Challenges and Issues for Nurses While Caring for Patients at the End Of Life in Critical Care Setting Saad Bin Zafar College Name Abstract This essay explores the challenges and issues being faced by the nurses today in providing end-of –life care (EOLC)…
Keywords: Nurses, End-of-life care, hospital mismanagement, obstacles Death is a grim reality, an undeniable fact, one which no one can escape. For decades nurses have been taking care of dying patients and their families, most of the time this happens in critical care setting. The role of nurses during the end of life period is a sacred one. It is the period in which it is expected that death is imminent and it cannot be avoided by using any intensive or life extending therapy (Kinoshita & Miyashita, 2011). The care provided during this period is known as end of life care, abbreviated as EOLC. The significance of EOLC is increasing and it is now becoming a subspecialty considering that 27% of deaths have occurred in ICU and of the deaths which occurred in hospital setting 42% of patients were in a specialty unit for the last three days (Bach, Ploeg & Black, 2009). For nurses a good death will be free of pain, will include comfort and respect for the patient and will allow the family to conduct their EOL rituals. In accordance with this the goal of EOLC is to offer support, consideration and attention to patients and their respective families during this period where one is in the last phase of his terminal illness (Doolen & York, 2007). Caring for dying patients is never easy which makes this job one of the most stressful ones. In addition to this nurses are facing a number of challenges and obstacles in providing the best possible care. There are a number of different barriers which are mentioned in various research articles. Crump, Schaffer & Schulte (2010) have identified lack of proper communication, insufficient staff and unfavorable treatment decision as obstacles (2010). However Doolen & York (2007) believe that cultural differences are the main issues which are causing problems in EOLC. This essay is written in order to identify and discuss these issues and challenges affecting the EOLC and see if they can be solved in order to help the nurses in their profession. It is very important to understand the role which culture plays in a health facility. Before this one must understand the concept of culture. Culture comprises of knowledge, ideals, beliefs, conscience, morals, habits, characteristics, perceptions and behavior of a particular society (Lewis, Heitkemper & Dirksen, 2004). Today many of the developed countries have cultural diversity. In accordance with this the nursing staff should also have had a similar diversity which unfortunately is not the case. According to Doolen & York (2007) cultural challenges have three significant elements which need to be considered. These elements include communication regarding the disease, family consultations and approaches regarding the different life extending therapies and advance directives. This can be seen in Korea where it is believed that one shouldn’t discuss death because talking openly about the death will not only bring sadness to the patient but will accelerate the dying process (Valente & Haley, 2007). In addition to this people belonging to the Filipino culture believe that if terms related to death are spoken loudly they will interfere with the natural process of healing and will result in death. On the other hand some cultures have beliefs which state that the decisions regarding EOLC are to be only shared with the family members and not with the patient itself in order to protect him from this burden while others have a belief ...
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