Essay on Palliative Care: History, Principles, and Delivery in Nursing

This essay provides a comprehensive overview of palliative care, beginning with its historical roots in the hospice movement and its evolution into modern healthcare settings. It delves into the core principles of palliative care, emphasizing the importance of a caring attitude, ethical considerations, effective communication, and shared decision-making between nurses, patients, and families. The essay further examines the practical delivery of palliative care, highlighting the need to assess patients' physical, emotional, and spiritual needs, manage symptoms, and provide pharmacological treatments while always prioritizing patient-centered care. The conclusion reinforces the significance of palliative care in improving the quality of life for terminally ill patients and their families, underscoring the crucial role of nurses in upholding its key principles. The essay is well-supported by references to relevant literature, including the World Health Organization guidelines.

Running head: PALLIATIVE CARE
Palliative Care
Name of the Student
Name of the University
Author Note

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Introduction
Palliative care refers to that approach which is associated with the improvement of
quality of life of the healthcare service users along with the families of the patients suffering
from issues regarding various life- threatening disease or condition. According to the World
Health Organization, this care approach helps in prevention of the aforesaid condition and
simultaneously helps in relief of various complex physical, psychological, spiritual condition
by early identification of the problems and delivering required treatment as well. In case of
nursing profession, it is very important to provide the palliative care to the patients suffering
from life threating illness. The palliative care is delivered by nurses, physicians, occupational
therapists, physiotherapists, speech language therapist and along with this, other health care
professionals also take part in this palliative care process or end of life care process (World
Health Organization 2019). In this essay, the history of palliative care, principles of this care
process and the delivery of palliative care are described in a brief manner.
History of Palliative Care
The term palliative care also refers to the concept of end of life care as well. This
care process was first initiated in the hospice movement and in recent time it is vastly used in
the care process of the patients in the hospitals. Hospices are the places where travellers can
take rest in the 4th century. In the 19th century, a religious order formed hospices for the dying
people in London and Ireland. The modern concept of hospice was generated in UK after the
establishment of St. Christopher’s Hospice in 1967. It was reported that, Cicely Saunders is
the founder of the modern hospice movement and after visiting the St. Thomas hospital in
1944, Cicely Saunders had become a service provider in that hospital. After performing with
the terminally ill patients in the hospitals, she went to be a doctor in 1957 (Clark 2016). After
being a doctor, she only wanted to start her own hospice so that, she could serve the people

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during their end of life. In US, the concept of hospice was initiated by the voluntary
movement and after that it was incorporated in the health care system as well. In US, the
hospice care was used to provide benefits in terms of medical services, pharmacologically, all
time services to the patients who are at the end of their life. Initially, this hospice care was
delivered at the home. Therefore, gradually this type of care entered in the nursing home
services, hospitals. The first hospital ,that initiated the palliative care services to the patients
was situated in US (Connor 2017). Therefore, the first palliative care program was designed
by Declan Walsh in 1987at the Cleveland Clinic Cancer Centre. It is reported that, this
integrated program was associated with various notable innovation in the health care sector
regarding palliative care in US. With the development of health care technologies, in 2009,
Norway become the first country in pan- Europe to develop a palliative care centre and end of
life care centre in the Trondheim. This centre was established at St. Olav’s Hospital and
NTNU’s faculty of Medicine. In UK, there were just 1700 hospice services in 2005 and it
comprised of 33 inpatient units for children with 255 beds, 220 inpatient units for adults with
3,156 beds, 263 day care services, 358 home care services, 104 hospice at home services and
293 hospital teams ( Clark 2016).
Principles of Palliative Care
While delivering palliative care to the patients, the nursing professional must follow a
few principles in order to provide a proper palliative care to the patients. A palliative care
includes a wide spectrum of care including the medical, psychological, cultural, social,
nursing and spiritual support to the patients. Apart from that, a holistic approach is also
required for providing a standard palliative care to the patients. According to the study of
Richardson, Percy and Hughes (2015), it is reported that, a caring attitudes of the nursing
personnel is one of the most common principles of palliative care. A caring attitude of the
nursing personnel may include the feelings of empathy, sensitivity and compassion that

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describes the concerns of the nursing personnel for the patients suffering from critical illness.
Moreover, the nurse should consider the ethical back ground of the patients so that the nurses
can understand the values and beliefs of the patients regarding that particular disease. During
delivering the care, the nurse should ask for the ethical, racial, religious and cultural
backgrounds of the patients. According to the study of Oliviere and Hargreaves (2017), it is
recommended that during designing the care plan for the patient, the nursing personnel must
consider the cultural aspects of the patients as the patient may be culturally sensitive towards
any treatment procedure. For taking information from the patients, the communication is
very important and a proper communication skill is another required principle for delivering
palliative care to the patients. Only a good communication skill of the care providers in the
health care settings will allow the nurses to deliver a good quality care to the patients. In
multiple studies, it is reported that, a good communication skill of the nurses will allow them
to communicate with the patient families and with the patients as well during palliative care
setting (Higginson 2016). On the other hand, the nurses should maintain the principle of
taking consent from the patients and family members of the patients during the delivery of
palliative care. As a part of the palliative care principle, to take consent from the patient or
from the family members of the patients. In many instances, it is reported that, a shared
decision making is preferred by most of the patients and so it is the duty of the nurses to take
consent before taking any decision and the principle of taking shared decision should be
followed (Davies et al. 2014).
Delivery of Palliative
During delivering palliative care to the patients, the nurses should identify the needs
of the patients and as a part of this, the nurse should firstly assess the patients’ physical,
social , emotional, and spiritual distress and reassess family members for social, emotional, or
spiritual distress. After the identifying the care, the nursing personnel will try to relieve the

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pain and other distressed symptoms of the patients. Along with this, the nursing personnel
should identify the psychological and social needs of the patients as well so that, the nursing
personnel can provide the complete care to the patients. Therefore the nurses should identify
the symptoms of the patients and according to the nature of the pain the nurses can plan care
for the particular patients (World Health Organization 2016). As per the symptoms, the
nurses will start the pharmacological treatment for the patients as well. However, before
taking any decisions, they should consult the patient as part of the patient centred care and in
many cases, it may possible that, the nurses need to consult with the family members of the
patients. Therefore a shared decision making will cause the enhanced quality of care as well.
The patients or the family members should be informed about the available treatment options
and this will reduce the anxieties of the patients and the family members as well (World
Health Organization 2016).
Conclusion
Hence, it can be concluded that, the concept of palliative care is one of the important
care process in the health care sector. It is the duty nurses to provide a quality care to the
patients who are terminally ill so that the quality of life of the patients and their family
members can be improved as much as possible. Therefore, it is also quite evident that, the
nursing personnel should follow a few principles while delivering care to a terminally ill
patients.

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References
Clark, D., 2016. To Comfort Always: a history of palliative medicine since the nineteenth
century. Oxford University Press.
Connor, S.R., 2017. Hospice and palliative care: The essential guide. Routledge.
Davies, N., Maio, L., Vedavanam, K., Manthorpe, J., Vernooij‐Dassen, M., Iliffe, S. and
IMPACT Research Team, 2014. Barriers to the provision of high‐quality palliative care for
people with dementia in E ngland: a qualitative study of professionals' experiences. Health &
social care in the community, 22(4), pp.386-394.
Higginson, I.J., 2016. Research challenges in palliative and end of life care. Bmj
Oliviere, D. and Hargreaves, R., 2017. Good practices in palliative care: a psychosocial
perspective. Routledge.
Richardson, C., Percy, M. and Hughes, J., 2015. Nursing therapeutics: Teaching student
nurses care, compassion and empathy. Nurse Education Today, 35(5), pp.e1-e5.
World Health Organization, 2016. Planning and Implementing Palliative Care Services: A
guide for Programme. World Health Organization. Retrieved from-
https://apps.who.int/iris/bitstream/handle/10665/250584/9789241565417-eng.pdf?
sequence=1
World Health Organization, 2019. WHO Definition of Palliative Care. World Health
Organization. Retrieved from- https://www.who.int/cancer/palliative/definition/en/
[Accessed on 15th June 2019]

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