To Comfort Always: A Nurse's Guide to End-of-Life Care / Edition 1

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Caring for patients at the end of life's journey is challenging, but rewarding. To Comfort Always: A Nurse's Guide to End-of-Life Care prepares nurses to care for dying patients and their families by providing a primer that is both practical and insightful. From emotional needs such as relief of suffering to physical needs such as relief of pain, To Comfort Always supplies nurses what they need to know to deliver holistic, effective care. Linda Norlander brings her expertise in end-of-life care to this book that will serve as a valuable resource for nurses committed to comforting patients and families at one of life's most moving passages.

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Product Details

  • ISBN-13: 9781930538733
  • Publisher: Sigma Theta Tau International
  • Publication date: 11/1/2008
  • Edition description: Older Edition
  • Edition number: 1
  • Pages: 144
  • Product dimensions: 5.90 (w) x 8.80 (h) x 0.40 (d)

Table of Contents

Dedication iii

Acknowledgements iv

About the Author v

Introduction x

Chapter 1 Where to Begin

Introduction 1

Guiding Principles of End of Life Care 2

Core Nursing Responsibilities: Skilled Clinician, Advocate, and Guide 4

What Do Patients and Families Want for Care at the End of Life? 5

When Do We Start Providing End of Life Care? 6

A Team Approach 7

Chapter 2 Advance Care Planning

The Courageous Conversation 11

Skilled Clinician: Understanding the Elements of Advance Care Planning 12

Advance Directives 15

A Note on DNR/DNI Status and POLST Forms 16

Advocating in Advance Care Planning: Making Sure Wishes Are Honored 16

Guiding in Advance Care Planning: Recognizing the Common Barriers 17

Common Questions Patients Ask About Advance Directives 19

Cultural Considerations in Advance Care Planning 20

Chapter 3 Pain Management: It's More Than Knowing the Meds

Listening to the Patient's Pain 23

Skilled Clinician: Assessment and Management of Pain 25

Advocating: Ensuring That the Patient's Pain Relief Goals Are Met 29

Guiding Patients and Families: Addressing Common Fears 31

Know the Resources 33

Chapter 4 Physical Symptom Management

Common Symptoms 35

Skilled Clinician: Assessment and Management of Common Symptoms 36

Advocating: Linking the Needs of the Patient and Family to the Health Care System 43

Guiding Patients and Families: Preparing, Listening, and Assuring 44

Chapter 5 Suffering: It's Not Just the Pain

What Is Suffering at the End of Life? 47

Skilled Clinician: Assessing Suffering 48

Advocating for Patients: Ensuring a Holistic View 52

Guiding Patients and Families: Start with Yourself 53

Chapter 6 Active Dying: The Final Days and Hours

Active Dying: What Does It Mean? 57

Skilled Clinician: Assessing and Intervening When Death Is Near 58

Advocating for Both the Patient and Family: Communication Is the Key 63

Guiding: Walking That Difficult Path 64

A Note on Withdrawing Life-Sustaining or Life-Extending Treatment 65

Chapter 7 After the Death: The Long Journey to the Car

What Happens after a Patient Dies? 67

Skilled Clinician: Understanding Grief 68

Advocating for the Family: Accommodating Their Comfort Needs 69

Guiding the Family: Accepting the Loss 70

Self Care 73

Chapter 8 When a Child Is Dying: Pediatric End of Life

Children Die, Too 75

Skilled Clinician: Assessing and Intervening in the Care of Children 77

Advocating for Children: Meeting the Needs of Both the Patient and the Family 80

Guiding Children and Families: Understanding the Needs of the Child 82

Chapter 9 Cultural Sensitivity: Looking through Different Eyes

Making Room for Cultural Diversity 85

Understand Your Own Beliefs 87

Listen to the Patients 88

Avoid Stereotyping and Making Assumptions 89

Use Trained Medical Interpreters 89

Use Community Resources 90

Advocating for Patients and Families 91

Chapter 10 Hospice

A Philosophy of Care 95

Who Qualifies for Hospice Care? 96

How Do I Approach Patients and Families about Hospice Care? 97

The Hospice Medicare Benefit 98

Advocating for Your Patients 100

Chapter 11 Ethical Issues in End-of-Life Care

Health Care Ethics 104

Common Ethical Dilemmas and Conflicts 105

Role of the Skilled Clinician in Difficult Decisions 106

Advocate: Making Sure Wishes Are Honored 107

Guide 108

What about a Nurse's Personal Ethics, Beliefs, and Values? 109

Ethics and Culture 109

Chapter 12 A Final Note: Taking Care

Burning Brightly, Burning Dimly 113

Living in the Present Moment 114

The Joy and the Laughter 115

A Final Note 115

Index 117

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