Research on experiences of intensive care nurses has revealed good death as one which is extremely trouble-free and where self-esteem and ease of patients were given due attention. Family involvement and complacency with care also greatly factor in. for, patients at the last terminal of life, sustained care and communication are vital and nurses are to heavily contribute in such scenarios. Harmony between the patient s’ aspiration for care and the actual care meted out is the barometer of a good death. Most of the patients are believed to spend their last days in very uneasy conditions of pain.
In these scenarios, particular interventions become all the more necessary to give them as much comfort as possible otherwise they would not die an easy death. There are times when death is expected even it can be accurately forecasted. In such cases, the treatment ends transform from facilitating offensive curative therapies to ease concentrated line of action of care. This is the time of the increased patient and physician interaction. There is also a dire need for individual and societal dedication to increasing the care of the person who is on the verge of death.
Aspirations, predictions, ends, and cure interventions all hinder facilitating the end of life care. The patients who are hesitant to give vent their feelings, intermediaries can better find out their norms, beliefs, and experiences underpinning their actual wishes. There are other hedges that bear the provisos of sufficient relief to the patient struggling against death. Nurses are well aware of the canon of double effect which states that proving ease to the patient may prompt him or her to die earlier but this is worthy of consideration when the patient is in extreme trouble and life has become a too severe burden for him or her to shoulder it any more.
The pain management plan must be persistent, consistent, and flexible. Continued evaluation of the state of the patient is also essential. Pain may be an indicator of emotional or spiritual uneasiness. Interventions, therefore, would be aimed at the actual reason for pain which is anchored in the cultural basis. “Prior to the development of antibiotics and other medical advances, people often died quickly, usually of infectious diseases or accidents. Today, the vast majority of Americans have a more protracted experience with death. Families and terminally ill patients, whether young or old, have a broad range of physical, psychological, social, spiritual, and practical needs” (Athealth, 2005).
Listening attentively is the bedrock of fruitful communication. Even though patients and families are expected to be realistic towards a care management plan but at the same time we do not want them to shed away their hope. Spiritual experts must be engaged in the process because it is extremely beneficial for the patients and families who are to cope with the stress of the imminent death. Some patients and their families do not want to speak of death in an explicit way and rely on metaphors to speak their minds. On these occasions, interpretations are not feasible. Communications also ooze out of the behavior of nurses.
Empathy and concern should not be manifested in a manner that is dampening. Pleasant nurses may also do remarkably well in these trying circumstances of patients. Some titbits can also do a fine job to alleviate the pain and sufferings of those who are about to be stripped of the paradigm of life.
The majority of nurses hail the significance of compassion and the growth of a reliable relationship as main elements to facilitate quality care at the end of life. Nurses exploit all of the expertise at their disposal to explain their compassion for the dying one. It may include cultural regard, presenting, and support of the patient. The Comfort level of the patient these days demands utmost care and energy on behalf of those who are involved in the care management plan.
The mental needs of patients are paid special attention as this may be a great lessened of pain and grief. Nurses are in extreme contact with the patient and can better interpret the wishes of the patient and communicate them to others who may adopt the most feasible approach of caring for the patients. “ Hospice and palliative care both focus on helping a person be comfortable by addressing issues causing physical or emotional pain, or suffering. Hospice and other palliative care providers have teams of people working together to provide care. The goals of palliative care are to improve the quality of a seriously ill person’s life and to support that person and their family during and after treatment( Robert, 2008).
End-of-life skills entail lifelong learning signs that are vital for nurses. They include reformed listening expertise, attention to feasible ambiance for end-of-life debates, and consent to provide end-of-life debates. Open visitation practice also gains more importance and the limit to such visiting hours is curtailed. Nursing interferences for extremely ill patients should embrace acknowledgment and regard for the cultural individuality of each patient. In contemporary pluralistic society, culture impacts the nursing care of patients in diverse methods from pain management and visitation hopes to the care of the body after its expiration.
Nurses must take into account the distinctness of every individual and the manners that impact the requirements of the family. “All end-of-life choices and medical decisions have complex psychosocial components, ramifications, and consequences that have a significant impact on suffering and the quality of living and dying. However, medical end-of-life decisions are often the most challenging for terminally ill people and those who care about them. Each of these decisions should ideally be considered in terms of the relief of suffering and the values and beliefs of the dying individual and his or her family” (Carrese, & Rhodes,1995).
Patients should be inquired gently of their religious or spiritual inclinations. Their corresponding spiritual teachers should also be contacted to support them in their hour of trial. Their experiences with these spiritual moments should also be asked so that they can contribute in this time too. Religious items can be placed near them to give them a feeling of spiritual comfort. Verses from scriptures can also be spoken to the dying patients to decrease the sensation of pain that is quite crushing for them. Their best friends can also be engaged in the process as they can play a great role in these moments. They know their wishes very well and can guide the care management staff.
References
Athealth. (2005). End Of Life Care. Web.
Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation. JAMA, 274, 826.
Robert.(2008). How Can Palliative Care Help? Belmonster publication. Web.