• Subject Name : Nursing

Nurses and Palliative Care

Introduction to The Nurse's Role in Palliative Care

In the profession of nursing, nurses have to be acquaintedwith patients who are suffering from chronic life-threatening diseases. This role demands expertise and knowledge while performing palliative care for the patients. Palliative care is the care which is given to the patients who are dying or are severely ill because of a disease. This care has been provided to them so that their quality of life could be improved. With that, palliative care also helps the patient's family to cope with the situation. It could be provided in any kind of setting for example in hospitals, palliative care units, hospices and nursing homes (Sekse, Hunskår&Ellingsen, 2018). Patients usually spend most of their time with nurses who are looking after them. Nurses are their point of contact other than their family members. Therefore, nurses have to work with the patient and also have to bear the burden and the mental strain from the passing of the patient and they have to offer their support to the patient's family member and friends. They need to make them more comfortable in terms of social, spiritual, psychosocial and social aspects. Thus, it can be said that nurses have a very significant role in performing palliative care (Schroeder & Lorenz, 2018; Chang, 2018; Paknejadi et al., 2019).

Research question

The research question that can be formulated can be: How do nurses help in palliative care? This research proposal is significant because palliative care is a very sensitive topic as it is the end of life care and nurses could help the patients who go through these difficult times. Therefore, it is important to look into the roles and responsibility of nurses during this time of the patient's life and how can they help the diseased person and his family. This topic will also highlight the impact of palliative care on the patient.

Literature Review of The Nurse's Role in Palliative Care

The research conducted by Schroeder & Lorenz has mentioned about palliative care and that it is given to prevent, treat or anticipate the suffering of the patient and the families(Schroeder & Lorenz, 2018). They have mentioned that if the holistic care is not provided to the dying patient than it could be a reason for physical, spiritual, emotional and social suffering. They have distinguished the roles of nurses such as a registered nurse could educate or provide advice and emotional support to the patient family and to the patient. They could also do counselling or could do wound care and health promotion. They talked about that an advanced practice registered nurse could provide services to the suffering patient. They could also develop a patient-centred care plan which could enhance the patient's quality of life. The researchers also talked about skills that are needed for palliative nursing which are effective communication with the patient and his family, compassion towards the diseased individual and human vulnerability discussed (Schroeder & Lorenz, 2018). They have also revealed the primary and specialist palliative care that is provided by the nurses. With that, they have also focused on nursing in the case of palliative oncology. Researchers have also mentioned how nurses could support community practice that is by doing home visits to the patients how are severely ill.Therefore for this study, it could be said that it has accurately highlighted the roles of the nurses in palliative care. They have given the pieces of evidence as to where can nurses help. The problem with the study is that it only talked about oncology-related palliative care whereas there are various other diseases which can also be discussed (Schroeder & Lorenz, 2018).

In the paper which is presented by Broom and his colleague, it is stated that nurses play very important roles in patient’s palliative care (Broom et al., 2015). This area of nursing is very much prone to complexities which are interpersonal, emotional difficulties and also with conflict which is interprofessional. They also mentioned that palliative care enhances the desire of hope in patient and in their families. For their study, they have taken 20 nurses who are of Australian origin and have taken into account their transition to palliative. They have done this by taking their interviews. They have also asked them about the strategies they used for this type of sensitive care and how they communicate with the patient. They also questioned them about their emotional engagement with the diseased person and in addition have asked about the main interprofessional challenges that they faced. It was noticed the researchers that nurses were trying to relieve the patient's sign and symptoms because they don't want the patients to suffer. Nurses also offered a lot of support to the patient's kids and to their partners as well (Broom et al., 2015). Nurses also managed to give information about how they communicate and have hard conversations. They in addition have to balance the sentiments while working. Nurses with that have to tell the patient and the family about the medical status of the patient and that they have to provide counselling on grief. Besides, all of this, they have to resolve the disputes and multiple other emotional works. Therefore, this study focuses on the experiences of the nurse in various aspects while they are providing palliative care to the patient. The research conducted by the researchers is quite good as many aspects of palliative nursing are highlighted in this. They have managed to state about how this also affect the nurse's emotional wellbeing and what re the responsibilities they have to bear while working with a patient have the life-threatening disease (Broom et al., 2015).

In the research conducted by Head and his colleagues, it is stated that advance care planning is a very crucial part of providing palliative care to the patient which demands expertise in communication skills life (Head et al., 2018). They have also talked about communication and advanced form of palliative care for the present state. They have discussed education's role in palliative care. They have focused on education in the general nursing program, education of the public and continuous education for nurses. Researchers have also mentioned about clinical care and have taken factors into consideration such as family and patient’s outcome. They have outlined the role of nurses in making a clear understanding of options for the treatment to the patient and his family and also the preferences that should be of utmost importance in the care setting. In the paper, they have in addition to this state about the policies and regulations and also about the research. Therefore, the study which is presented by them offersa holistic view of the nurse's role in providing the advanced palliative care to the patient who is at his last stage of life (Head et al., 2018).

Potential Impact of The Proposed Study

The potential impact of the proposed study on the wider community will be positive as palliative care provided by the nurses would enhance the quality of life of the patient who is severely ill and also his family. Due to this care, nurses could identify the needs and requirements of the patient and could fulfil them. Palliative care would also support the patient's family and other people who face difficulty during the end of life care. Overall, palliative care will look after people patient and his family’s emotional, social, psychological and physical concern. 

Opportunities that Question Produced

Opportunities that the questions produce are that we can identify the role and the responsibilities which nurse have to play while taking care of the patient. We come to know that nurses not only have to take care of patient's disease but also his emotional and psychological wellbeing. They also have to look after families need with that of the patient. Through the study, we can also find the challenges nurses have to face while they perform palliative care. 

Suggestions for Changes

Based on the reflection, it could be suggested that changes should be made in nursing programs so that nurses don’t feel strain and stress while they transform to palliative care. They should also be taught how to manage their interprofessional role while working with a severely ill patient. In addition, they should also be notified how they can manage their emotions so that they won't become a barrier while providing palliative care to the patient. Policies and guidelines should also be changed so that more people could access palliative care.

Conclusion on The Nurse's Role in Palliative Care

In conclusion, it could be said that palliative care is the end of life care which is given to increase the quality of patient's life. Nurses are the main healthcare providers who help patients and their families at this difficult time. They have to face various problems like personal and interprofessional challenges while working with these patients. They have various roles to play at the same time. Some of them are relieving the symptoms of the patient so that his suffering could be reduced and communicating effectively with the family and the patient about the treatment plan and medication. Nurses in addition to this have to educate and counsel the patient and his family. They have to provide them with emotional support. Nurses have to sort out social, psychological and physical concern as well. Palliative care on a wider basis affects the community in a positive way by dealing with all the concern and proving the patient and his family the holistic care. But, some changes could be made so that nurse’s transition to palliative care could become smoother and they could also be given knowledge about managing the challenges they might face while providing the end of life care.

References for The Nurse's Role in Palliative Care

Broom, A., Kirby, E., Good, P., Wootton, J., Yates, P., & Hardy, J. (2015). Negotiating futility, managing emotions: Nursing the transition to palliative care. Qualitative Health Research25(3), 299-309. https://doi.org/10.1177/1049732314553123

Chang, W. P. (2018). How social support affects the ability of clinical nursing personnel to cope with death. Applied Nursing Research44, 25-32. https://doi.org/10.1016/j.apnr.2018.09.005

Head, B. A., Song, M. K., Wiencek, C., Nevidjon, B., Fraser, D., &Mazanec, P. (2018). Palliative nursing summit: Nurses leading change and transforming care the nurse’s role in communication and advance care planning. Journal of Hospice & Palliative Nursing20(1), 23-29. https://doi.org/10.1097/NJH.0000000000000406

Paknejadi, F., Hasavari, F., KhaleghdoostMohammadi, T., &KazemnejadLeili, E. (2019). Nurses’ knowledge of palliative care and its related factors. Journal of Holistic Nursing and Midwifery29(4), 236-242.

Schroeder, K., & Lorenz, K. (2018).Nursing and the Future of Palliative Care. Asia-Pacific Journal of Oncology Nursing5(1), 4–8. https://doi.org/10.4103/apjon.apjon_43_17

Sekse, R. J. T., Hunskår, I., &Ellingsen, S. (2018). The nurse's role in palliative care: A qualitative meta‐synthesis. Journal of Clinical Nursing27(1-2), e21-e38. https://doi.org/10.1111/jocn.13912

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