END-OF-LIFE CARE: -Part 7
ARE NURSES EDUCATIONALLY PREPARED?
IV. SUMMARY
The concept of EOL care practices is once again at the
forefront of public and healthcare consciousness. Historically,
EOL care was depicted as an important aspect of the life
process, although it was not well advanced. The trend to
provide heroic measures using technological advances in the
1900's, stunted the exploration of EOL care and left patients
and families feeling abandoned. Today, there is resurgence
toward focusing on EOL issues utilizing advanced research and
technology to provide comfort measures to the dying. Although,
nurses are not performing optimally, since they are not well
educationally prepared.
Two major focus areas for improvement have been identified as
spiritual- psychosocial health areas and physical health areas.
The spiritual-psychosocial health areas encompass: anxiety,
delirium depression, and communication. Physical health areas
include: pain, dyspnea, gastrointestinal symptoms,
anorexia/cachexia, and asthenia.
Recommendations for improved EOL nursing care outcomes have
been identified as improvement in curricular content and
continuing education utilizing care competencies, and revision
of texts, which incorporate current research, to enhance EOL
care. Achieving these objectives will take the collective
effort of publishers, researchers, educators, and nurses.
Tremendous opportunity exists in the next decade to change EOL
care. The strengthening of nursing education certainly is an
essential step toward meeting that goal. This will provide a
more comprehensive and compassionate approach in the delivery
of EOL nursing care.
We often think of the dying as “them” and the living as “us,”
as if we were separate. Among the benefits of caring for a
dying patient is the erasure of this distinction. We are all on
the same journey, come from the same entrance, and leave by the
same exit. We are all wayfarers on the road, and all of us need
to stop for refreshment and comfort before the end of our
journey. With advancement in EOL care, we will have a choice
about how we would like that stop to be.
V. REFERENCES
AACN: Peaceful Death: Recommended Competencies and Curricular
Guidelines for
End-of-Life Nursing Care: Amercian Association of Colleges of
Nursing Publications, Washington, D.C.: 2001: p, 1-5, Retrieved
from: http://www.aacn.nche.edu
Buchingham, RW: The Handbook of Hospice Care: Prometheus Books,
New York: 1966:
p. 15-58
Ersek M; Kraybill BM; Hansberry J; Assessing the Educational
Needs and Concerns of
Nursing Home Staff Regarding End-of-Life Care; Journal of
Gerontological Nursing; 2000 Oct; 26(10), p. 16-26. Retrieved
from: http:///80- tpdweb.umi.comauthenicate.lib
Ferrell B; Virani R; Grant M; Coyne P; Uman G; End-of-Life
Care: Nurses Speak Out,
Nursing; 2000 Jul: 30(7), p. 54-7. Retrieved from:
http://80-tpdweb.umi.com.authenicate.lib
Ferrell B; Virania R; Grant M; Analysis of End-of-Life Content
in Nursing Textbooks;
Oncology Nursing Forum; 1999; Vol26N5, 869-876
Fetter MS; End-of-Life Care: The Nursing Role; MEDSURG Nursing,
- 2000 Oct; 9(5),
p.230-1. Retrieved from:
http://80-tpdweb.umi.com.authenicate.lib
Heller BR; Oros MT; Durney-Crowley J: The Future of Nursing
Education: Ten -Trends
to Watch; NLN Journal; 2001 Sept. Retrieved from:
wysiwyg://6/http://www.nln.org/nlnjournal/infotrends.htm
Kirshhoff KT; Beekstrand RL; Critical Care Nurses' Perceptions
of Obstacles and
Helpful Behaviors in Providing End-of-Life Care to Dying
Patients: American
Journal of Critical Care; 2000 March; 9(2), p. 96-105.
Retrieved from:
http://80-tpdweb.umi.com.authenicate.lib
Kirshhoff KT; Spuhler V; Walker L; Hutton A; Cole BV; Clemmer
T; Intensive Care
Nurses' Experiences with End-of-Life Care; American Journal of
Critical Care 2000 Jan; 9(l), p. 36-42. Retrieved from:
http://80- tpdweb.umi.com.authenicate.lib
Ross MM; Fisher R; McClean MJ; End-of-Life Care for Seniors:
The Development of a
National Guide; Journal Palliative Care; 2000 Winter; 16(4), p.
47-53. Retrieved from:
http://80-tpdweb.umi.com.authenicate.lib
Schlegel KL; Shannon SE; Legal Guidelines Related to
End-of-Life Decisions; Are
Nurse Practitioners Knowledgeable?; Journal of Gerontological
Nursing; 2000 Sep; 26(9), p. 14-24. Retrieved From
http://80-tpdweb.umi.com.authenticate.lib
Schwarz JK; Assisted Dying and Nursing Practice; Journal of
Nursing Scholarship,
1999; 31;4, 367-373.
Tomko LP; Maxwell TL; Beyond Pain Management; A Primer for
Providing Quality
End-of-Life Care; The Internet Journal of Family Practice: 2001
Vol1N2: Retrieved from:
http://www./caap.org/iuicode?/32./2.2
White PJ; Urvash BP; Are Nurses Adequately Prepared for
End-of-Life Care? ;
Journal of Nursing Scholarship; 2001; 33:2. p.
147-151.
Lisa Marie Chiplaskey, MSN, Ed.,
BSN
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