able to die with dignity. The thought of being unable to care for yourself or recognize your family is particularly frightening and unwanted by most people. Mentally competent adults have a basic human right to end their lives when they suffer from a fatal or irreversible illness or excessive pain, when their quality of life is personally unacceptable, and the future holds only hopelessness and misery. Arizona is one of 34 states that have explicitly criminalized assisted suicide; only the states of Oregon and Washington permit physician assisted suicide with the remaining fourteen states somewhere in between. In my research paper, I will contact Compassionate Choices of Arizona, previously known as the Hemlock Society and The Final...
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...The Comfort Care Concept at End of Life Introduction End of life is a 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...
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...Health Care Provider and Faith Diversity: Peer Review Ryan J. Bartholomeo Grand Canyon University Spirituality and Christian Values in Health Care and Wellness April 25, 2013 Health Care Provider and Faith Diversity: First Draft Knowledge and acceptance are one of the two most important factors when discussing the diversity of faith expressions and belief systems of patients as a health care provider. For this assignment, I decided to research Christianity and one other diverse faith group; interviewing said friend about her faith, Naturalism. In the health care industry, health care providers whose spiritual beliefs differ from their own personal beliefs are a common issue. Learning how to appropriately and respectfully handle each individual’s diversity and faith or belief system is of the upmost importance within the health care industry. Interview Assessment Analysis When conducting my interview with my close friend, Asyia Aanandi, asking a wide range of questions on her faith was required for further assessment; furthermore, the best way to incorporate Asyia’s beliefs of a Naturalist toward her philosophy of providing care from the perspective of her faith. Asyia Aanandi’sAanandi spiritual beliefs are that of a Naturalist, believing in only one single notion; Homo-sapiens feel, think, and act on, due to “chemical reactions” inside ones brain and body. Naturalism is the belief that as humans, acting on...
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...instead I will give them different characteristics that characterize each group. Day 4: Life Cycles: This will deal with the different cycles each animal group has to go through. Day 5: Metamorphosis: Another lead in from the Life cycles lesson. Day 6: Offspring: I will be discussing with the students the animals and their babies. Day 7: Caring for their young: Here is where we will have a lesson on how the animals take care of their young. Day 8: Identifying the Needs of the animals: Like humans, animals have certain needs too and I will delve into these needs. Day 9: How they meet their needs: Another follow up from the previous lesson, I will do a part two lesson where I will teach a lesson on how the animals meet these needs. Day 10: Habitats: This is where we’ll discuss the homes of the animals. Day 11: How the animals move: This deals with how they use their bodies to run from their prey. Day 12: Adapting to the Environment: How these animals survive in their environments and where they live. Day 13: Food Chain: where their groups belong on the food chain. Teacher: Marianne Lettieri Grade: 2; Animal Groups Specific Expectation(s): In this first lesson, by the end, the students should be able to identify and describe the six major animal kingdoms Strand: Growth and Changes in Animals Materials and Resources: chart paper, magazines, markers, tape,...
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...Palliative and End of Life Care provide a holistic approach to care for those who are suffering from illnesses with a poor prognosis. It focuses on symptom management in an effort to improve quality of life (Ranallo, 2017). This approach to care for pediatric oncology patients with a terminal prognosis is not focused on a cure, rather emphasizes comfort when the patients and their families need it most. Various research studies explain the importance of initiating Palliative and End of Life Care early after the patient’s diagnosis. Given nurses’ roles, they have the opportunity to help provide this care. The purpose of this paper is to discuss ways to improve the quality of life of pediatric oncology patients through nurses helping to facilitate...
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...https://gumroad.com/l/Teayh SOC Final Paper Final Paper To complete this assignment, read through the scenario below and address the specific questions and issues indicated. Review the "Introduction to the Miller Family" document for specific information on each member of the family. Grandmother Ella has been dealing with cancer for years now and has tried alternative remedies and juicing. She went into remission for some time, but now the cancer has returned and she is in the hospital. Her husband, of American Indian descent, has his ideas about what needs to be done as Ella comes to the end of her life. Ella has her preferences, though she is now so weak that she has given up in many ways. The family members are each experiencing their own fears and are grieving as they face the loss that will occur as Ella’s life comes to a close. Ella prefers to die at home and has felt stressed by the discord and discomfort of family members since being hospitalized. You are the social worker for this case. You meet this family in the hospital setting as they are considering whether the patient will remain there for her final days or whether hospice and palliative care will be provided for her in her home. For this assignment, you will: Synthesize the current research that is relevant to this scenario. Discuss the cultural or traditional issues that could arise at this time. Consider how the integration of alternative and complementary medicine and beliefs, mainstream...
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...Analysis Paper The Impact of Advance Care Planning on End of Life in Elderly Patients Amber Frederick April 9, 2013 College of Saint Elizabeth Professor Marranca Many patients do not have advanced directives and often enter the hospital where various medical care is received and sometimes unwanted. This is because many patients are not given the opportunity to plan ahead and choose the care they would want. In order to improve patient satisfaction, reduce family burden and decrease health care cost, advance care planning is suggested. Health care providers play a major role in facilitating discussions and planning for patients’ medical future. All too often patients come into the ER in some type of distress and are often resuscitated or intubated by medical personnel in order to save their lives. When patients are extubated and coherent, they become upset because those resuscitation efforts were not wanted by the patient. Other times, family sees their family member on mechanical ventilation and is disheartened because they know their loved ones didn’t want to be in that situation. These patients may have terminal illnesses and resuscitative efforts only prolong their suffering and impede their comfort. There is a way to educate patients and families about their different options and it starts with the Primary Care Provider (PCP). PCP’s are able to help their patients with advanced care planning. This is a process “whereby a patient, in consultation with health care providers...
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