Role of Nurse in Caring for Dying Patient and Their Families

This article discusses the role of nurses in providing end-of-life care for dying patients and their families. It emphasizes the importance of personal support, cultural competence, and spiritual care in ensuring a peaceful death. The article also explores the ethical dilemmas faced by nurses and the nursing theories that guide their practice. Additionally, it provides information on the sections of the CA Advanced Directive that allow patients to express their wishes regarding treatment and organ donation.

Running Head: ROLE OF NURSE IN CARING FOR DYING PATIENT 1
Role of Nurse in Caring for Dying Patient and Their Families
Student’s Name
Institutional Affiliation

Role of Nurse in Caring for Dying Patient and Their Families 2
Role of Nurse in Caring for Dying Patient and Their Families
When caring for a dying patient, the treatment tends to shift from putting active effort to
cure the illness, and concentrate on minimizing distress and effects of the disease. Thus, the
nurse aims at providing terminal care to give the patient personal support and maintain an
acceptable lifestyle, which will enable a peaceful death. This needs to happen in regards to the
sufferer’s beliefs and culture, preferences, and values. In spite of this, the nurse should consider
the patient’s relatives and friends because their emotions are sensitive; this is because losing a
loved one is quite intense and hard for some people to process. It is vital to note that the response
of losing a loved one often reflects the intensity of the relationship that the friends and family
had with the dying patient. Therefore, the article focuses on the role of nursing staff in end of life
care; which may involve psychological, physical, spiritual, and social care of the patient and his
family and friends.
According to Harris (n.d), the personal concern and support of the nurse are highly
valued by both the relative, friends and patient. This is because the nurse tends to share the
experience with them by acknowledging their psychological pain, and help them cope with the
distress of losing a loved one. It is worth noting that it is not wrong for a nurse to express her
feeling towards the dying patient-she needs not to feel embarrassed when admitting her
emotional reaction when caring for a dying patient. Furthermore, the nurse may require a wide
range of skills and values, which express their support and compassion — for instance,
communicating sensitively and apparently with the patient and his family. Also, acknowledging
when the patient is in distress and pain, which may help the nurse take swift action in assisting
the patient (Royal College of Nursing, n.d).

Role of Nurse in Caring for Dying Patient and Their Families 3
Values and Beliefs of the Nurse’s Personal Faith Tradition Related to Death
The nurse has a role of providing end of life care that is personal and culturally
competent and relevant for each patient. Hence, the care provided to the sufferer during his final
hours will be treasured and remembered by the friends and family of the dying patient. It is
crucial to note that if the nurse comes from a different cultural background, then it is critical to
provide care that is appropriate as per certain faith and cultural traditions of the dying patient.
Therefore, it is crucial for the nurse to take time and learn some of the necessary information,
which may help them bind by the cultural practices regarding death. According to Lewis et al.
(2017), spiritually significant in nursing especially when providing palliative care because
guidelines regarding spiritual care are developed. These guidelines give nurses a general
understanding of the importance of acquiring a caring attitude, which should be responsive and
recognized by the patient’s individual needs. Moreover, the personal nurse faith is crucial in
palliative care because most patients have deep concerns and fears that are commonly require
spiritual care (Giske & Cone, 2015).
Rome, Luminais, Bourgeois & Blais (2011) assert that the primary purpose of palliative
care is to relieve the patient from suffering, and give his family and friends some peace through
comprehensive assessment. Thus, as a patient approaches death, the symptoms of the disease
may need more aggressive palliation-this means comfort measures ought to be taken in
supporting the dying patient’s family and friends. Nevertheless, skilled therapeutic
communication may facilitate discussions that are aimed at enhancing and maintaining the
relationships that the dying patient may have built. Alternatively, the patient’s age plays a vital
role in nursing care. For instance, when caring for a dying child, the nurse needs to work hand in

Role of Nurse in Caring for Dying Patient and Their Families 4
hand with the parents because the child may lack knowledge for spiritual pain. On the other
hand, older dying patients may be lonely, and lack any form of social networks. It is worth
noting that they are more spiritually aware compared to other people. In spite of this, chronic
health issues may affect the ability of the patient to communicate, which automatically modifies
the patient-nurse relationship. Contrary, the interaction between the dying patient and the nurse
may depend on how long their relationship lasted. Fortunately, the nurse can manage to develop
a relationship with the patient through understanding and evaluating the patient’s environment.
This may provide the nurse with information regarding the patient’s values and interests, though
the patient may need to confirm the meanings of symbols and signs that the dying patient shows.
Caldeiera, de Carvalho & Vieira (2014) utter that elderly patients who may be suffering
from cancer may require spiritual care because cancer is a feared disease. This is because the
illness is associated with premature death arrival, and also it causes suffering to patients due to
the treatment they undergo. Also, advanced care planning is appropriate because it aims at
encouraging the nurse and patients at considering discussion and documentation of future wishes
for care. Furthermore, discerning time assists the nurses to allocate enough time caring for the
dying patient. This would also help the nurse to uncover deep concerns that may be critical to the
patient and his family; hence the process should be conducted respectably when trying to
identify, and understand these issues. Lastly, the nurse should always respect the patient’s
privacy, which may involve acknowledging the spiritual concerns of the patient. Thus, the
uncovering process cannot take place without the knowledge of the patient. In addition, active
listening may allow the patient to speak because he may feel free associating with the nurse
regarding his feelings and thoughts. As such, attentive engaging may aid the peace on the dying

Role of Nurse in Caring for Dying Patient and Their Families 5
patient, which may relieve them from the fear and distress they may be feeling due to his current
state of health.
Eliopoulos (2010) asserts, “Gerontological nurses commonly face the reality of death
because more than 80% of deaths occur in old age. In addition to facing this reality,
gerontological nurses must learn to deal with the entire dying process; the complexity of
experiences that dying individuals, their family, their friends, and all others involved with them
go through.” Hence, nurses currently offer a more humanistic technique in caring for dying
patients. This means that emphasizes they have been made on meeting the needs of a sufferer in
a holistic manner, which stimulates greater concern regarding the spiritual and psychological
care of the dying patient. As such, the family members and friends play a crucial role in the
dying process that ought to be considered by the medical practitioner. It is worth noting that the
dying process is exquisite for every human being. Thus the nurse needs to individualize any
nursing intervention that may be recommended.
However, there are common reactions that are observed in order to provide a suitable and
understood process. For example, Elisabeth Kubler Ross was able to develop an appropriate
framework after several years of caring for dying patients. This enabled her to create suitable
outlines that emphasize on the coping mechanisms of a dying patient in terms of five important
stages. Therefore, it is the nurse’s responsibility to familiarize herself with these stages, which
includes understanding the essential therapeutic nursing interventions that are required for each
stage. It is vital to note that not all dying patients will progress through all the five stages, and
neither will every dying sufferer experience any of these stages (Eliopoulos, 2010). Contrary,
being aware of the Kubler-Ross conceptual approach would assist the nurse in supporting the

Role of Nurse in Caring for Dying Patient and Their Families 6
dying patient because the medical practitioner has the skill and knowledge regarding complex
reactions associated with death.
Understanding a Nurse’s Role in Supporting the Patient through the Dying Experience
ANA Center for Ethics and Human Rights (2016) insinuate that primary palliative care is
fundamental in caring for a dying patient because the nurse requires skills and knowledge, which
includes basic symptom management. This would enable the nurse to have accurate
physiological data that enhances proper care for the patient. Moreover, the provision of an
appropriate end of life care requires the nurse to have excellent knowledge in the
pathophysiology of the terminal disease. Additionally, the systems to provide an active end of
life care needs to be consistently available without causing severe financial depletion. It is
important to consider that the end of life care is complicated.
According to Sekse, Hunskår & Ellingsen (2018), the role of the nurse should comprise
of ethical and moral dilemmas when caring for a dying patient. One ethical dilemma is
considering an aggressive medical management technique, especially when the nurses know it
would not change the outcome of the patient. Hence, a nurse working in the intensive care unit
may experience difficulty when the current treatment fails to enhance the life of the patient; as
such a palliative approach may be appropriate. Alternatively, the nurse may take part in various
activities in the palliative care department, which may include tasks identified in different acute
wards. As such, the nurse may be tasked by providing comfort care such as bathing the dying
patient, mouth care, hair care and emotional care of the patient.
To provide a spiritual assessment on a dying patient, the nurse must understand the
cultural practices and beliefs of the sufferer; this can be done through respecting, and

Role of Nurse in Caring for Dying Patient and Their Families 7
acknowledging the traditions of the patient (O'Brien, 2018). Two religious traditions are
generally considered-Eastern spirituality and spiritual philosophy. In spite of this, there are three
primary Western religions; Islam, Judaism, and Christianity. On the other hand, Eastern
traditions consist of Hinduism, Confucianism, and Buddhism. Therefore, the spiritual care of a
dying patient is based on the nursing theory that includes palliative care. Thus, numerous nursing
theories are considered in providing spiritual comfort that a dying patient may need especially
when he is in constant pain.
According to the nursing theory of Betty Neuman, the conceptual framework aims at
addressing the various spiritual dimensions and needs of the dying patient. The approach further
states that a patient system is regularly assessed in five perspectives: spiritual, psychological,
physiologic, developmental, and sociocultural. Additionally, Callista Roy’s adaptation approach
focuses on an adaptive need to care for the dying patient and his family. Thus, this model
addresses the self-ideal, self-consistency, and spiritual self. Taylor (2002) insinuates that a
modest and direct correlation is evident between the various religious services, which increase
the preference for spiritual care by nurses on dying patients. This helps in distress and managing
spiritual management of patients who suffer from chronic disease.
Section 2 and 3 of the CA Advanced Directive
Section 2
This form lets the individual give certain instructions regarding any aspect of his or her
health care. The choices are given for the person to express his or her wishes regarding the
withdrawal or provision of treatment. Furthermore, the form enables the patient to express his
wishes regarding pain relief provision. It should be noted that in this section the patient has a

Role of Nurse in Caring for Dying Patient and Their Families 8
decision to make regarding his or her choice to prolong life or not to do so. Most of the dying
patients often chose the option of not to prolong life because the treatment that had been offered
made no positive progress in curing them (California Advance Directive Forms, n.d). In spite of
that, some dying patients may choose not to prolong life because of the financial burden they
may impose of their family yet the health of the sufferers are still deteriorating.
Section 3
This form is often considered when the dying patient has chosen not to prolong life. As such, the
patient may decide to donate some of his or her organs at death.
Conclusion
The nurse aims at providing palliative care to give the dying patient because the personal
support and maintain an acceptable lifestyle will enable a peaceful death. The nurse should
always consider the patient’s relatives and friends because their emotions are sensitive. This is
because losing a loved one is quite intense and hard for some people to process. Therefore,
primary palliative care is vital in caring for a dying patient because the medical practitioner
requires skills and knowledge that may include basic symptom management.

Role of Nurse in Caring for Dying Patient and Their Families 9
References
ANA Center for Ethics and Human Rights. (2016). Nurses’ roles and responsibilities in
providing care and support at the end of life. ANA American Nurses Associated.
Available from: https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics/
endoflife-positionstatement.pdf
Caldeiera, S., de Carvalho, C. E., & Vieira, M. (2014). Between spiritual wellbeing and spiritual
distress: possible related factors in elderly patients with cancer. Original Article.
Available from: http://www.scielo.br/pdf/rlae/v22n1/0104-1169-rlae-22-01-00028.pdf
California Advance Directive Forms. (n.d). Planning for important healthcare decisions. Caring
Connections. Available from:
https://cvmchospital.org/sites/www/Uploads/files/Form/CA%20Advance
%20Directive.pdf
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