View Full Version : Question for nurses on end of life care.

09-29-2008, 10:54 AM
I am a second year BScN nursing student and have my first single client focus. My client is on palliative care and I am hoping to expand my knowledge and therapeutic communication skills of clients on end of life measures. Any opinions, advice or information would be greatly appreciated!

Thanks so much,

09-29-2008, 11:42 AM
Julie, I think palliative care is an amazing privilege. I've done little of it as a nurse, but have been involved with palliative care from the pastoral care aspect. Palliative care is a recognized specialty in medicine, btw; another indicator of its unique qualities.

Assisting patients and families (sometimes communities)with living at the end of life, and dying, can truly transform you. It can be sadly sweet, sweetly sad. It can grant you the privilege of sharing in some of the deepest moments in patients' and families' lives. In old, traditional Jewish communities it was the holiest individuals who would accompany someone as they transitted into the next life. We don't see this much anymore. Palliative care can involve real spiritual awakening and experience.

How about you tell us what you think so far, share some of your musings and questions. So far you've left it very vague. Where is this experience taking you so far?

10-02-2008, 01:27 AM
In my area we have at least one dying patient at any time, usually they are elderly but not always. I work in a medical area so its not necesarily a cancer patient, mostly they are just old with maybe a stroke or a pneumonia.They are all different, their families are all diferent and so is what they will need of you. Of course they will all need similar basic nursing cares and comfort measures but tweaked to fit them. I think that the most important thing I can do when I take over the care of that person is to ask them and or their family what do you understand to be happening?, what do you know/understand of the plan of care? I then know what sort of position they are in, frightened? defensive? stressed out? An observation of mine is that people who know too much have a hard time, like patients or families who have nursing or medical knowledge, they frighten themselves with the posibilities or sometimes (unfortunately I have seen this with family members who are nurses) they don't trust us to care properly for the relative.
Another group is those who know nothing who struggle to understand what we are doing and why and possibly have no understnding of the reality of the situation. Such as what is medically possible or even ethical and legal(no we can't give mum/dad/sis/ more morhine to hurry it up). I recent had a family who elderly relative was dying at her own pace and in her own way and this family were not medical people but they were very well informed, they had listened to what was told them and trusted and believed the Doctors, they had a little knowledge regarding what would happen and I could fill in what else they wanted and needed to know and they were so calm, they spent long hours with the relative enjoying the coming and going of the friends and other relations ands it was one of the most graceful experiences I have seen and so easy for us nurses. I believe that death is too far removed from us in our western culture so that it can be unnecessarily traumatic for some people when they are finally faced with it (for the relatives).

10-29-2008, 06:29 PM
A 'new' system is being used in a few hospitals here. It is along the lines of the living will. A list of questions are used to determine what is important to the patient, rather than asking direct medical questions about resus and intabation. It is receiving good responses and allows for people to stipulate not just the care they want, but also who/what they want around them.

I have had patients writing their own funeral ceremonies (not the most positive of things) but they just wanted to take the pressure off the family.

11-09-2008, 09:54 AM
Julie, I think palliative care is an amazing privilege. A privilege...does it really get any better than that? That quote says it all. "It's an amazing privilege."

12-23-2012, 11:55 PM
Good to hear some insight/scenarios here about end of life issues! In my student life, I was not able to experience taking care of patients who eventually die under my care, so I am preparing myself how to deal with such situation if I am already in the clinical area working as a registered nurse!

01-10-2013, 10:29 AM
Hi guys!Thanks for all your inputs about this question. I get a lot from you