The End Of Life Care Assignment Discussion Paper

The End Of Life Care Assignment Discussion Paper

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How uncomfortable was the conversation concerning end-of-life care?

I was uncomfortable throughout the conversation. As a patient, I knew it was essential to express my wishes concerning the end of life care. According to Arruda et al. (2019)The End Of Life Care Assignment Discussion Paper, decisions made by acutely ill patients guide healthcare providers during end-of-life care. Previously expressed wishes are essential during the end of life care since terminally ill patients are incompetent to make decisions at the end stages of their lives. Despite knowing the importance of advanced directives, it was challenging to figure out and state my wishes concerning the last days of my life.

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Similarly, it was emotional and challenging to ask the patient questions about the end-of-life as an NP despite understanding the importance of advanced care planning in elderly adults. Studies state that healthcare providers should encourage elderly adults and critically-ill patients to give advanced directives (Rajdev et al., 2020)The End Of Life Care Assignment Discussion Paper. Planning for end-of-life care enables individuals to receive the desired the end of life care. Early planning also makes things easier for family members and healthcare professionals involved during end-of-life care. At the beginning of the conversation, I needed clarification about how to question the patient concerning end-of-life care. However, later I gained courage and figured out what I would like to know when providing end-of-life care to a patient. I asked the patient empathetically if he wished to receive prolonged treatment at the end-of-life stages or if he would end his suffering through induced anesthesia. I also asked the client if he wished his family members would be present during end-of-life care. Lastly, I asked the patient if his culture support end-of-life care for terminally-ill individuals. Despite being a challenging activity, it enhanced our understanding of essential information that NPs should collect when planning for care.

A difficult conversation that was encountered previously

I previously had a similar discussion with a parent whose 8yo son was diagnosed with chronic kidney failure. The mother believed that his son’s condition could be treated through medication. I took my time to explain to the mother that his son required a kidney transplant to prevent his condition from deteriorating. According to Haffner (2020), a kidney transplant is the most effective treatment intervention for childhood kidney failure. Therefore, I knew that the client’s kidney would continue functioning normally after the procedure. On the contrary, the mother was against the idea of a kidney transplant, claiming it would expose his son to more health complications. As a nurse, I am guided by ethical principles, including patient autonomy, which gives individual clients the right to make significant decisions concerning their treatment (Jacobs, 2019)The End Of Life Care Assignment Discussion Paper. In this case, the client was a minor giving the mother the right to make a treatment decision on behalf of her son. I respected the client’s decision and engaged the physician on duty to prescribe medication for the client.

Additionally, I asked the mother if their religious beliefs support organ transplants. According to Markey et al. (2019)The End Of Life Care Assignment Discussion Paper, nurses should focus on providing culturally competent care to patients with diverse ethnic and cultural backgrounds. Hence, it was important to consider how the client’s culture views kidney transplants since she was from a different cultural background. The patient’s mother reported that receiving an organ from another person was against her religious faith since it lowers human dignity. I supported the client’s treatment decision as a way of providing culturally competent care. However, I advised her to return to the medical facility if his son’s condition deteriorates despite taking the prescribed treatment regimen.

How did the NP explain the situation?

The NP explained the situation of end-of-life care effectively. He stated that end-of-life care provides physical, social, emotional, psychological, and spiritual support to terminally-ill patients and their family members. He further emphasized that end-of-life care does not focus on curing the patient but aims to prolong the client’s lifespan by controlling pain and other symptoms (Hoare et al., 2022). However, he stated that medical interventions applied during end-of-life care significantly depend on advanced directives provided by the client. For this reason, terminally ill patients and elderly adults are encouraged to give directives concerning their end-of-life care. Throughout the discussion, the NP was empathetic. She listened attentively and responded to all questions with respect and concern. The NP provided a wide range of materials discussing the topic to meet my wishes and learn more about end-of-life care. Lastly, the NP was concerned about what my culture states concerning the end-of-life care. He emphasized that cultural beliefs apply when making end-of-life care decisions The End Of Life Care Assignment Discussion Paper.

References

Arruda, L. M. A. D., Abreu, K. P. B., Santana, L. B. C., & Sales, M. V. D. C. (2019). Variables that influence the medical decision regarding Advance Directives and their impact on end-of-life care. Einstein (São Paulo), 18 (3), 1-7.

Haffner, D. (2020). Strategies for optimizing growth in children with chronic kidney disease. Frontiers in pediatrics, 8, 399.

Hoare, S., Antunes, B., Kelly, M. P., & Barclay, S. (2022). End-of-life care quality measures: beyond place of death. BMJ Supportive & Palliative Care, 4 (3), 1-7.

Jacobs, G. (2019). Patient autonomy in home care: Nurses’ relational practices of responsibility. Nursing ethics, 26(6), 1638-1653.

Markey, K., Tilki, M., & Taylor, G. (2018). Understanding nurses’ concerns when caring for patients from diverse cultural and ethnic backgrounds. Journal of clinical nursing, 27(1-2), e259-e268.

Rajdev, K., Loghmanieh, N., Farberov, M. A., Demissie, S., & Maniatis, T. (2020). Are health-care providers well prepared in providing optimal end-of-life care to critically ill patients? A cross-sectional study at a tertiary care hospital in the United States. Journal of Intensive Care Medicine, 35(10), 1080-1094 The End Of Life Care Assignment Discussion Paper.

Learning Objectives

By the end of this week, you will be able to:

• Discuss what it feels like to have the difficult conversations of stopping treatment and end of life care.
• Identify cultural aspects of end-of-life care.

Week 7: Learning Materials

Readings

Required

Read the following articles and web resources:

• • Hicks, E., Sims-Gould, J., Byrne, K., Khan, K. M., & Stolee. P. (2012). “She was a little bit unrealistic”: Choice in healthcare decision making for older people. Journal of Aging Studies, 26(2), 140–148.
  • MedlinePlus. (2020, January 12). Deciding about treatments that prolong life.
  • Morrow, A. (2020, March 8). Withhold or withdrawing life-sustaining measures. Verywell Health.
  • National POLST. (n.d.). National POLST form: Portable medical order The End Of Life Care Assignment Discussion Paper.

Week 7 Assignment 1: Peer Practice Video

Choose one of your classmates to be partners with for this assignment. With your partner, role play having an end-of-life conversation. Use Zoom. Select one partner to host and record the entirety of your session. Review how to create a local recording in Zoom for more information.

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Partner A should be the NP, and Partner B should be the patient. Using Homer Grant’s diagnosis and prognosis, have the discussion of end-of-life care. Then, switch roles. Research a specific culture and include a cultural component in the end-of-life discussion.

After you have each had the opportunity to be the NP in the conversation, provide each other with feedback. Answer these questions together:

1. How uncomfortable were you in the conversation?
2. Have you had to have a difficult conversation like this before? If so, was it with a family member or a patient? What was the reaction to the conversation?
3. When you were in the patient role, how well did the NP explain the situation? Was the NP empathetic, and offer resources to meet your wishes? The End Of Life Care Assignment Discussion Paper