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Congress Abstracts 2005
47
END OF LIFE CARE. Barbara Virchick, RN, MS, APRN-BC, Mass General Hospital, Boston, MA.
Topic: Nurses providing end-of-life care not only impact the quality of life for the patient but the grief process and future memories of family members who share this important milestone. The goal of end-of-life care is to help patients and their families maintain optimal quality of life through the dying process, so that they will experience a “good death.” Nevertheless, many nurses feel unprepared for the challenge of providing compassionate care for patients facing death.
The purpose of this presentation is to demonstrate how advance practice nurses can assist staff nurses gain expertise in providing quality end-of-life care.
A curriculum was developed to assist staff nurses on an acute, inpatient oncology unit in an academic medical center in developing skills for providing holistic end-of-life care for dying patients and their families. The curriculum covers the epidemiology of dying in America, evolution of the end-of-life care movement, and nursing care for the dying patient using Ferrell’s Quality-of-Life approach which is organized around four domains of well-being: physiological, psychological, social, and spiritual. If a dying patient or family members have unmet needs in any of the four domains, suffering will result. The curriculum also integrates content from the End-of-Life Nursing Education Consortium (ELNEC).
Feedback from nurses who attended the program was overwhelmingly positive.
The Advanced Practice Nurse (APN) has both the opportunity and responsibility to disseminate specialized knowledge to other providers on the multi-disciplinary care team. The APN with in-depth knowledge and expertise in terminal care is well placed to impact the quality of care provided by nurses at the bedside through education and clinical guidance. Farrell’s Quality-of-Life paradigm provides a useful structure around which to organize education on principles of end-of-life care for acute care nurses.