End Of Life Nursing Role

Nursing Roles in End-of-Life Decision Making

Introduction

Encountering death constitutes one of the most stressful events that a nurse inevitably encounters. Patients and families often face complex choices as patients approach the end of their lives. These decisions often affect many aspects of a person’s well-being and may be spiritual, psychosocial, or legal. Dying patients have to consider their wants and needs from treatment, while also considering the ramifications that can accompany these choices. This paper discusses a professional nurse’s role in promoting a good death, personal experiences regarding my encounters with death, and how all nurses can effectively facilitate end of life decisions.

Characteristics of a Good Death

The

(2006) the main obstacles that created barriers to a good death included, but were not limited to, the shortage of nurses and inconsistent staffing patterns, communication challenges, disagreement related to the physician’s decisions and behavior, and unrealistic expectations from those receiving care. Staffing patterns and shortage was the most prominent complaint among nurses. The nurses’ desire for afforded time-sensitive care was often impaired by unrealistic assignments and staffing shortages. Time spent with the patient and family is crucial in building relationships and allows for a better death to be facilitated. Another barrier includes the lack of communication by the healthcare team and patient. To address this, the healthcare team must educate the patient on potential options for their plan of care and respect these wishes. Unrealistic expectations can stem from this lack of communication. Realistic and compassionate care is essential in breaking the barriers associated with the end of life process (Beckstrand, Callister, & Kirchhoff,

Ethically, it is a nurse’s duty to prioritize patient care and provide alternatives when their wishes interfere with the doctor’s preferences. It is important to incorporate the patient’s beliefs into care that is best for them. The Code of Ethics for Nurses with Interpretive Statements states, “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (American Nurses Association [ANA], 2015, p.468). This provision discusses the importance of a patient’s right to privacy, being fully educated, the right to safety, and to be fully protected from impaired practices (American Nurses Association [ANA], 2015, p.471-472). A professional nurse should provide privacy and is a right to all recipients of care. It is mandated that confidentiality exists in order to maintain this right. Nurses also have the duty to advocate for the patient’s full understanding about practices related to their plan of care. This allows for fully ethical and competent decisions to be made by all participants of the multidisciplinary team. Professional nurses should involve the patient in all aspects of care and help employ decisions relevant to personal circumstances. An example of being an advocate is a nurse educated a dying client on medical orders that allow for client’s to deny recessive treatment. DNRs and Advance Directives are two ways that allow for the patient to make primary