International journal of palliative nursing
-
Experiences of family members of terminally ill patients with hospital end-of-life care were explored. The study is part of a larger study that investigated patients' and families' experiences; this study describes family members' unique experiences. ⋯ Nurses can best improve families' experiences of hospital end-of-life care when they are aware of families' priorities and take excellent care of the patient first, but, in addition, recognize family members, approach them actively and integrate them as co-caregivers as much as wished by patient and family member.
-
The End of Life Care Strategy (Department of Health, 2008a) states that acute hospitals need mechanisms in place to ensure that people who are approaching the end of life have their needs assessed, their wishes and preferences discussed, and an agreed set of actions reflecting these choices recorded in a care plan. The Supportive Care Plan was designed to encourage discussion of patients' preferences for end-of-life care, and to provide a tool for recording those preferences and communicating them to other healthcare professionals. Initial analysis of the results of a pre- and post-implementation audit of patient notes suggests that there has been an improvement in the documentation about preferred place of care and patient and family understanding of the illness. ⋯ Feedback from patients and relatives was positive. The main barriers to implementation were difficulties for staff in prognostication, especially for patients with a non-cancer diagnosis, and a reluctance from staff to initiate discussions that were perceived to be too time-consuming. There were also concerns about dealing with the emotions that such a discussion may generate in both patients and relatives.
-
This study aims to explore the lived experience of nurses who provide comfort to palliative care patients in an acute setting in a small urban hospital in the west of Ireland. A qualitative approach using Gadamerian hermeneutic phenomenology was chosen for the study and data were collected using open interviewing. ⋯ The study findings will contribute to a greater understanding of the difficulties and challenges that general non-specialized nurses in the acute setting have to understand and apply the philosophy of palliative care to patients in an acute care setting. The findings should also contribute to a broader appreciation between specialized and non-specialized nurses who are responsible for the delivery of holistic, individual person-centred care to patients requiring palliative care.
-
Review Case Reports
Dire deadlines: coping with dysfunctional family dynamics in an end-of-life care setting.
Working in a hospice and being able to focus on individualized, specialized end-of-life care is a privilege for the hospice staff member. However, it also presents the hospice staff with unique challenges. This descriptive study is based upon two cases from an end-of-life care setting in Denmark, where dysfunctional family dynamics presented added challenges to the staff members in their efforts to provide optimal palliative care. ⋯ Higher expectations and demands of younger, more well-informed patients and family members challenge hospice staff in terms of information and communication when planning for care. The inherent risk factors of working with patients in the terminal phase of life become a focal point in the prevention of the development of compassion fatigue among staff members. A series of coping strategies to more optimally manage dysfunctional families in a setting where time is of the essence are then presented in an effort to empower the hospice team, to prevent splitting among staff members, and to improve quality of care.
-
This study aims to describe nurses' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. ⋯ Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that 'weaves' together care and compassion with skills and knowledge in their nursing practice.