Personal and individual experience influences ones' ability to make decisions. As individuals we draw from those experiences and use them to learn and assist with future decision making. Those who have experienced death and dying are at a greater advantage to assist others through this process, however, how can we, as a profession, assist those who are not experienced to initiate end-of-life care discussions? This is a topic that needs continued attention for nurses to be better equipped to assist others and provide caring at end-of-life. The ultimate goal is for nurses to assist patients in a peaceful, caring death. society continues to make this difficult as a lack of care and additional treatments could be viewed as rationing healthcare. In our current healthcare system, a patient without an advance directive is left to rely on the wishes of their family. If the family insists on continuing care then we continue to provide care at any cost, whether futile or not. As healthcare providers, it is our responsibility to "pay more attention to the importance of developing skilled communication in end-of-life discussions and improve at moving patients and families into making end-of-life decisions that are more realistic in the face of futility" (Martinez, l., Pope, Tl, Day, L., & Sherman, D., 2009). Ultimately, "the patient has the right to be treated with respect and dignity and to determine what is to be done with his or her body" (Westrick & Dempski, 2009, p. 260). Additionally, we must be willing to accept other's viewpoints and decisions.
Florence Nightingale stated in her last letter addressed to her students in 1900: "Christ was the author of our profession. We honor Christ when we are good Nurses. We dishonor Him when we are bad or careless nurses. We dishonor Him when we do not do our best to relieve suffering - even in the meanest creature: (Phillips, 2006, p. 270). It is imperative that we, as nurses, involve our patients in their care as much as possible and acknowledge that they may not choose to follow all advice given for healthcare. The patient has the autonomy to decide what is their destiny as long as they have been provided with the benefits and risks associated with those decisions, and we must honor those decisions.
Upon completion of this course, I would like each of you to complete and advance directive for yourself to identify specifically what type of care and treatment you desire if faced with end-of-life care. The following is a website where you can obtain a free advance directive:
http://www.totallegal.com/livingwill2.asp
Finally, I would like each of you to answer the following two questions based on what you have learned and how you feel from the experiences in this class.
1. As a nurse, what would you consider to be a major challenge for you professionally when dealing with end-of-life care issues? How would you attempt to overcome these challenges?
2. Considering what you have learned about end-of-life issues surrounding adults, how would your view of end-of-life care differ if associated with a pediatric patient?
I hope that this class has provided some insight for each of you in the reconciliation of your feelings toward caring for end-of-life care patients. Best of luck to each of you. I anxiously await your responses to the above questions.
References
Martinez, L., Pope, T., Day, L., & Sherman, d. (2009), May). Controversies abound in end-of-life decisions... Medical futility, personal goods, and social responsibility. American Journal of Critical Care, 18(3), 279-282. American Journal of Critical Care. 18(5), 401-403. Retrieved from CINAHL Plus Full Text database.
Phillips, S. (2006). Ethical decision-making when caring for the noncompliant patient. Journal of Infusion Nursing 29(5), 266-271. Retrieved from CINAHL with Full Text.
Westrick, S.J., & Dempski, K. (2009). Essentials of Nursing Law and Ethics. Sudbury, Ma.: Jones and Bartlett Publishers.
Tuesday, July 3, 2012
Monday, July 2, 2012
Money? More or Less?
Think back to the initial Youtube Video published in the first blog. Although this was an exaggeration, those of us who have worked in a critical care setting know that some of what was depicted is not that far from the truth.
Today, while at work and caring for a very critically ill patient post open heart surgery, I found myself wondering what are the costs of the care we are providing and will this patient be able to survive this?
What is the cost of hope? Modern medicine has become so proficient at keeping the terminally ill alive that the inevitable process of dying is prolonged (cbsnews, 2010). It has been estimated that one third or out overall healthcare resources are spent in the last year of life (Harding, 2010). Medicare paid $55 billion dollars for the last two months of patient's lives. This accounts for more that the entire budget for Homeland Security. Furthermore 20-30% of these expenses have no meaningful impact (cbsnews, 2010).
Are we saving individuals with improved medical technology or are we preventing individual from dying a natural death?
Ask yourself, what is worse: having a loved one die or having a loved one die badly? It is well documented that most individuals would prefer to die at home. The reality is that 75% die in with hospitals or nursing homes (cbsnews, 2010). And remember back to our first video the Hospitalist vs the ICU end of Life Palliative Care: once a patient is admitted into the hospital, several consults and physicians order a multitude of tests in which many are not essential.
Communication and explanations are necessary to clearly identify a patient's wish for end of life care and potentially reduce the costs of dying or better termed the costs of hope.
Think of the savings, both money and quality associated with dying, that could be obtained if open conversations could take place to clearly identify individuals' wishes.
References
Harding, A., 2010. End-of-life care costs continue to climb upward. Retrieved from http://www.teuters.com/assets/print?aid=USTRE69C3KY20101014
The Cost of Dying: End-of-Life Care. 2010. Retrieved from http://www.cbsnews/2102-18560-6747002.html?tag=contentMain;contentBody
Today, while at work and caring for a very critically ill patient post open heart surgery, I found myself wondering what are the costs of the care we are providing and will this patient be able to survive this?
What is the cost of hope? Modern medicine has become so proficient at keeping the terminally ill alive that the inevitable process of dying is prolonged (cbsnews, 2010). It has been estimated that one third or out overall healthcare resources are spent in the last year of life (Harding, 2010). Medicare paid $55 billion dollars for the last two months of patient's lives. This accounts for more that the entire budget for Homeland Security. Furthermore 20-30% of these expenses have no meaningful impact (cbsnews, 2010).
Are we saving individuals with improved medical technology or are we preventing individual from dying a natural death?
Ask yourself, what is worse: having a loved one die or having a loved one die badly? It is well documented that most individuals would prefer to die at home. The reality is that 75% die in with hospitals or nursing homes (cbsnews, 2010). And remember back to our first video the Hospitalist vs the ICU end of Life Palliative Care: once a patient is admitted into the hospital, several consults and physicians order a multitude of tests in which many are not essential.
Communication and explanations are necessary to clearly identify a patient's wish for end of life care and potentially reduce the costs of dying or better termed the costs of hope.
Think of the savings, both money and quality associated with dying, that could be obtained if open conversations could take place to clearly identify individuals' wishes.
References
Harding, A., 2010. End-of-life care costs continue to climb upward. Retrieved from http://www.teuters.com/assets/print?aid=USTRE69C3KY20101014
The Cost of Dying: End-of-Life Care. 2010. Retrieved from http://www.cbsnews/2102-18560-6747002.html?tag=contentMain;contentBody
Saturday, June 30, 2012
Ethics & End-of-Life
Hello class,
Today we will focus on the ethical dilemmas associated with the Terri Schiavo case. The ethical question here is Does one have the right to die? As we have learned, Terri Schiavo lived in a persistent vegetative state for 15 years. Her husband, Michael and her parents, the Schlinders had differing opinions regarding Terri's right to die. Despite numerous medical opinions that Terri had little to no chance of returning to a normal life, her parents insisted that as a devout Catholic, Terri would not want to be removed from life support. However, Michael, her husband, was trying to abide by Terri's wishes. Unfortunately, these wishes were not written in any form. In Florida, the law is clear in that it states that artificial feedings are considered life support and Terri was being fed through a feeding tube. She also was able to breath on her own since her brainstem was not affected. Ethically, the principles of autonomy, freedom need to be expired.
The questions are:
1. Does Terri have the right to die?
2. Is Michael, as her husband, able to decide Terri's fate?
"In the event that an advance directive is absent, the patient's wishes about treatment and death can still be honored"(Porter, Johnson, & Warren, n.d., p.86).
3. Do the Schlinders have a say in Terri's fate?
The Schlinders brought this case to the media which in turn reached political involvement as high as the president.
4. Where and how will her care be funded?
Michael won a medical-malpractice suit of 1.5 million dollars of which 700,000... dollars was placed into a fund to pay for medical costs. However, the majority of this money went to legal battles.
5. What are the goals of treatment?
6. How can the patient benefit from treatment?
7. How can harm be avoided in her care?
Such decisions depend on individual experiences, religion, moral and ethical values. We live in a society that encourages life at all costs. We, as a society fear death. What is the difference between quality and quantity?
8. Was this a case of medical futility?
Medical futility is defined as : the unacceptably low chance of achieving a therapeutic benefit for the patient" (Butts & Rich, 2008, p. 464).
Terri's case, lasting 15 years with no measurable improvement, meets the definition of medical futility.
Lets review several ethical principles:
Autonomy: the ability of an individual to speak/make decisions for oneself
Freedom: The ability to decide one's own course of treatment
Beneficience: To do good and prevent harm in caring for a patient (Westrick & Dempski, 2009).
Nonmaleficence: protection of the patient from circumstances that may cause harm (Westrick & Dempski, 2009).
With unlimited funds, Terri could be kept alive and survive in a nursing home in a persistent vegetative state. She was able to survive largely due to her age. It is unknown how long Terri would have survived.
Think about these questions. I look forward to your discussions.
References:
Butts, J. B., & Rich, K. L. (2008). Nursing Ethics Across the Curriculum and Into Practice ( Second Edition ed.). Sudbury, Ma.: Jones and Bartlett Publishers.
Porter, T., Johnson, P., & Warren, N. (n.d.). Bioethical issues concerning death. Critical Care Nurse Q, 28(1), 85-92. Retrieved from OVID with Full Text.
Westrick, S.J., & Dempski, K. (2009). Essentials of Nursing Law and Ethics. Sudbury, Ma.: Jones and Bartlett Publishers.
Today we will focus on the ethical dilemmas associated with the Terri Schiavo case. The ethical question here is Does one have the right to die? As we have learned, Terri Schiavo lived in a persistent vegetative state for 15 years. Her husband, Michael and her parents, the Schlinders had differing opinions regarding Terri's right to die. Despite numerous medical opinions that Terri had little to no chance of returning to a normal life, her parents insisted that as a devout Catholic, Terri would not want to be removed from life support. However, Michael, her husband, was trying to abide by Terri's wishes. Unfortunately, these wishes were not written in any form. In Florida, the law is clear in that it states that artificial feedings are considered life support and Terri was being fed through a feeding tube. She also was able to breath on her own since her brainstem was not affected. Ethically, the principles of autonomy, freedom need to be expired.
The questions are:
1. Does Terri have the right to die?
2. Is Michael, as her husband, able to decide Terri's fate?
"In the event that an advance directive is absent, the patient's wishes about treatment and death can still be honored"(Porter, Johnson, & Warren, n.d., p.86).
3. Do the Schlinders have a say in Terri's fate?
The Schlinders brought this case to the media which in turn reached political involvement as high as the president.
4. Where and how will her care be funded?
Michael won a medical-malpractice suit of 1.5 million dollars of which 700,000... dollars was placed into a fund to pay for medical costs. However, the majority of this money went to legal battles.
5. What are the goals of treatment?
6. How can the patient benefit from treatment?
7. How can harm be avoided in her care?
Such decisions depend on individual experiences, religion, moral and ethical values. We live in a society that encourages life at all costs. We, as a society fear death. What is the difference between quality and quantity?
8. Was this a case of medical futility?
Medical futility is defined as : the unacceptably low chance of achieving a therapeutic benefit for the patient" (Butts & Rich, 2008, p. 464).
Terri's case, lasting 15 years with no measurable improvement, meets the definition of medical futility.
Lets review several ethical principles:
Autonomy: the ability of an individual to speak/make decisions for oneself
Freedom: The ability to decide one's own course of treatment
Beneficience: To do good and prevent harm in caring for a patient (Westrick & Dempski, 2009).
Nonmaleficence: protection of the patient from circumstances that may cause harm (Westrick & Dempski, 2009).
With unlimited funds, Terri could be kept alive and survive in a nursing home in a persistent vegetative state. She was able to survive largely due to her age. It is unknown how long Terri would have survived.
Think about these questions. I look forward to your discussions.
References:
Butts, J. B., & Rich, K. L. (2008). Nursing Ethics Across the Curriculum and Into Practice ( Second Edition ed.). Sudbury, Ma.: Jones and Bartlett Publishers.
Porter, T., Johnson, P., & Warren, N. (n.d.). Bioethical issues concerning death. Critical Care Nurse Q, 28(1), 85-92. Retrieved from OVID with Full Text.
Westrick, S.J., & Dempski, K. (2009). Essentials of Nursing Law and Ethics. Sudbury, Ma.: Jones and Bartlett Publishers.
Wednesday, June 27, 2012
TheTerri Shaivo Story
End-of-Life care brings forth many emotions for many of us. That is why it is so important that we all gain as much knowledge as possible and explore our own feelings regarding this subject.
However, we must also review some of the ethical and legal issues associated with end-of-life care. There are numerous case studies available for review, but the one that carried on for years and was at the forefront of the news over a long timeframe is the Terri Schiavo case. Please go to the link below and read about this case, the ethical and legal implications involved. It may surprise you just how far this case was taken and how emotions were impacted with this scenario.
The whole Terri Schiavo Story from WorldNetDaily. (2005)
http://www.wnd.com/2005/03/29516
However, we must also review some of the ethical and legal issues associated with end-of-life care. There are numerous case studies available for review, but the one that carried on for years and was at the forefront of the news over a long timeframe is the Terri Schiavo case. Please go to the link below and read about this case, the ethical and legal implications involved. It may surprise you just how far this case was taken and how emotions were impacted with this scenario.
The whole Terri Schiavo Story from WorldNetDaily. (2005)
http://www.wnd.com/2005/03/29516
Tuesday, June 26, 2012
Jean Watson, Theorist
Class,
I wanted to provide you with the link for Jean Watson's Transpersonal Caring Model inclusive of her Carative Factors and Caritas Process.
Watson Caring Science Institute. (n.d.). http://www.watsoncaringscience.org
Please navigate through this for further discussion as to how the Caritas can be applied directly to nursing care at end-of-life.
I wanted to provide you with the link for Jean Watson's Transpersonal Caring Model inclusive of her Carative Factors and Caritas Process.
Watson Caring Science Institute. (n.d.). http://www.watsoncaringscience.org
Please navigate through this for further discussion as to how the Caritas can be applied directly to nursing care at end-of-life.
Education and Competencies with End-of-Life
Teaching and learning strategies are influenced through observations, experiences, emotions, attitudes, and reactions from others (Bandura, 1977). Through this process, individual form opinions and behaviors within their lives. These opinions and behaviors impact the type of care they provide to individuals. Knowles (1984), describes the adult learner as self-directed and responsible for decisions. Other motivating factors for adult learners are: they need to know why they need to learn something, they learn through experience, they problem-solve and the need for the learning must be of immediate value (Knowles, 1984). Learning has been described though Bloom's Taxonomy but has been revised by Overbaugh & Schultz, (n.d.) to a newer process containing six criterion:
Remembering: Can the student recall the information?
Understanding: Can the student explain ideas or concepts?
Applying: Can the student use the information in a new way?
Analyzing: Can the student distinguish between the different parts?
Evaluating: Can the student justify a stand or decision?
Creating: Can the student create new product or point of view?
Meeting this criterion, the full circle of learning has become complete.
The AACN in it's creation of the Recommended Competencies for Peaceful Death hopes to achieve the above learning principles. I will provide the link to this website for review and also list the 16 competencies that are now recommended for all student nurses.
http://www.aacn.nche.edu/elnec/publications/peaceful-death
1. Recognize dynamic changes in population demographics, health care economics, and service delivery that necessitate improved professional preparation for end-of-life care.
2. Promote the provision of comfort care to the dying as an active, desirable, and important skill, and an integral component of nursing care.
3. Communicate effectively and compassionately with the patient, family, and health care team members about end-of-life issues.
4. Recognize one's own attitudes, feelings, values, and expectations about death and the individual, cultural, and spiritual diversity existing in these beliefs and customs.
5. Demonstrate respect for the patient's views and wishes during end-of-life care.
6. Collaborate with interdisciplinary team members while implementing the nursing role in end-of-life care.
7. Use scientifically based standardized tools to assess symptoms (e.g., pain, dyspnea [breathlessness] constipation, anxiety, fatigue, nausea/vomiting, and altered cognition) experienced by patients at the end of life.
8. Use data from symptom assessment to plan and intervene in symptom management using state-of-the-art traditional and complementary approaches.
9. Evaluate the impact of traditional, complementary, and technological therapies on patient- centered outcomes.
10. Assess and treat multiple dimensions, including physical, psychological, social and spiritual needs, to improve quality at the end of life.
11. Assist the patient, family, colleagues, and one's self to cope with suffering, grief, loss, and bereavement in end-of-life care.
12. Apply legal and ethical principles in the analysis of complex issues in end-of-life care, recognizing the influence of personal values, professional codes, and patient preferences.
13. Identify barriers and facilitators to patients' and caregivers' effective use of resources.
14. Demonstrate skill at implementing a plan for improved end-of-life care within a dynamic and complex health care delivery system.
15. Apply knowledge gained from palliative care research to end-of-life education and care.
16. The purpose of the competency statements is to assist nurse educators in incorporating end-of-life content into nursing curricula. This document is developed with the understanding that few schools of nursing would offer a discrete course in end-of-life care. Thus, this document offers an approach to incorporating end-of-life content throughout the currently existing curriculum.
Additionally,There are four components of a "natural death" in the ICU described by Cronquist, Theorell, Burns & Lutzem (2004). These are:
1. The process of dying is not prolonged or rushed (timing).
2. Technical death is aligned with bodily death.
3. The family has accepted the death.
4. Careful planning of withdrawal of treatment is made to enable control of the situation so the family can witness a gradual, quiet and dignified death.
Thinking about such care, it becomes obvious of the need for all nurses to become educated and explore their own feelings about death and dying to better assist patients and families with this process.
Your thoughts?
References
Cronquist, Al, Theorell, T., Burns, T., & Lutzem, K. (2004). Caring about-caring for: Moral obligations and work responsibilities in intensive care nursing. Nursing Ethics, 11(1), 63-76. Retrieved from CINAHL Plus with full text.
Knowles, M. (1984). Andragogy. Retrieved from http://www.instructionaldesign.org/theories/andragogy.html
Overbaugh, R.C., & Schultz, L. (n.d.). Blooms Taxonomy. Retrieved from http://www.odu.edueducrpverbau/Bloom/blooms_taxonomy.htm
Peaceful death: recommended competencies and curricular guidelines for end-of-life nursing care. (2012). Retrieved from http://www.aacn.nche.edu/elnec/publications/peaceful-death
Remembering: Can the student recall the information?
Understanding: Can the student explain ideas or concepts?
Applying: Can the student use the information in a new way?
Analyzing: Can the student distinguish between the different parts?
Evaluating: Can the student justify a stand or decision?
Creating: Can the student create new product or point of view?
Meeting this criterion, the full circle of learning has become complete.
The AACN in it's creation of the Recommended Competencies for Peaceful Death hopes to achieve the above learning principles. I will provide the link to this website for review and also list the 16 competencies that are now recommended for all student nurses.
http://www.aacn.nche.edu/elnec/publications/peaceful-death
1. Recognize dynamic changes in population demographics, health care economics, and service delivery that necessitate improved professional preparation for end-of-life care.
2. Promote the provision of comfort care to the dying as an active, desirable, and important skill, and an integral component of nursing care.
3. Communicate effectively and compassionately with the patient, family, and health care team members about end-of-life issues.
4. Recognize one's own attitudes, feelings, values, and expectations about death and the individual, cultural, and spiritual diversity existing in these beliefs and customs.
5. Demonstrate respect for the patient's views and wishes during end-of-life care.
6. Collaborate with interdisciplinary team members while implementing the nursing role in end-of-life care.
7. Use scientifically based standardized tools to assess symptoms (e.g., pain, dyspnea [breathlessness] constipation, anxiety, fatigue, nausea/vomiting, and altered cognition) experienced by patients at the end of life.
8. Use data from symptom assessment to plan and intervene in symptom management using state-of-the-art traditional and complementary approaches.
9. Evaluate the impact of traditional, complementary, and technological therapies on patient- centered outcomes.
10. Assess and treat multiple dimensions, including physical, psychological, social and spiritual needs, to improve quality at the end of life.
11. Assist the patient, family, colleagues, and one's self to cope with suffering, grief, loss, and bereavement in end-of-life care.
12. Apply legal and ethical principles in the analysis of complex issues in end-of-life care, recognizing the influence of personal values, professional codes, and patient preferences.
13. Identify barriers and facilitators to patients' and caregivers' effective use of resources.
14. Demonstrate skill at implementing a plan for improved end-of-life care within a dynamic and complex health care delivery system.
15. Apply knowledge gained from palliative care research to end-of-life education and care.
16. The purpose of the competency statements is to assist nurse educators in incorporating end-of-life content into nursing curricula. This document is developed with the understanding that few schools of nursing would offer a discrete course in end-of-life care. Thus, this document offers an approach to incorporating end-of-life content throughout the currently existing curriculum.
Additionally,There are four components of a "natural death" in the ICU described by Cronquist, Theorell, Burns & Lutzem (2004). These are:
1. The process of dying is not prolonged or rushed (timing).
2. Technical death is aligned with bodily death.
3. The family has accepted the death.
4. Careful planning of withdrawal of treatment is made to enable control of the situation so the family can witness a gradual, quiet and dignified death.
Thinking about such care, it becomes obvious of the need for all nurses to become educated and explore their own feelings about death and dying to better assist patients and families with this process.
Your thoughts?
References
Cronquist, Al, Theorell, T., Burns, T., & Lutzem, K. (2004). Caring about-caring for: Moral obligations and work responsibilities in intensive care nursing. Nursing Ethics, 11(1), 63-76. Retrieved from CINAHL Plus with full text.
Knowles, M. (1984). Andragogy. Retrieved from http://www.instructionaldesign.org/theories/andragogy.html
Overbaugh, R.C., & Schultz, L. (n.d.). Blooms Taxonomy. Retrieved from http://www.odu.edueducrpverbau/Bloom/blooms_taxonomy.htm
Peaceful death: recommended competencies and curricular guidelines for end-of-life nursing care. (2012). Retrieved from http://www.aacn.nche.edu/elnec/publications/peaceful-death
Monday, June 25, 2012
Let's take a look at one family that utilized Palliative Care as intended for their loved family member. An advantage in this Youtube clip is that the patient had already completed a Living Will.
After reviewing this clip, I would like to see some responses describing the benefits of completing a living will.
Is it important for individuals to communicate their wishes of end-of-life care to other family members?
What would you want for yourself at end-of-life?
www.youtube.com/watch?v=ilYXIPz0-dg
After reviewing this clip, I would like to see some responses describing the benefits of completing a living will.
Is it important for individuals to communicate their wishes of end-of-life care to other family members?
What would you want for yourself at end-of-life?
www.youtube.com/watch?v=ilYXIPz0-dg
Thursday, June 21, 2012
Questions to create discussion
Hello students,
I would like for each of you to read the article, The Cost of Dying: End-of-Life Care, and respond to the following questions:
1. Is rationing care realistic? Do we, as a country do this in any form currently?
2. How much money is too much? or not?
3. Should we look more at quality versus quantity of tests when dealing with end-of-life care?
I look forward to your responses and discussions.
Link to the article, The cost of Dying: End-of-Life Care
http://www.cbsnews.com/2012-18560_162-6747002.html?tag=contentMain;contentBody
I would like for each of you to read the article, The Cost of Dying: End-of-Life Care, and respond to the following questions:
1. Is rationing care realistic? Do we, as a country do this in any form currently?
2. How much money is too much? or not?
3. Should we look more at quality versus quantity of tests when dealing with end-of-life care?
I look forward to your responses and discussions.
Link to the article, The cost of Dying: End-of-Life Care
http://www.cbsnews.com/2012-18560_162-6747002.html?tag=contentMain;contentBody
Tuesday, June 12, 2012
Despite the increase use of Hospice and palliative care for en-of-life situations, costs continue to rise. Harding (2010) estimates that one third of overall healthcare costs are associated with care surrounding the last year of life. This is a staggering number. Another article by CBS News (2010) stated that "Medicare paid $55 billion just for doctor and hospital bills during the last two months of patients' lives." Is this justifiable? What do you think? This is actually more that the entire Homeland Security budget. Furthermore, 20-30% of these expenses do not have any meaningful impact. Much like the Youtube video in the previous post. When assessing individual patients who are hospitalized at end-of-life, many (18-20%) are in the ICU which can cost up to $10,000.00 per day. Is it acceptable, both morally and ethically for the government to be paying such extreme amounts of money to prevent the inevitable?
Not only is it important for us to review the costs associated with end-of-life care but is is also necessary for us to determine to what extreme do we, as a population, want to continue this type of spending and at what cost? What are we willing to give up to continue on this path?
Prior to answering these questions, we must first identify:
1. The role of the nurse.
AACN Competencies
2. Review Nursing Theory that can be applied to end-of-life care, such as Jean Watson's Caring Model.
3. Define Death and Dying.
4. Examine alternatives for care: Palliative and Hospice care.
5. Review both legal and ethical issues with end-of-life care.
6. Identify the purpose of the Advance Directive.
7. Discuss Living Wills and the importance of having one and the impact on care.
8. Review some high profile case studies surrounding the Right to Die.
Not only is it important for us to review the costs associated with end-of-life care but is is also necessary for us to determine to what extreme do we, as a population, want to continue this type of spending and at what cost? What are we willing to give up to continue on this path?
Prior to answering these questions, we must first identify:
1. The role of the nurse.
AACN Competencies
2. Review Nursing Theory that can be applied to end-of-life care, such as Jean Watson's Caring Model.
3. Define Death and Dying.
4. Examine alternatives for care: Palliative and Hospice care.
5. Review both legal and ethical issues with end-of-life care.
6. Identify the purpose of the Advance Directive.
7. Discuss Living Wills and the importance of having one and the impact on care.
8. Review some high profile case studies surrounding the Right to Die.
References
Monday, June 11, 2012
The End-of-Life Debate
The End-of-Life Debate
End-of-Life: When does it begin? What costs are associated with this? Who's decision is it? Many studies and publications exist but the real truth is that the moment we are born we begin our journey towards death. Our society has difficulty recognizing death and conversely has a quest for eternal youth along with endless life. The question here is how do we handle end-of-life care? What are we willing to spend on care and to what extremes are we willing to go to extend life or prevent the inevitable? Will we examine quality in this equation? Or does that matter? Obviously moral and ethical issues arise and need to be examined. What legal implications are already associated with end-of-life and what are the regulatory agencies perspectives with end-of-life care? The questions are endless as are the individual viewpoints.
Take a moment and review the following Youtube video: Hospitalist vs ICU End-of-Life Palliative Care retrieved from: thehappyhospitalist.blogspot.com
End-of-Life: When does it begin? What costs are associated with this? Who's decision is it? Many studies and publications exist but the real truth is that the moment we are born we begin our journey towards death. Our society has difficulty recognizing death and conversely has a quest for eternal youth along with endless life. The question here is how do we handle end-of-life care? What are we willing to spend on care and to what extremes are we willing to go to extend life or prevent the inevitable? Will we examine quality in this equation? Or does that matter? Obviously moral and ethical issues arise and need to be examined. What legal implications are already associated with end-of-life and what are the regulatory agencies perspectives with end-of-life care? The questions are endless as are the individual viewpoints.
Take a moment and review the following Youtube video: Hospitalist vs ICU End-of-Life Palliative Care retrieved from: thehappyhospitalist.blogspot.com
Subscribe to:
Posts (Atom)