Discuss about the Contemporary Nursing : Issues, Trends, and Management.
Palliative care is a narrower vigorous term for end of life undertaking treatment of patients with both curable and incurable diseases. Some of the care requirements by the patients suffering from terminal conditions are pain management and palliative support. Different issues prevail in the optimal implementation and regulation of effective remedial treatment. Besides this, optimal nursing also faces certain issues that prevent imparting effective and professional practices to the patient.
The topic for this essay is optimal implementation of end of life care to the patients suffering from terminal diseases and illness.
This essay outlines the importance of effective end of care for people suffering from terminal conditions covering the care requirements by the patients and prevailing issues in it. Further discussing the issues faced by nurses in imparting optimal treatment.
According to a research conducted by Bloomer (2015) in different hospitals of Australia, 52% of people die due to ineffective end of life care. There are unable to get optimal care requirements such as pain management and palliative practices for soothing the distressed condition. Patients wishes for certain psychological and social care from nurses besides physiological interventions. This requires additional somatic and mental inputs from the healthcare professionals such as nurses (Bloomer, 2015). Nurses require providing optimal remedial and therapeutic treatment to the suffering patients for effective equilibrium in the somatic and mental status of the patient but lacks in delivering effective and on time care to such patients. There have been certain loopholes in the acute hospitals of the Australia regarding the effective delivery of healthcare services in terms of optimal end of life care by nurses (Hui et al., 2013). The prevailing issues in acute Australian hospitals are ineffective pain management and ineffective communication between patient and nurses. Some other prevailing issues are lack of appropriate information on the condition of the patient, late recognition of the degrading condition of the patient and incomplete knowledge on treatment of the malady and illness associated (Cosgrove & Bari, 2015).
The two issues prevailing in the optimal care of the dying patient and associated family are ineffective assessment of pain and lack in fulfilling the wish of receiving optimal palliative care.
Ineffective assessment of pain and wish of palliative care are two crucial issues in providing relief to the patients suffering from critical maladies and illness. Lack in assessment by acute hospitals creates a huge gap in implementation remedial inputs to the patient. Healthcare professionals such as nurses usually underestimate the extent of pain among patients which allows them to regulate remedial therapeutic actions on the basis of guesswork (Reid, Eccleston & Pillemer, 2015).
Ineffective palliative care also creates a big gap in effective treatment. Unproductive communication is a factor responsible for ineffective treatment and palliative services (Gelinas et al., 2013). Ineffective communication leads to barrier on regulation of efficacious questioning between patients and healthcare professionals. Patient lacks in explaining their symptoms, prevailing condition and expectations of optimal support from the nurses. Furthermore, communication provides the views on remedial treatment in terms of medication and non pharmacological intervention of patient and associated family (Broom et al., 2014). Religious beliefs and spiritual needs also play an important role in effective end of life care due to heterogeneity of the society human beings live in. Some religions do not allow medication due to certain ingredients while some religion does not allow certain non pharmacological interventions such as therapies and massage for pain management. Besides this, lack in updated technology also plays an essential factor in preventing the implementation of optimal care. Updated technology is required in accordance with updated information and communication technology (ICT) for enhanced implementation of tools for effective treatment. Optimal assessment of pain is essential for the implementation and regulation of effective treatment to the aged patients suffering with terminal maladies. This factor is interrelated with other factors as mentioned that prevents effective treatment (Payne, 2017).
Another important factor that prevents optimal remediation is the approach of nurses towards the remedial treatment. Ineffective training of nurses and uncompetitiveness are certain prevailing factors that intercept the optimal treatment.
Lack in optimal training leads to insufficient knowledge on the regulation of remedial medication and non pharmacological interventions that are essential for effective palliative care. Ineffective knowledge prevails due to improper training on the tools, clinical handover and handling of critical situation under pressure. These leads to late recognition of degrading condition of the patient that leads to death, by them (Cherry & Jacob, 2016). Furthermore, incomplete knowledge on the maladies and their treatment is another prevailing factor that prevents optimal treatment. This incomplete knowledge and inefficient practices occurs due to degrading and outdated facilities provided by the legislation and the hospital management. This leads to ineffective decision-making during critical conditions for the optimal treatment. Lack in optimal decision making also revolves around the ethical dilemma nurses face during the treatment of the patients under critical conditions. Such ethical dilemma is termination of life longing therapies used in case of diseases such as cancer, AIDS, pulmonary fibrosis and others. Besides this, patient autonomy does not allow nurses to implement and regulate certain remedial treatments as they are not allowed by patients. Example of this can be the barrier provided by religious beliefs and spiritual needs on the optimal implementation of non pharmacological intervention such as therapy or hypnoses (Johnstone et al., 2016).
Uncompetitiveness also prevails due to lack of interest towards work by the nurses. Below average and degrading quality of existing living standards in terms of social, economical and cultural status prevents nurses in developing interests for efficient treatment by them. Nursing profession is extremely demanding and requires somatic and mental attention by nursing professionals to provide any misharm during remedial treatment. This attention increases to a great extent in case of terminal patients. Lower allowance and minimal facilities prevents nurses from taking extra efforts for the effective treatment of elderly people. Increment in the economical and social status of the nurses is an essential step required to overcome the lag prevailing in the optimal healthcare inputs in term of pharmacological and non-pharmacological interventions (Candlin & Candlin, 2014).
Conclusively, this essay undertakes analysis on the treatment of the terminal patients by the healthcare professionals such as nurses. Furthermore, an analysis has been conducted on the existing loopholes at the legislative, hospital management and nurse level. End of life care is essential hospice along with palliative care provides effective guidelines for the effectual implementation of remedial medication and therapeutic treatment. This is the need of the hour to formulate and implement effective measures to enhance the existing practices. Care management for pain assessment and need of palliative care includes effective communication between nurse and patient for the determination of the extent and effectual implementation of medication and non pharmacological interventions. Legislation and hospital management must provide optimal funding for the upgradation of the tools and services required for treatment. Furthermore, frequent training must be undertaken to update nurses with existing healthcare practices. Besides this, overall social, mental and cultural well being of the nurses must be regulated and enhanced by the hospital management to maintain the competitiveness by nurses providing care to elderly people with terminal maladies and illness. Nurses must undertake ethical approach for decision-making during critical conditions in order to undertake efficient delivery of acute care.
References:
Bloomer, M. (2015). The challenges of end of life care in acute hospitals. Collegian, 22(3), 241-242.
Broom, A., Kirby, E., Good, P., Wootton, J., & Adams, J. (2014). The troubles of telling: managing communication about the end of life. Qualitative Health Research, 24(2), 151-162.
Candlin, S., & Candlin, C. N. (2014). Presencing in the context of enhancing patient well-being in nursing care. The Routledge handbook of language and health communication, 259-278.
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.
Cosgrove, J. F., & Bari, F. (2015). End-of-life care on the intensive care unit: an overview for hospital medical practitioners. Surgery (Oxford), 33(10), 515-518.
Gélinas, C., Arbour, C., Michaud, C., Robar, L., & Côté, J. (2013). Patients and ICU nurses’ perspectives of non?pharmacological interventions for pain management. Nursing in critical care, 18(6), 307-318.
Hui, D., De La Cruz, M., Mori, M., Parsons, H. A., Kwon, J. H., Torres-Vigil, I., … & Kang, D. H. (2013). Concepts and definitions for “supportive care,”“best supportive care,”“palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks. Supportive Care in Cancer, 21(3), 659-685.
Johnstone, M. J., Hutchinson, A. M., Redley, B., & Rawson, H. (2016). Nursing roles and strategies in end-of-life decision making concerning elderly immigrants admitted to acute care hospitals: an Australian study. Journal of Transcultural Nursing, 27(5), 471-479.
Payne, M. (2017). Older Citizens and End-of-Life Care: Social Work Practice Strategies for Adults in Later Life. Routledge.
Reid, M. C., Eccleston, C., & Pillemer, K. (2015). Management of chronic pain in older adults. bmj, 350(7995), 1-10.
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