Dynamics (Pembroke, Ont.)
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Critical care involves caring for complex and acute needs of patients with life-threatening conditions. Despite skilful interventions, there are times when the care needed by patients and their families is primarily palliative. In this article, the author focuses on examples of ways nurses can make the palliative care they provide exemplary. ⋯ This article includes a description of key ways critical care nurses may address the needs of patients who are palliative. Specifically, the themes of helping people live on, individualizing care, defending human dignity, sensitive listening, sharing hope, and keeping the promise to never abandon are described. These themes all fall under the overarching theme of simple gestures, which is also described in this report.
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As most Canadians die in hospital, the final contact of family members with their loved ones is frequently in an unknown and uncomfortable environment. Family members are integral to the end-of-life decision-making process and are vital contributors to the comfort of dying patients. A quantitative study was conducted in three critical care areas where the stated goals were to provide not only quality care to patients, but also support to families. The researchers sought to determine levels of satisfaction with care, visitation, support, comfort and pain measures. ⋯ Consistency in nursing care and provision of information to family members may be difficult in the fast pace of an ICU, but are reasonable program objectives considering the positive influence this has on perceptions of care. Further, flexible visitation policies which maximize access between family members and both their dying loved one and health care professionals appear to have a beneficial effect on satisfaction.
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Dynamics (Pembroke, Ont.) · Jan 2005
ReviewImproving pain management for critically ill and injured patients.
The under-treatment of pain continues to be a problem in patient care. Evidence shows a significant percentage of patients suffering with acute and chronic pain, despite the treatment options available. ⋯ As health care professionals, nurses have a responsibility to advocate for patients and provide the best pain management possible. Efforts to improve pain management will help avoid complications, such as chronic pain syndrome, while improving comfort, function, and quality of life.
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Hypothermia can result from exposure to a cold environment (e.g., accidental drowning) or it can be induced and used as a brain protection strategy (e.g., therapeutic hypothermia). One common ECG presentation with hypothermia is the J wave, which is related to the altered cellular activities during hypothermia. A case study is used in this article to illustrate the presentation of a J wave with a patient experiencing hypothermia.