International journal of palliative nursing
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This article describes time as a contextual factor in palliative caring practices and contributes to an understanding of the connections between time and the quality of palliative care. The article is based on an explorative and qualitative research study inspired by grounded theory. The empirical data of the study were obtained through field studies and interview. ⋯ Two scenarios are presented: one in which clock time is insufficient and another in which clock time is sufficient. Each scenario outlines how nurses relate to time in different ways according to whether clock time is insufficient or sufficient, respectively. It is found that the two scenarios have different implications for palliative care, nurses' personal time, and nurses' opportunities for reflection and professional development.
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When caring for terminally ill patients and their families, nurses are confronted with the subject of terminal dehydration and the question of artificial hydration at the end of life. Terminal dehydration and artificial hydration are still controversial topics of discussion and, to this day, data remain insufficient to reach a final conclusion on the benefits or harm of dehydration in terminally ill patients (Ersek, 2003; Fainsinger, 2008). Nurses, just like physicians, have different attitudes about the usefulness of artificial hydration. ⋯ This article reflects on the meaning of dehydration for the patient and their family, and reviews the role of the nurse within the decision-making process. Arguments for or against artificial hydration are illuminated through patient situations which took place in the clinical setting of a hospice. The article further highlights the importance of recognising dehydration in frail and elderly patients, and critically assesses policies that may hinder its optimal palliation in different settings in Switzerland.