...Nurses are on the frontlines of health as care givers. They have been trained to know the various ways in which sickness or disease can manifest in people. Nurses are also trained to carry out a plan of care authorized by the patient’s physician. Statistically speaking, the average people know more nurses and are on a first name basis with a nurse as opposed to doctors. They feel nurses can empathize with them much better than a physician and feel much freer to discuss their condition with a nurse often before they do with a doctor. There are very, very many times that it is at the urging of a nurse who will send a patient to a doctor who may well fear what a doctor will tell them their symptoms actually mean, which is why nurses urge people to see a doctor if they are the first health provider people seek, as they assuage their fears and bolster the...
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...staff nurses and hospice nurses collaborate on the administration of morphine. The rationale for this question is nurses are to medically provide comfort to the dying but not assist with a rapid increase of death. Appendix B on page 28 asked the following questions: 1. What is the problem and why is it important? The problem that exist is morphine being issued to hospice patients and the medication suppresses respirations. 2. What is the current practice? The current practice is hospice patients are being ordered morphine as a standard of practice by hospice nurses and staff nurses are the practitioners who have to implement the orders. 3. What is the focus of the problem? The focus of the problem are clinical, educational. and administrative 4. How was the problem identified? Safety/Risk Management Quality Concerns Unsatisfactory Patient, Staff, or Organizational Outcomes 5. What is the scope of the problem? The scope of the problem is institution. 6. What is PICO components? P - Patient, Population, Problem - Hospice patient receiving medication as standard. The medication is noted to reduce respirations. I - Intervention - Collaborate with hospice nurses to order morphine as a individualized medication and not automatically used for protocol C - Comparison with other interventions, if applicable Research to be done to do comparison, O - Outcomes that include metrics for evaluation - The outcome of hospice staff...
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...one fade away. But there are programs out there to help not just the dying person but also the families of the dying person. Palliative care and Hospice care are two of the programs in the U.S that are tailored to medical care, pain management, and emotional and spiritual support for the patient and family. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so. Palliative care focuses on relieving symptoms that are related to chronic illnesses, such as cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer’s and other dementias, AIDS, Amyotrophic Lateral Sclerosis and other neurological diseases. World Health Organization defines Palliative care as “improving the quality of life of patients and families who face life-threatening illness, by providing pain and symptom relief, spiritual and psychosocial support to from diagnosis to the end of life and bereavement” (“WHO”, 2013). Palliative care is accessed at any point during the course of a chronic illness regardless of life expectancy. It is typically provided through regular physician and nursing visits in an inpatient consultation service in a hospital setting. Palliative care is provided by a team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Some treatments and medications may be...
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...Running head: HAT Task 2 1 HAT Task 2 Anita Worley Community Health Practice March 27, 2013 Western Governor’s University A. Personal Perceptions As a Registered Nurse for thirteen years in an acute care hospital setting, I have tended to many dying patients. It is my personal belief that quality of life and health promotion are imperative to the care of the terminally ill patient. Personally, I am a big fan of palliative care nursing. The World Health Organization (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” B. Strategies Improving Mrs. Thomas’ quality of life would comprise of assisting her with her increased level of pain, limited amount of emotional support, and financial concerns. Firstly, Mrs. Thomas’ physical comfort needs addressed immediately. As evidenced by the patient spending large amounts of her day crying in bed, her pain is not under control. As her nurse, I would listen to her fears about addiction, but discuss quality of life versus drug addiction. I would explain how once her pain is tolerable, she will be able to assume a more productive, engaged role in her own life. Secondly, addressing Mr. and Mrs. Thomas’ financial...
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...care advocate is the most important role a nurse serves as a health care provider. Nurses serve to support the patient, sometimes having to put their own personal beliefs and values to the side. Although this is ingrained in us as nurses, sometimes health care providers allow their emotions to alter their perspective when dealing with death and dying. For twenty-four years I have served as a critical care nurse, and as an ICU nurse, I have been trained to help patients and families through this time of illness to provide care to help them heal and get better. Despite all that we do to treat patients, sometimes their illnesses are such that they do not get better and a decision is made to pursue comfort care. Since we are trained to help patients and families heal, this can be difficult to handle. Regardless of my personal feelings or beliefs, I always encourage my patients and their families to make the decisions that are best for them with the information they have been given. Our job as patient care advocates is crucial, especially when dealing with end of life and quality of life issues. The National Institute of Health defines hospice as “end of life care provided by health professionals and volunteers.” This type of care gives attention to pain control while trying to keep the patient as alert as possible. A referral to hospice is placed when a patient has been given less than six months to live. The goal of hospice is to maintain dignity and comfort while making...
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...Nursing Nurses face various ethical and legal issues in the medical setting. As professionals, nurses must be aware of these legal and ethical issues when they occur. Nurses have a legal and ethical obligation to respond to these issues. Being a professional nurse requires a nurse to assess the pros and cons of different situations, but also to withhold their personal beliefs and listen and respect the beliefs and traditions of others. Legally Nursing implications require nurses to maintain licensure, obey state and federal laws and to remain within their scope of practice. Within these legal and ethical issues the American Association Code of Nursing ethics, personal and societal values, legal aspects and legal responsibilities all affect decisions. Two different cases will be discussed and explored; an advance directive case involving a woman by the name of Marianne, and a malpractice case involving a nurse and the involved healthcare organization. The American Nurses Association Code of Nursing Ethics can influence the final decision made in the case study involving Marianne’s family by designating a surrogate. According to "American Nurses Association" (2011), “The nurse supports patients self-determination by participating in discussions with surrogates, providing guidance, referral to other resources as necessary, and identifying and addressing problems in the decision-making process” (1.4). In the case study involving malpractice, the nurse being called upon...
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...Come Join the Hospice and Palliative Nurses’ Association Houston chapter! Why Join HPNA Houston Chapter? • Free monthly subscription to CHPNA TODAY, a nursing journal with up-to-date articles and the most cutting edge research in hospice and palliative nursing • Speakers teach us how to apply research findings in clinical practice! • Bi-annual workshops and CEU’s • Fellowship with like minded professionals and networking opportunities • Houston chapter sponsors a bi-monthly newsletter for all things local in Hospice and Palliative Care! • Free study materials for CHPN certification! • Free Tote bag, T-shit and professional pin! Requirements for Membership: • Must be RN or LVN practicing in Hospice and/or Palliative Care setting for 18 months+ (special circumstances considered) • $120 yearly member ship fee, waived for members 55 years and up! American Cancer Society says, “HPNA is leading the charge for evidence based practice in a bourgeoning specialty.” Ruth M RN says, “ I have been a hospice nurse for 10 years, and yet I learn something new about this field and how to deliver care nearly every week!” Come see for yourself! This Monday November 15th HPNA Houston chapter is hosting an Ice Cream Social with keynote guest speaker Dr. John Wessley. Topic: “Caregiver Fatigue: Caring for yourself and Others, an RN’s perspective” Monthly meetings held the third Friday of the month 7:00p-8:30p In the M.D. Anderson...
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...Franciscan Hospice and Palliative Care Cindra Jones BSHS301 September 29, 2012 Christopher Bingham FRANCISCAN HOSPICE AND PALLIATIVE CARE I chose Franciscan Hospice and Palliative Care because I am interested in the valuable service they provide to the community. I wanted to know exactly what they do and how it is paid for so I made an appointment to talk to someone at the Franciscan Hospice and Palliative Care facility. Hospice is care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than a cure. The word “hospice” comes from the Latin “hospitum” meaning guesthouse. It was originally a place of shelter for sick and weary travelers. Palliative care is the treatment and relief of mental and physical pain for those with a life threatening illness. This treatment uses several types of therapy to make a person comfortable and free of pain. I was very fortunate to meet Pam Ketzner, the hospice educator and registered nurse at the Franciscan Hospice and Palliative Care facility located in University Place, Washington. Pam is in charge of educating the hospice nursing staff. With new equipment and medications always becoming available, she instructs the nurses on their proper use. She has been a nurse for 35 years. She was a visiting nurse to begin with and then became the head of education so she spends most of her time at the facility. She feels very privileged to be a part of...
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...Review of Literature Essay When a person is placed on hospice, it is generally seen as a comfort measure instead of a curative measure (Villet-Langomarsino 2018). Pain management of the hospice patient is of great importance because it is one of the few things that can be done during the end stage of life when treatment of a disease is no longer desired. Pain is a common symptom in health care and should be one of the easiest to treat due to its popularity, but unfortunately it is not. Since pain is so unique to person, assessment and treatment must be custom tailored to each patient. The problem with pain management is its specificity to each person and disease plus the numerous ways to treat it. Without one specific roadmap of treating...
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...Children in Hospice Katrina Williams RES/110 April 26, 2012 Professor James Lazos Children in Hospice Research suggests that every year there are between 100,000 to 150,000 children born in the United States with a genetic disorder or defect. This represents approximately 20% of infant deaths each year. However, many of these children live to age well beyond the expectation, and some are enrolled in hospice. According to Armstrong-Daily and Zarbock (2001), “The concept of hospice today is applied to patients who are traveling through the final stages of their lives-in effect seeking shelter and comfort.” Hence, the main focus of this program is to prepare families for the death of a loved one. Although accepting these services is optional, families suddenly faced with the harsh reality that adulthood or even adolescence is not in their child’s future are in need of support services that offer much more than the comfort of a shoulder to cry on. There is an urgent need for organizations that strive to assist parents in helping the child to reach his or her full potential while encouraging loved ones to celebrate and cherish the time spent without the constant reminder that death is near. Caring for a child with a disability can be challenging. Immediately upon the child’s initial discharge from the hospital, life changes drastically. Parents are instantly bombarded with phone call from social workers, medical supply companies, and nursing staff for updates about...
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...Hospice care The main goal of hospice care is to aid patients to live their last days as alert and pain-free as possible. Hospice care attempts to manage symptoms so that the person's last days may be spent with dignity and a good quality of life. Hospice care treats the person rather than the underlying disease; it focuses on quality of life rather than length. Hospice care is family oriented; it includes the patient and the family in the care and decision making. The care is planned to cover all 24 hours of a day, and all 7 days of the week. Care is given in the home, a hospital, nursing home, or hospice facility. Hospice care is what we resort to when the patient can no longer be helped by a curative approach, and the patient is expected to live less than 6 months. Hospice is palliative care, which means that the approach is to relieve symptoms, but not to cure the disease; its main purpose is the improvement of the patient’s quality of life. The patient, his/her family and the physician decider when hospice care should begin. Hospice care is managed by an interdisciplinary care team. What it means is that the different disciplines interact and work together towards a common goal. Doctors, nurses, CNA’s, social workers, therapists, and volunteers work together to care for the patient and his/her family. All of these people offer their support based on their individual special areas. Together, they give the patient and their loved ones complete palliative care aimed...
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...The aim of this essay is to explore an aspect of care that a client group receives whilst in the community setting. The chosen aspect of care will be palliative care delivered to those patients who have been told they have a non-curative illness but are not yet at the end of life. The stage of the illness of the client group chosen is one where the patient is managed at home because there as there is nothing anyone can do to make things better (Calman-Hine Report 1998). The essay will also briefly describe three different professional groups involved in providing palliative care. It will then go on to discuss how good communication and collaborative working between these professional can provide the best quality of care of the patient and how poor communication can compromise the patients quality of care. Palliative care can be defined as the overall care of patients whose disease does not respond to curative treatment. The aim of Palliative care is to improve as much as possible the quality of life of patients and their families facing a life-threatening illness. This can be achieved by providing pain and symptom relief, spiritual and psychosocial support from diagnosis to bereavement (WHO 2002). Patients with life threatening illness may require care from a variety of different specialists and services at a number of points in their illness; this will include both statutory and non-statutory organisations (National Health Service Executive 1998). To ensure that all...
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...Physician-Assisted Suicide Must Be Legalized Sheryl Tello GEN 499 Prof. David Ward March 14, 2014 Physician-Assisted Suicide Must Be Legalized Imagine that you just received a phone call from your physician’s nurse and she told you that the doctor wants to see you right away. When you ask her what is the problem; she tells you that it would be best if you came into the office as soon as possible. You tell her that there is no way that you can come in until next week; she asks if you can hold for a minute while she relays the message to your doctor, and the next thing you know your physician is on the phone and tells you that he wants to see you today. You try to rationalize everything that your physician could possibly tell you. Then you tell yourself that it cannot be too bad because you have always taken good care of your body, you eat right, you get plenty of exercise, and you see your doctor once a year. At the doctor’s office, the doctor informs you that there is no easy way of telling you that a large amount of cancer cells have been found in your blood work. As you try to speak, he continues to inform you that the cancer cells have completely taken over your blood and have migrated to your vital organs. As you try to speak again, he interrupts you one more time, however, this time it is to deliver the final blow; you only have six weeks left to live, which you will surely spend in extreme pain and unremitting suffering as your body goes into complete organ...
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...Grand Canyon University: NRS-433V Introduction to Nursing Research May 20, 2012 Research Critique, Part 1 Advanced Care Planning (ACP) is a huge part of healthcare. Dying is a part of life, but that doesn’t make the subject any less scary. Just because healthcare professionals handle end of life issues on a regular basis, doesn’t mean that they are immune to the sensitivities of the topic. End-of-life decision making is the process that healthcare providers, patients, and patients’ families go through when considering what treatments will or will not be used to treat a life-threatening illness. (Thelen, 2005) Many nurses who deal with death and decision making burn out. Hospice staff, because of their work with the terminally ill, are considered a high-risk group for burnout. Often, the reason behind the decision to leave or take a sabbatical from hospice work is that the staff member reached the limits of his or her capacity to care and “couldn’t take it anymore.” (Keidel, 2002) A qualitative study done, on anticipating emotion, related to ACP, was chosen to be critiqued, due to this highly sensitive topic in the healthcare industry. The subject this study was critiqued on, were, the problem statement, purpose and research question, literature review, and conceptual/theoretical framework. The clinical problem, addressed, is that end of life discussions between healthcare professionals and clients have many areas of hindrance, due to the sensitiveness of the discussions...
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...Hospice Care Hannae Warren HCS/212 Kristie Racca October 24, 2011 Hospice is a term that is traced back to medieval times; it was a place where tired or sick travelers could find a place of shelter, rest, and care (“History of Hospice Care,” 2010). Since the medieval times hospice care has evolved into a contemporary program that offers patients facing terminal illnesses medical, spiritual, and psychological care. A physician named Dame Cicely Saunders first proposed the thought of specialized care for the terminally ill in 1963, and in 1967 she founded the first modern hospice in a residential suburb of London (“History of Hospice Care,” 2010). This was the beginning of modern day hospice care which provides patients the humane and compassionate care that is beneficial to people that are in their last phases of incurable diseases, so that they may live as much as possible and as comfortably before they pass away (“Hospice Care,” 2011). The Hospice viewpoint is that death is the final stage of life, they support life, and neither rush nor delay death (“Hospice Care, 2011). The ultimate goal of any hospice is to assist patients live their last days on earth as a alert and as pain-free as possible (“Hospice Care,” 2011). Hospice care is helpful when...
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