Assessments

Course HLTENN068 Provide end of life care and a palliative approach in

:
Unit nursing practice

Assessmen
: Case Study
t type

Student ID
Case Study 1

1.1 
Individuals may express their preferences for medical care via advance directives, which are
legal documents, in the event that they are unable to make their own decisions. Among other life-
saving alternatives, this might include deciding whether or not to get CPR or artificial
ventilation. All Documents Quality Assurance Study Materials Original Case Study Mark
expressed a desire to die at home. In Mark's case, his advance directive stated that he did not
want to receive any therapies that might prolong his life. This suggests that if he had a cardiac
arrest or stopped breathing, medical personnel would not attempt to revive him. Instead, they
would allow him to die peacefully. 

Mark's wife, Cathy, supported his decision and organized more home help to help him with his
personal care, hydration, and medication. Three weeks later, Mark died suddenly at home with
his loved ones at his side.

Everyone has the right to make their own decisions, even if giving up life-supporting measures
could be a tough decision. Some individuals believe that dying is preferable to being kept alive
artificially. Others may feel that they owe it to their loved ones to prolong their lives as much as
possible. To make sure that everyone is on the same page, regardless of the person's reasons,
family members and medical professionals must be consulted. Future misunderstandings or
disputes could be prevented by doing this.

1.2

Cathy has a few options available to her when she needs a break from caring for Mark at home.
One option is respite care, in which case a separate individual is hired to take care of the patient
temporarily. One of the organizations that can assist with this is the local Area Agency on Aging.
Hospice care, which offers assistance and care to those with terminal diseases, is an additional
option. Several hospice organizations may be used to make these arrangements. The family
might also choose to hire a home health aide to take care of Mark. Respite care might be a great
option for Cathy when she needs a break from taking care of Mark. She'll be able to unwind and
replenish knowing that Mark is in capable hands. Hospice care is yet another fantastic option that
might help Mark and his family during this difficult time. Another fantastic option is hiring home
health aides, who can take care of Mark while Cathy rests.

1.3

It is my duty as Mark's nurse to make sure he is comfortable and that Cathy, Mark's wife, is
looked after. I would collaborate with the home health aide to ensure Mark receives the care he
requires and that his medications are properly managed. In addition, I would often check in with
Cathy to see how she was doing and to provide help as necessary. My ultimate goal is to provide
Mark and his family with the best experience possible at this tough time.

One of the most important things I can do for Mark and Cathy is to help them communicate.
Given that Mark's decision to die at home is unpleasant, Cathy must support it. I would suggest
that they be open and honest about their aspirations and concerns. Additionally, I would inform
them of what to expect if Mark's condition worsened. Additionally, it is my duty to make Mark
as comfortable as possible. He also needs to manage his pain and other side effects. I would
collaborate with the home health aide to ensure Mark receives the care he requires and that his
medications are properly managed. In addition, I would often check in with Cathy to see how she
was doing and to provide help as necessary.

My ultimate goal is to provide Mark and his family with the best experience possible at this
tough time. I'll make every attempt to help and reassure Cathy and Mark.

1.4

There are several organizations that help grieving families. Several of these companies are:

The National Bereavement Resource Center is an organization that provides support and
resources to families experiencing loss. They offer a resource library, an online support
community, and a grief hotline, among other things.

2. The National Widows' Organization: This organization provides resources and help to widows
and their families. They provide counselling, financial help, and support groups.

3. The Compassionate Friends: This organization provides services and assistance to families
that have lost a child. Services like counselling and support groups are offered by them.
Grief Share: This organization provides resources and support to bereaved families. They
provide a directory of bereavement therapists, support groups, and online resources.

5. The National Alliance for Mourning Children: This organization helps families with mourning
children by providing resources and support. Services like counselling and support groups are
offered by them.

Sixth on the list is the National Organization for Victim Assistance, which provides support and
services to families who have lost a loved one to violence. They provide counselling, support
groups, and financial assistance.

1.5

Supporting someone outside of work may be difficult, especially if you don't get along with them
well. But it's vital to go out of your way to be accessible to them. One way to achieve this is to
be a good listener. If they want to talk about what's occurring, be willing to listen and provide
whatever help or direction you can. Another way to support someone outside of the job is to
offer to help them with whatever they may need. This might include everything from carrying
out household duties to doing errands. If you are able, offer to help in any way you can.

Finally, try to be understanding and patient. It's important to recognize that every person
responds to events differently. If someone is not prepared to talk about what is occurring, do not
force them to. Simply let them know that you are available to help them at any time.

Even if helping someone outside of work may be difficult, it's important to do your best. A little
listening, a little helping, a little sympathy can go a long way.
Case Study 2

2.1

The patient's reaction to pain

Anxiety and depression are frequent psychological reactions to pain. Pain that won't go away
might cause sentiments of hopelessness and helplessness, which raises the possibility of the
patient having a more severe form of depression.
2.2

Her hips contain bone metastases, as my research will demonstrate. Her in-home palliative care
treatments will be enhanced and she will begin taking painkillers. Together, the family and the
care team will see ACD through. Following that, nursing will come by once per week. On the
upcoming visit, the nursing team will see Macey becoming more bedridden, sleeping for
prolonged periods of time, and sometimes growing restless. She will decline any more treatment
and blood tests and acknowledge that time is running out.

2.3

The role of families in making decisions and the legal system

FMs are very important to the care of patients because they help make decisions, help the
medical staff care for the patient, improve the quality of care, help with home care, and meet
societal and family expectations.

2.4

Interventions in healthcare

Nursing interventions include making meals, helping people get around, planning for and
teaching about discharge, giving emotional support, helping people take care of themselves and
their teeth, keeping track of fluid intake and output, and keeping an eye on the person's general
condition.

2.5
Family involvement in patient care

Family-centered care makes the healthcare experience better for the patient and their family. It
also reduces anxiety, improves communication, reduces conflict (including legal action), and
helps children with chronic diseases live better lives.

The nurses' support for the family

Nurses should provide consistent information in the treatment plan and encourage families to use
community and counselling options to reduce and prevent pressures in health-related conditions
to assist families in coping with stress and crisis.

2.6

Occupational limitations

Professional boundaries separate the nurse's authority from the patient's vulnerability. The
patient's needs come first when nurses err on the side of professionalism, whether on purpose or
by mistake. Some examples of when professional boundaries have been breached are as follows:

Revealing sensitive or private information or maintaining patient or client privacy.

Favoritism includes things like spending more time with a patient than is necessary, siding with
one person in a family argument, or doing personal favours outside the scope of your
employment. Favoritism includes acting like a "super nurse" by saying you are the only one who
can understand the patient or care for them.

2.7

An advanced care directive is now being polished by Macey. Once a month, you (the nurse) go
to see Macey to see how she's doing and to see if you can help. When Macey is assessed by the
nursing team, they will see that she appears to be in a lot of pain. They saw Macey crying and
gripping her hip, and they decided not to go to the doctor or take any more pain pills.

care requirements during death.

Patients and their families get physical, emotional, social, and spiritual assistance as part of end-
of-life care. Reduced pain and other symptoms are the main objectives of end-of-life care.
Palliative, supportive, and hospice care are a few types of end-of-life care.

2.8

Maintaining one's health

While providing palliative care to someone who has a life-limiting illness, you may look for
support to aid you and your family. By eating correctly, getting enough sleep, relaxing,
exercising often, and taking care of your personal wellbeing, you may be able to find the energy
and vitality you need for your professional career.

Nursing-related skills and actions

All nurses must be certified to offer palliative care in order to treat the symptoms of patients with
life-limiting illnesses and improve their quality of life. Much like they are in nursing practice, the
three main components of delivering palliative care are symptom management, communication,
and advocacy.

Improving nurse care;

The company's employee wellness programs provide opportunities for self-care planning.

-Promote nurse and midwife support to all nurses, midwives, nursing and midwifery students,
employers, educators, and concerned family and friends.

Increasing the accessibility of counselling services

Consider clinical supervision as an official kind of worker aid. On the Palliative Care Bridge,
you can find out about clinical supervision and care for the caregiver.

Give staff members frequent chances to practice reflective thinking.

Consider creating formal or informal teams of allied health experts to help patients undergoing
palliative care for debriefing and inter-professional support, especially for rural and distant
practitioners such as the general practitioner, nurse, counsellor, psychologist, and dietician.
The Maslach Burnout Inventory is one tool that may be used to monitor burnout symptoms in
palliative care team leaders.

2.9

We prospectively enrolled children with acute abdominal trauma at six emergency departments
in order to evaluate the PECARN prediction rule's accuracy in a new multicenter validation
cohort (EDs). Before CT imaging, if it was done, doctors wrote down whether the prediction rule
was positive or negative. The bulk of your hospital-based continuous care and treatment is
managed by nurses, while support and administrative staff assist with day-to-day operations. As
you listen to the patients, think about their bodily and emotional needs. Individuals with direction
and health education To coordinate therapy, they collaborate with specialists and other health
care providers. Keep up with changes in medical procedures, medications, and treatments.
References:

 Davis, J., Morgans, A., & Dunne, M. (2019). Supporting adoption of the palliative
approach toolkit in residential aged care: an exemplar of organisational facilitation for
sustainable quality improvement. Contemporary Nurse, 55(4-5), 369-379.
 Sachs, G. A., Shega, J. W., & Cox-Hayley, D. (2004). Barriers to excellent end-of-life
care for patients with dementia. Journal of general internal medicine, 19(10), 1057-1063.
 Saurman, E., Wenham, S., & Cumming, M. (2021). A new model for a palliative
approach to care in Australia. Rural and Remote Health, 21(4).
 Stajduhar, K. I., Giesbrecht, M., Mollison, A., & d'Archangelo, M. (2020). “Everybody in
this community is at risk of dying”: An ethnographic exploration on the potential of
integrating a palliative approach to care among workers in inner-city settings. Palliative
& Supportive Care, 18(6), 670-675.
 Ferrell, B. R. (2005). Overview of the domains of variables relevant to end-of-life
care. Journal of Palliative Medicine, 8(supplement 1), s-22.
 Gallagher, E., Carter-Ramirez, D., Boese, K., Winemaker, S., MacLennan, A., Hansen,
N., ... & Howard, M. (2021). Frequency of providing a palliative approach to care in
family practice: a chart review and perceptions of healthcare practitioners in
Canada. BMC family practice, 22(1), 1-9.