Palliative care refers to the care for fatally ill and their family members (Howk & Wasilewski-Masker, 2011). Mainly the health care organizations provide the palliative care. Various nursing issues can affect the palliative care like lack of support and collaboration, moral and ethical distress such as lack of support and knowledge. In case of many people in Australia, needs palliative care at the end of their life as they suffer from various acute diseases. They do not get proper care therefore; they have to readmit again in hospitals. Palliative care is associated with the patient, nurse, family and friends.
The discussion focuses on the significance of the care requirements that can affect the palliative care. The care requirements of palliative care patients are discussed that is the pain management and support to the patients and family. The nursing issues regarding the palliative care end of life is discussed. The issues and cross-cultural end of life practice may be raised and provide suggestions to negotiate the common problems.
In case of Palliative care helps in the pain management. For example, if a patient is suffering from analgesia, he may need quality care. Pain assessment is one of the effective tools that help to reduce the pain and provide relief to the patient. The caregiver may provide oral medication to the patient to reduce the pain for terminal illness. The Main requirement of palliative care is to provide the pain medicine, algiatry and pain management to the patient. They employ interdisciplinary approaches to ease the suffering and improve quality of life of the people, suffering from chronic diseases.
Palliative care helps people to live their life completely and comfortably during the terminal illness. This type of care identifies the symptoms and the treatment may be of spiritual, social, emotional and physical. This provides relief of the shortness of breathing, pain and vomiting. The palliative care as the family centered model of the care as this type of care provide emotional and practical support. The illness of patient affects the entire family. Palliative care for patient at home may be strenuous for the family (van der Plas et al., 2015). This may affect the health of the family members that harms the family members physically and emotionally. Therefore, the family members need to keep themselves strong emotionally and physically, that will help the caregivers also to perform their jobs properly (Casey et al., 2011). The needs of the family increase with the progress of the illness of the patient. Therefore, the families need special care to cope the terminal illness. The early detection of the illness can make the family emotionally strong. With the terminal illness development, the patient may need the support of family members to avoid the death. Some of the families choose to take the patient home at the end of life. Therefore, the caregivers need to support them and provide the proper teaching about the palliative care and logistic support (Powell, Zadeh & Wiener, 2015).
The main issues of that the nurses face during giving the palliative care are the lack of communication skills and lack of knowledge. The nurses need to recognize the patient of the end of life and should know the caring system of them. If the nurses do not know the caring system properly then it may create issues. Moreover, the nurse needs to be polite with the patient and family members. They should not hurt the patient emotion that may affect the health of the patient. The nurse should know the difference between personal and professional behavior. The nurse should not show their grief to the terminally ill patients. Zadeh and Wiener (2015) mentioned that the nurses might face problems during decision-making. The family may not support the nurses therefore; it can affect the patient. The nurses need to maintain the ethical responsibilities regarding the palliative care. The nurses need to take the permission of the family and friends before providing care treatment to the terminally ill patient. The nurses should inspire the patient and support him to reduce the pain of sufferings. The nurse should explain the pros and cons of a treatment to the patient and his family.
Caregivers need to communicate properly with the family members to avoid the nursing issues regarding the communication. Clark and Fasciano (2015) mentioned that in case of palliative care, the involvement of the family members is very necessary. The patient and family members need at least six hours of sleeping each night. The caregivers need to take care of the end of life patients (Howk & Wasilewski-Masker, 2011). Most of the family members may feel burden to take any risky decision regarding the patient’s health. The caregiver needs to teach the family members about the importance of the decisions (Zimmermann et al., 2014).
According to Crawford et al. (2013), in palliative care, honesty and open communication is very necessary that reduces the nursing issues of end of life. Strong communication can reduce many of the conflicts and confusion in between the physicians, nurses, patients and family members. For example, in case of a cancer patient, he may need chemotherapy therefore; the nurse needs to inform this to the patient and family members. Some of the extensive evidence showed that the palliative care depends upon the communication in between the multidisciplinary team members (van der Plas et al., 2015). The palliative care is one of the aspects of health services, from which may of people are not aware. This care mainly helps those patients who have no expectation to get well soon like cancer patients, COPD patients and patients with chronic kidney problems. Powell, Zadeh and Wiener (2015) mention that palliative care may not provide proper recovery to the patient but can help to reduce the problem and pain of the patients.
The caregivers need to be careful about the culture and background of the patient who is suffering from fatally illness. The family members and nurse or physicians may not be agreed about the treatment that is harmful for the patient. The families members need to understand the necessity of that particular treatment whereas the nurses also need to co-operate with the family members (Quill & Abernethy, 2013). The patient may get comfort via the cultural and communal things. Physicians need to assess cultural background of the fatally ill patients and request about the values, which can affect the care at the end of life. The nurses should be aware of particular beliefs and practices of the patients whom they serve. In case of palliative care, the culture, background and beliefs play important role (Zhao et al., 2013). However, in case of end of life the palliative care is more helpful than the evidence based nursing.
From the above discussion, it can be concluded that in case end of life, palliative care is necessary. Various nursing issues affect the palliative care like lack of support and collaboration, moral and ethical distress. The caregivers need to communicate properly with the family members to avoid the nursing issues regarding the communication. The care givers need to be careful about the culture and background of the patient who is suffering from fatally illness. The nurse should know the difference between personal and professional behavior. The nurse should not show their grief to the terminally ill patients.
References
Casey, D., Murphy, K., Ni Leime, A., Larkin, P., Payne, S., Froggatt, K. A., & O’Shea, E. (2011). Dying well: factors that influence the provision of good end?of?life care for older people in acute and long?stay care settings in Ireland. Journal of clinical nursing, 20(13?14), 1824-1833.
Clark, J. K., & Fasciano, K. (2015). Young adult palliative care: challenges and opportunities. American Journal of Hospice and Palliative Medicine®, 32(1), 101-111.
Crawford, G. B., Brooksbank, M. A., Brown, M., Burgess, T. A., & Young, M. (2013). Unmet needs of people with end?stage chronic obstructive pulmonary disease: recommendations for change in Australia. Internal medicine journal, 43(2), 183-190.
Howk, T., & Wasilewski-Masker, K. (2011). Palliative care for adolescents and young adults: a pediatric perspective. Journal of adolescent and young adult oncology, 1(1), 11-12.
Powell, D., Zadeh, S., & Wiener, L. (2015). Perceived Level of Emotional Support and Self-reported Areas of Post-traumatic Growth in Parents of Children Undergoing Cancer Treatment. Pscyho-oncology, 24, 214.
Quill, T. E., & Abernethy, A. P. (2013). Generalist plus specialist palliative care—creating a more sustainable model. New England Journal of Medicine, 368(13), 1173-1175.
van der Plas, A. G., Onwuteaka-Philipsen, B. D., Francke, A. L., Jansen, W. J., Vissers, K. C., & Deliens, L. (2015). Palliative care case managers in primary care: a descriptive study of referrals in relation to treatment aims. Journal of palliative medicine, 18(4), 324-331.
Zadeh, S., & Wiener, L. (2015). Opening end-of-life discussions: how to introduce Voicing My CHOiCES™, an advance care planning guide for adolescents and young adults. Palliative and Supportive Care, 13(03), 591-599.
Zhao, X. D., Cai, B. B., Cao, R. S., & Shi, R. H. (2013). Palliative treatment for incurable malignant colorectal obstructions: a meta-analysis. World J Gastroenterol, 19(33), 5565-5574.
Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl, N., Oza, A., … & Donner, A. (2014). Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. The Lancet, 383(9930), 1721-1730.
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