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Principles of Nursing: Palliative Approach

Introduction to Palliative Care and The Promotion of Best Practices

People who are suffering from chronic diseases which are life-limiting have complicated and multiple needs. Many of them receive care from healthcare professionals in various health care setups such as hospital, home and residential care. Individuals who are going through these life-limiting diseases require good care and for that palliative care principles are adopted. Attention should also be paid towards the patient's quality of life and just not his disease. It is also necessary to take help and partner with other service providers so as to take care of all the needs of the person in every sector of care (Sawatzky et al., 2017).

Access to proper quality support and care at the final stage of life is identified as basic human rights (Bernard et al., 2017). Palliative care is the total care of a person’s body, spirit and mind. Therefore, healthcare professionals such as doctors and nurses play a very important role at this stage. Nursing managers, clinicians, policymakers, educators, health care administrators should promote practices which will make sure the experience of the patient is positive. For that synthesis of knowledge about proper palliative care and its application is required. Giving that, more people are developing critical diseases with life-limiting situations there should be improvements in the delivery of care by nurses, doctors and other healthcare professionals (Sawatzky et al., 2017).

Standards

For proper and quality palliative care standards have been set in Australia. The first one states that assessment of the needs to be done. The needs which have to be looked after are patient's physical, cultural, spiritual, psychological and social needs. The second standard states that a plan should be developed for the patient’s care. The individual who is at the critical phase, his family members and carers need to work in association and partnership to make goals and make informed decisions about the plan for the care. The third standard states that taking care of the people who are providing support. It is very essential that healthcare services should value and respect the role of the patient's family and other carers by knowing and assessing the amount of care they are willing to give. The fourth standard mentioned providing care which is based on the needs and requirements of the person and information provided by pieces of evidence. The care should also be consistent with goals, preferences and values of the person as it was documented in their approved plan of care (Palliative care, Australian Government, 2020).

The fifth standard stated about transitions inside and among services. One way to do this is by supporting all the oral communication by the care provider by adequate written information on the patient’s condition, goals and their plan of care so as to avoid any ineffective care to the patient. The sixth standard talks about helping with grief. Supporting family members and the other care provider and preparing them for death and helping them acknowledged the dying process is also necessary. The seventh standard talks about service culture. The service has values, structure, environment, philosophy and culture that help in the delivery of palliative care which is person-centred. The eighth standard talks about the improvement of the quality. Healthcare services are involved in the improvement of quality and research so as to make provisions and development better (Palliative care, Australian Government, 2020).

Barriers

Barriers to giving palliative care can be the lack of professional and public awareness about the benefits of palliative care, shortage of workforce and training which is inadequate. Other factors can be the capacity of the organization is insufficient, inadequate evidence for effective and safe practice and oversight. Specialists in palliative care fall short of numbers by looking at the current population. It will be unrealistic to think that specialist in the workforce will be enough to take care of the needs of the people who all are ill. The capacity of palliative care is largely absent for individuals suffering from chronic diseases and are at living in their homes, nursing homes or in the village area. The experts have the duty to attain only the most complicated cases or the ones who are closest to life’s end. Other risks to palliative care can be under the treatment of the patient, poor care quality and too much expenditure (Meier et al., 2017).

Promotion of Best Practices

To improve the standards and to eliminate the barriers, the nurse also needs to check and monitor the well-being and functional status of the patient by making talks about the issues they are facing emotionally. Hence, giving the patient’s spiritual and psychosocial care in addition to the physical one. Nurses should also be able to tell their vision of how holistic palliative care will benefit the patient. The nurses besides this should focus on providing the best care while working with relatives and patients when the relationships between them are difficult. Nurses to provide best practice should have interpersonal skills and emotions of warmth, genuineness, kindness and compassion. They should also be open towards the live experiences of the patient and their history. They should also be dedicated to educating and supporting the patient and his family (Sekse, Hunskår, & Ellingsen, 2018).

References for Palliative Care and The Promotion of Best Practices

Bernard, M., Strasser, F., Gamondi, C., Braunschweig, G., Forster, M., Kaspers-Elekes, K., ... & Marthy, S. (2017). Relationship between spirituality, meaning in life, psychological distress, wish for hastened death, and their influence on quality of life in palliative care patients. Journal of Pain and Symptom Management54(4), 514-522.

Fox, M. Y. (2014). Improving communication with patients and families in the intensive care unit: palliative care strategies for the intensive care unit nurse. Journal of Hospice & Palliative Nursing16(2), 93-98.

Frey, R. A., Barham, S., Balmer, D., Robinson, J., Boyd, M., & Gott, M. (2020). Palliative care delivery in residential aged care: Bereaved family member experiences of the Supportive Hospice Aged Residential Exchange (SHARE) intervention.BMC Palliation Care, 19, 127. https://doi.org/10.1186/s12904-020-00633-x

Meier, D. E., Back, A. L., Berman, A., Block, S. D., Corrigan, J. M., & Morrison, R. S. (2017). A national strategy for palliative care. Health Affairs, 36(7), 1265-1273.

Palliative care, Australian Government.(2020). National palliative care standards. Retrieved from https://palliativecare.org.au/standards

Sawatzky, R., Porterfield, P., Roberts, D., Lee, J., Liang, L., Reimer-Kirkham, S., Pesut, B., Schalkwyk, T., Stajduhar, K., Tayler, C., Baumbusch, J., & Thorne, S. (2017). Embedding a palliative approach in nursing care delivery: An integrated knowledge synthesis. Advances in Nursing Science40(3), 261–277. https://doi.org/10.1097/ANS.0000000000000163

Sekse, R. J. T., Hunskår, I., & Ellingsen, S. (2018). The nurse's role in palliative care: A qualitative meta‐synthesis. Journal of Clinical Nursing, 27(1-2), e21-e38.

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