Principle and Practice of Palliative Care: A Case Study of Mrs. Brown

Introduction
WHO refers Palliative care as a practice of care in which quality of life of patients with
end-of-life illness and their carers/family members is improved by preventing and
minimising the suffering through early diagnosis and accurate assessment and
management of the disease and other issues such as mental state, spiritual needs,
social health, etc. (WHO, 2017). One of the major component of palliative care is control
of debilitating symptom. It is the professional and ethical duty of nurses and other health
care professionals as it causes physical as well as mental distress. This assignment will
explain the principle and practice of palliative care. It will discuss in detail two high
priority palliative for the case study of Mrs. Brown.
Discussion
Palliative care collaborates a range of expertise care which includes medical,
psychological, and social, etc. Nurses must make use of a holistic approach which
integrates these broad aspects of care to deliver efficient palliative care. In case of Mrs.
Brown, nurse must manage the palliative care ethically in various areas such as
symptom control such as acute shortness of breath, psychological care that is
preventing depression, and maintaining social status by ensuring social contact and
inclusion in society. The cardinal ethical principles followed by nurses while delivering
palliative are autonomy, beneficence, non-maleficence and justice. Certain factors that
can put palliative care nurses in dilemma are honesty, site of care, extension of
beneficial end-of-life care until death, use of antibiotics, blood transfusion procedure,
privacy, artificial nutrition and hydration and negligence towards human rights. Delivery
of the best possible terminal nursing care and services to Mrs. Brown and at the same
time maintaining the professional boundaries that respects human rights is necessary.
Collaboration of delivery of palliative care and ethical principles of medicine will improve
the safeguard and satisfaction of Mrs. Brown and her family (Mohanti, 2009).
Practice of Palliative Care in Mrs. Brown Case
The essential components in provision of palliative care to Mrs. Brown will include
symptom control, effective communication, rehabilitation to maximise autonomy,

terminal care, support in grief, education, etc. Nurses must maintain an empathetic,
compassionate, non-judgemental and impartial attitude while providing services to Mrs.
Brown. While palliative care planning for Mrs. Brown, her individual psychosocial
concerns of must be acknowledged by the nurse apart from disease management.
Nurse must obtain informed consent from Mrs. Brown or her husband prior to giving or
ending the treatment.
High priority palliative nursing strategy 1- Disease management
Issue- Managing acute shortness of breath is an essential high priority nursing strategy
for Mr. Brown. Shotness of breath is the most disabling symptom of COPD. An
important aspect of palliative care practice is that the strategies must be focused at
easing the suffering and improving the QoL of Mrs. Brown, and not necessarily at
continuation of life. Mrs. Brown was admitted to the hospital due to shortness of breath.
Increase in the chronic morning productive cough, rhinorrhoea and cough indicates the
chronicity and worsening of the disease which must be managed to improve quality of
life of Mrs. Brown.
Strategy- Nurses must acknowledge and accept self-reported level of dyspnea of Mrs.
Brown and also properly assess the shortness of breath. After assessing the level of
dyspnoea, suitable nursing interventions must be implemented that are medication
administration through the most effective of route, oxygen therapy, etc. Nurses must
collaborate with experts in respiratory field to deliver best possible care to Mrs. Brown
and provide maximum assistance to her family (Mudiginda & Mudigonda, 2010).
Justification- The level of perceived breathlessness is related to the respiratory effort.
More the ineffective respiratory effort exerted by Mrs. Brown, more the sensation of
breathlessness she will face (Bailey, et al., 2013). It is essential that her symptom of
shortness of breath is controlled or it may have adverse consequences for her including
death. Other symptoms can be managed later once her survival is ensured.
High priority palliative nursing strategy 2- Retaining mental/psychological health