Palliative Care Nursing: Issues in End-of-Life Care, Australia

This essay delves into the realm of palliative care nursing, specifically within the Australian healthcare context. It examines the crucial aspects of providing specialized medical care to patients with serious illnesses, with a primary focus on enhancing the quality of life for both patients and their families. The essay explores the multifaceted nature of palliative care, encompassing pain management, spiritual needs, and effective communication strategies. It highlights the importance of addressing the care requirements of dying patients, including the significance of advanced care directives. Furthermore, the essay identifies various nursing issues encountered in delivering end-of-life care, such as the challenges related to recognizing dying patients, the impact of nurses' personal experiences, and the importance of adequate training and support. The conclusion emphasizes the need for collaborative efforts among patients, families, and healthcare teams to optimize end-of-life care and provide comprehensive support.

Palliative care nursing

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Palliative care is the process of rendering special medicare care to patients who are
suffering from serious diseases. It is basically focused on improving the quality of life of family
and patients both. The parties included in offering special care consists of specially-trained
doctors, specialist who work with doctors and nursing staff which ensure the extra layer support.
The thesis statement for the essay is that delivery of palliative care should be done in the
line of standards set by healthcare and maintain the well being of patients as well as families in
content of emotional and psycho-social (Schroder and et. al., 2009). Present essay is based on
palliative care offered to patients of Australia in acute care setting where focus is laid on
improving the life quality of sufferers. Furthermore, essay covers issues related to pain
management, support from patients and families as well as knowledge associated with treatment.
Apart from this, care requirement of dying patients in the acute care setting has also been
explained.
MAIN BODY
Care requirement of dying patients and their family
The care requirement of dying patients and their family is considered in term of pain
management, spiritual needs, communication as well as advanced care directive. At this juncture,
patients generally seek for the appropriate kind of communication between doctors and family in
order to increase their dependence (Morgan, 2017). At the same time, emotional support is
needed from the experts or doctors which generate positive feeling among patients and make
them feel happy. However, it covers several kind of illness such as Colon Cancer, HIV/AIDS
and Dementia as well as Cancer etc. These kind of treatment must be provided with detail
discussion with families and patients both for getting appropriate support (Rodriguez, Barnato
and Arnold, 2007). For example, person centered approach can be followed through which all
connected people of patients get to know about the treatment and they also follow the same steps
for betterment.
Generally acute hospitals shed light on diagnosis and treatment of the patients in term of
cure and discharging. At this juncture, recognition phase reflects that patients seek for the end of
life and in need of interventions. For this purpose, sometimes communication and care planning

with patients might become typical, due to negligence of psychological and spiritual needs. For
this purpose, role of senior and junior clinician is very important. However, lack of experience
and knowledge among junior staff in recognizing and meeting the expectation of patients affect
the care plan to a great extent (Gutierrez, 2005). This indicates that effective treatment is not
possible without association of skills and experienced staff who care for the patients effectively.
The process of pain management begins with the physical effects and its function impact
on pain. After assessing these two things doctors move forwards with assessment of psychosocial
factors and spiritual aspects. For this purpose, nursing staff must focus on spiritual needs thereby
it becomes easy to meet their expectations effectively. In addition to this, advanced care directive
is required by patients in order to make them a bit self dependent and promote their healthy life.
At the same time, specific information is provided to family members regarding the treatment
and special care so they can be certain about the some future consequences of the provided
services (Le and Watt, 2010.). For this purpose, National Framework for Advance Care Directive
in 2011 was endorsed through The Australian Health Ministers Advisory Council. It assists care
staff to record the wishes of patients for future care treatment in document which reflects legal
status too.
Nursing issues faced in delivering end of life care
There are several kind of issues which are being faced by nursing staff in delivering the
end of life care. For example, Clinician participants believed that advance care directives is
relatively less helpful in rendering services and taking the clinician decision making. On the
other hand, some of the nurses find it difficult to recognize a dying patients due to their lack of
knowledge in the same field (Fagerlin and Schneider, 2004). It happens due to lack of training
program which can be resolved by offering preparatory programs for end-of-life care through
medical specialties such as oncology, intensive care and geriatrics. However, poor regulations
and lack of knowledge among nursing staff create issue to meet the care requirement of
terminally ill patients as well as families connected to them.
Apart from this, their poor experience affect the care quality they are offering the
patients with severe disease or to end life care. Apart from this, personal pain of nursing staff
affect them at the time of delivery of services or end of life care plan. Most of the nursing staff
found it is most painful experience to taking care of dying patients (Bezzina, 2009). Such kind of

emotional feelings of nursing staff become more painful for families of patients. Owing to this, it
is important for experts or specialists to involve the nursing staff in rendering services and
enhance their experience to render the appropriate kind of services for the needed people.
Personal pain management is also learned with the help of guidance of senior staff only whereby
people can effectively manage their pain. Instead of focusing on personal pain, nursing staff must
focus on the situations through which families are suffering. It would be highly effective for
nursing staff the understand the exact situations and treat the patients in a more effective manner.
This in turn dying patients and families as well as other connected person get the services in
most appropriate manner.
Apart from this, personal discomfort with death become negative for doctors or
specialists as the feel that it is sign of their failure. At that particular point of time, they do not
consider it as it eh natural process of life (Maddocks and Rayner, 2003). On the other hand,
insufficient compensation of nursing staff also become the reason behind job dissatisfaction. It is
because they devote much of their time to talk to patients or families of terminally illness
patients. Owing to this, they expect higher compensation or appropriate one. Moreover, absence
of maintaining the free flow of communication also do affect the care plan to a great extent
(Micallef, Skrifvars and Parr, 2011). Owing to this nursing staff must recognize the need of
patients with the help of enhancing own experience and knowledge. It would be effective to
conduct the initial assessment in a proper manner and determine the most suitable care of the
patients who are suffering from some of the specific severe disease.
CONCLUSION
The aforementioned report concludes that care plan of dying patients must be made
effective for catering requirement of their family and improving the life quality. It is also
important to shed light on difficulties which are being faced by patients and equal focus on own
professional and personal problems for the best care. It can also be concluded that end of life
care is optimized with the support or collaboration of different parties such as patients, families
and team offering treatment. Furthermore, training facilities should be provided for the nursing
staff working in the acute health care setting in order to treat the dying the patients effectively
and support their family members.

REFERENCES
Journals and books
Bezzina, A., 2009. Prevalence of advance care directives in aged care facilities of the Northern
Illawarra. Emergency Medicine Australasia. 21. pp.379-385.
Fagerlin, A. and Schneider, C., 2004. Enough the failure of the living will. Hastings Center
Report. 30-42.
Gutierrez, K., 2005. Critical care nurses’ perceptions of and responses to moral distress.
Dimensions of Critical Care. 24(5). pp.229-241.
Le, B. and Watt, J., 2010. Care of the dying in Australia’s busiest hospital: benefits of palliative
care consultation and methods to enhance access. Journal of Palliative Medicine. 13(7).
pp.855-860.
Maddocks, I. and Rayner, R., 2003. Issues in palliative care for Indigenous communities.
Medical Journal of Australia. 179. pp.S17-S19
Micallef, S., Skrifvars, M. and Parr, M., 2011 Level of agreement on resuscitation decisions
among hospital specialists and barriers to documenting do not attempt resuscitation
(DNAR) orders in ward patients. Resuscitation. 82(7). pp.815-818.
Rodriguez, K., Barnato, A. and Arnold, R., 2007. Perceptions and utilization of palliative care
services in acute care hospitals. Journal of Palliative Medicine. 10(1). pp.99-110.
Schroder, C. and et. al., 2009. Educating medical residnets in end-of-life care: Insights from a
multicenter survey. Journal of Palliative Medicine. 12(5). pp.459-470.
Online
Morgan, D., 2017. Caring for Dying Children: Assessing the Needs of the Pediatric Palliative
Care Nurse. [Online]. Available through:
<http://www.medscape.com/viewarticle/707801_4>. [Accessed on 20th March 2017].