NUR120 Introduction to Professional Nursing

Palliative care is defined as a person centered care that is provided to patients with chronic illness, old patients or patients who are on the verge of death. Special palliative team and family members mainly provide this type of care in order to ensure a better quality life to the patient. The caregivers tend to provide not only physical support but also emotional, social and spiritual support to the patients. They also tend to educate the family members about the various responsibilities that they need to take in order to make the life of the patient easier and provide a strong mental support to them in their hard times. The essay will mainly portray the different supports that the caregivers provide to the patient and their family members and will also portray the various barriers that can prevent caregivers from practicing palliative care for  the patient and the family members.

The research question will be ‘what are the various supports that palliative care can provide to the patients and what are the barriers that prevent them from providing palliative care to patients and family members?’

Researchers have often paid importance in clarifying the correct information about the patient to their family members. This will help the family members to prepare themselves on the behalf of the patient and thereby provide a meaningful role to the care. This would help them to handle difficult situations that may arise in the crucial junctures in the patient’s care. By providing clear direct and consistent information to the patient’s family members, they would keep the family members informed about the transitions along the illness trajectory and help them in making them aware of the diseases progression along with recognition of severity and urgency of the situation (Reidy et al., 2016).

Often it has been noted that patients and their family members often go through a severe phase of grief and depression, as they tend to near the inevitable truth of death (Porche et al., 2014). They feel a sense of immense loneliness and anxiety about the different situation that they tend to face as situations worsen. The feeling of hope tends to leave them as they fail to see anything positive in life and is encircled in a cloud of negativity, as they tend to accept the truth of their dear one leaving them forever. This creates a feeling of immense loss for which they require both emotional as well as spiritual needs. Researchers state that often providing spiritual and emotional needs of the patient and the family members make them stable and tend to develop their conditions towards betterment. Providing emotional support to the patent and the family members make them feel stable as they feel that their concerns are heard and emotionally cared for (Adams et al., 2014). This makes them to better as their real fears and emotions are addressed. They tend to rediscover sources of love and contentment. They feel that they are loved and accepted as human beings and hold themselves at a higher spot than their illness had provided them.

Researchers have also stated that caregivers also play an important role by providing spiritual support to the patients and its family members. They have stated that many patients sought for spiritual needs towards end of their life, which gives them relief. Various discussions about religions and larger questions regarding importance of life, its purpose and its meaning have been often asked to nurses providing palliative care.  Researchers therefore suggest that it becomes extremely important for the caregivers to be sensitive for the patient’s needs and answer each of their queries with patience and care (Skilbeck & Payne, 2013). Patients who are new in the domain of spiritual path, caregivers should be careful in providing the safe and trusted space to them so that they can express their spiritual longings in their lives for the first time. This would help them feel a sense of spiritual learning that will make them free from anxiety and fear and make them live comfortable lives in their last days (Kelly & Morrisan, 2015).

Researchers have also found that palliative care is unevenly distributed in Australia as well as in New Zealand. Because of this, it is found that the indigenous people of this nation and homeless people also do not get the chance of receiving palliative care (MacWilliams et al, 2014). This results in the increase of pain and emotional strain in their last days giving them an unfortunate death. This has been found as one of the domain where the government and the private healthcare groups should pay importance to overcome the issues faced in palliative care.

Researchers have often stated that the responsibility of the palliative care team does not end with providing the best care to the patients. Caregivers have often found that it becomes extremely important for them to meet the concerns and address the needs of the family members who are engraved with grief and depression of the family member who is facing death (Thomas et al., 2014). Nurses are also found to face a large number of challenges while caring for the family members who are undergoing anticipatory grief and suffering from post death bereavement. Researches also suggest that there is often lack of clarity in their role as they fail to understand what is expected from them. Such caregivers often have reported gaps in their knowledge about how to handle the concerns of family members of patients who are receiving end of life care (Aldridge et al., 2016) They do not have proper knowledge, education and expertise about how to break sad news or handle them after patient’s death.

 From the articles that had been selected for discussing the correct topic have provided a clear overview about the aid that a palliative care service may provide to patients with chronic illness and old age and their family members. It can be understood that the palliative care team is responsible for providing an all over comfortable life for the patients suffering severely and is nearing their life’s end. It also provides education to the family members about the way they should treat the patient and take care of them in such crucial moments (Malloy et al., 2014). Besides, members of the palliative care teams are also responsible for providing a strong emotional support to the family members who are in grief and are suffering from depression. Their thought of losing their loved one and their fear of seeing their patient nearing death, creates a huge mental pressure that often breaks them emotionally and physically. Herein, it becomes the responsibility of the caregivers to handle not only the patent but also give mental support to the family members in order to protect them from such strenuous condition (Adams et al., 2014).

Other than providing physical support to that patient, it also becomes important to handle their emotions, which becomes stronger by days as their situations worsen. In such cases, the caregivers are also seen to provide a strong emotional support as well as spiritual support to both the patient and their family members (Keal, Clayton & Burrow, 2014). This helps the patients and their family members to not only be strong and accept the fate with a brave heart, but also pleases their mind and reduces their stress and fears. Palliative care helps in symptom management along with the establishment and implementation of care plans. These are done in such a way so that the patient’s values and preferences are cared for. They also maintain a consistent and sustained communications with the patient and all of his carers and provide a spiritual, psychosocial, emotional and practical support in such a way so that the situations are handled properly lessening chances of harm for each of them (Namasivayam et al., 2014).

However, certain challenges are seen to be faced by different stakeholders of the palliative care teams. This makes their practice less efficient and harms the motives with which they are appointed in their respective roles. Recent research articles have already denoted the lack of proper education and experiences for the nurses who thereby fail to provide the best support for their clients. Besides, lack of support from their organization is also noted in many articles. Other issues have also been noted that act as barrier in providing the best care. These are lack of involvement and disagreement of team members in making end of life decisions for their patients and in care planning. Moreover, articles suggest that the role of the nurses is not entirely clear to themselves and this makes tem confused (Peter et al., 2013). Often they complain of unrealistic expectations of their families, which act as barriers in their provision of service. Inappropriate environmental setting around the patients and different barriers faced in alteration of such environment also acts as challenges that are faced by the caregivers when providing palliative care to patients (Beernaert et al., 2014).

It is very important for the governing authorities to look over the various challenges that the palliative team members face. The initiatives would consider researching the issues in depth and publishing of policies, which would help to remove the barriers in providing the best palliative care. Initiatives should also be taken so that equal distribution of palliative care services take place in the nations, so that homeless people and other indigenous people can also have access to such organizations and seek for palliative care (Robinson, Gott & Ingleton, 2014).

From the entire discussion, one can easily understand that palliative care has become one of the most important domains in healthcare sector. This domain assures a proper end of life treatment for patients who are suffering from chronic illness, old age disorders, cancer and many others. When healthcare teams treating the patients withdraw their hope, palliative care teams are the ones who mainly play an important part. The main goal of the palliative care consists of changing the intervention plan from curing to comforting the patient and his family members so that they can enjoy the remaining time and achieve personal goals. These are done by providing physical, emotional, spiritual and mental support to the patient and family members.  The team in providing such care faces a number of challenges. The public and private concerns should take this matter seriously and implement modifications, which will help in carrying on with their service uninterruptedly overcoming all barriers. This would make a nation that provided the best adieu to citizens leaving their companionship. 

References:

Adams, J. A., Anderson, R. A., Docherty, S. L., Tulsky, J. A., Steinhauser, K. E., & Bailey, D. E. (2014). Nursing strategies to support family members of ICU patients at high risk of dying. Heart & Lung: The Journal of Acute and Critical Care, 43(5), 406-415.

Adams, J. A., Anderson, R. A., Docherty, S. L., Tulsky, J. A., Steinhauser, K. E., & Bailey, D. E. (2014). Nursing strategies to support family members of ICU patients at high risk of dying. Heart & Lung: The Journal of Acute and Critical Care, 43(5), 406-415.

Aldridge, M. D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., ... & Meier, D. E. (2016). Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative medicine, 30(3), 224-239.

Beernaert, K., Deliens, L., De Vleminck, A., Devroey, D., Pardon, K., Van den Block, L., & Cohen, J. (2014). Early identification of palliative care needs by family physicians: a qualitative study of barriers and facilitators from the perspective of family physicians, community nurses, and patients. Palliative medicine, 28(6), 480-490.

Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of clinical nursing, 23(21-22), 3197-3205.

Kelley, A. S., & Morrison, R. S. (2015). Palliative care for the seriously ill. New Englan

Mac Williams, J., Bramwell, M., Brown, S., & O'Connor, M. (2014). Reaching out to Ray: delivering palliative care services to a homeless person in Melbourne, Australia. International journal of palliative nursing, 20(2).

Malloy, P., Paice, J., Coyle, N., Coyne, P., Smith, T., & Ferrell, B. (2014). Promoting palliative care worldwide through international nursing education. Journal of Transcultural Nursing, 25(4), 410-417.

Namasivayam, P., Lee, S., O'connor, M., & Barnett, T. (2014). Caring for families of the terminally ill in Malaysia from palliative care nurses’ perspectives. Journal of clinical nursing, 23(1-2), 173-180.

Peters, L., Cant, R., Payne, S., O’Connor, M., McDermott, F., Hood, K., ... & Shimoinaba, K. (2013). Emergency and palliative care nurses’ levels of anxiety about death and coping with death: A questionnaire survey. Australasian Emergency Nursing Journal, 16(4), 152-159.

Porche, K., Reymond, L., O’Callaghan, J., & Charles, M. (2014). Depression in palliative care patients: a survey of assessment and treatment practices of Australian and New Zealand palliative care specialists. Australian Health Review, 38(1), 44-50.

Reidy, J., Halvorson, J., Makowski, S., Katz, D., Weinstein, B., McCluskey, C., ... & Tjia, J. (2016). Health System Advance Care Planning Culture Change for High-Risk Patients: The Promise and Challenges of Engaging Providers, Patients, and Families in Systematic Advance Care Planning. Journal of Palliative Medicine.

Robinson, J., Gott, M., & Ingleton, C. (2014). Patient and family experiences of palliative care in hospital: what do we know? An integrative review. Palliative medicine, 28(1), 18-33.

Skilbeck, J., & Payne, S. (2013). Emotional support and the role of clinical nurse specialists in palliative care. Journal of advanced nursing, 43(5), 521-530.

Thomas, K., Hudson, P., Trauer, T., Remedios, C., & Clarke, D. (2014). Risk factors for developing prolonged grief during bereavement in family carers of cancer patients in palliative care: a longitudinal study. Journal of Pain and Symptom Management, 47(3), 531-541.