Nursing Public Health - Palliative and Hospice Care, Community Health Nurse Role, Ethical Viewpoint and Resource Use

This article discusses the relation between palliative and hospice care, clients who can be referred to palliative care, the role of community health nurse in palliative and hospice care, main issues in the delivery of health care to clients with chronic and life limiting illness, ethical viewpoint regarding resource use by chronically ill patient and scarce health resource utilization to treat diseases such as multiple myeloma.

Running head: NURSING PUBLIC HEALTH
Nursing public health
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Answer 1:
Palliative care is provided to patients who are suffering from serious illness such as
cancer, cardiovascular disease and other. In addition, hospice care is provided to people who are
suffering from terminal illness. The relation between palliative and hospice care is that both aims
to relieve pain and provide comfort to patient. In case of hospice care, the focus is to provide
comfort, peace and maintain dignity of patient during end stage of their life. Palliative care can
be given throughout treatment, after diagnosis and at the end of life, however hospice care is
given specifically at the end of life when there is no chance of survival.
Answer 2:
Clients who are suffering from serious or chronic illness such as cancer, heart disease,
lung disease, kidney failure, HIV and dementia can be referred to palliative care. Apart from
getting support for clinical management of serious illness, client can expect to get emotional,
social and spiritual support too. Palliative service can provide treatment for physical problems
like pain, breathing problem, insomnia and other physical issues. It also provide treatment to
address emotional, social and coping problem of client by interventions like counseling, support
group and referred to mental health staffs.
Answer 3:
The role of community health nurse is to meet the health care needs of patients or
vulnerable people who cannot visit hospitals. They play a role in providing care and support to
patient out of hospital such as in patient homes and health care centers. In palliative and hospice
care, the community health care nurse uses their clinical and communication skills to develop
therapeutic relationship with patient, manage emotion issues of patient and provide physical care

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to patient (Walshe & Luker, 2010). They also utilize public health code of ethics to prevent harm
and respect autonomy of clients.
Answer 4:
The main issues in the delivery of health care to client with chronic and life limiting
illness is the trends related to health care policy and health economics. Due to fragmented and
uncoordinated financing end-of-life care and palliative care financing, integration of acute and
long-term care services has become difficult. Health care in the United States plays a little
attention to provide holistic treatment to people with chronic illness. Because of flaws in the
hospital structure, there is little scope to explore and respect patient’s preference in care thus
leading to ethical conflicts. Mistry et al. (2015) explains that patient autonomy, addressing
physical and non-physical needs and communication development matters most at end-of-life.
Answer 5
My ethical view point regarding resource use by chronically ill patient is that advocating
for appropriate use of resource is necessary to ensure that valid resource is used by patient for
health and well-being. They should also consult with other nurses and health providers so that
ethical values of beneficence, non-malificence and client-centered care are maintained.
Answer 6
I have found that very scarce health resource is used to treat diseases such as multiple
myeloma. I feel that this has happened because of poor outcomes related to the resources.
However, with the advent of new therapies for multiple myeloma, it is expected that health care

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resource utilization can be increased and improvement in outcome of patient can be achieved
(Gonzalez-McQuire et al., 2018).

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Reference:
Gonzalez-McQuire, S., Yong, K., Leleu, H., Mennini, F. S., Flinois, A., Gazzola, C., ... & Fink,
L. (2018). Healthcare resource utilization among patients with relapsed multiple
myeloma in the UK, France, and Italy. Journal of medical economics, 1-18.
Mistry, B., Bainbridge, D., Bryant, D., Toyofuku, S. T., & Seow, H. (2015). What matters most
for end-of-life care? Perspectives from community-based palliative care providers and
administrators. BMJ open, 5(6), e007492.
Walshe, C., & Luker, K. A. (2010). District nurses’ role in palliative care provision: a realist
review. International journal of nursing studies, 47(9), 1167-1183.