Introduction to Palliative
The “Palliative” word has been derived from the Latin word ‘Pallium’, which means cloak or cover.
Palliative care focuses on the relief of pain and other symptoms which are of serious illness. It is not the same as hospice care; palliative care is set with the goal to prevent and ease suffering and to offer patients and their families the best possible quality of life.
World Health Organization (WHO) defines Palliative Care as follows:
“It is the approach to improve the quality of life of patients facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual”.
Palliative Care includes palliative doctors, nurses and social workers. Palliative Care may include disease-modifying treatments. It can also be defined as interdisciplinary care of the patient and family. So in general we can say that palliative care applies to the care of patients with any type of life-threatening progressive disease. Often the term palliative care is said to be ‘low tech and high touch’. It also helps patients achieve and maintain their maximum potential physically, psychologically, socially and spiritually, no matter how much limited these have become as a result of disease progression. (Ferrell, 2001)
History and Development of Palliative Care
Although the history of Palliative Care has been brief the achievement in this respect has been very prosperous. The Palliative Care specialty started in the mid 19th Century. The hospice movement during the nineteenth and twentieth centuries demonstrates the innovations of many charismatic leaders. These charismatic leaders were enthusiastic about their particular contribution to care of the dying and they also taught the next generation of palliative physicians. Balfaur Mount opened a hospice model at the Royal Victoria Hospital of McGill University in Montreal. The value of the presence of a hospital-based palliative care service was demonstrated by this model. It was Mount who first used the term Palliative Care. (Watson, n.d)
Palliative Care in Hospices
By the term hospice, we mean a shelter or a place to live for travelers, pilgrims, foundlings, especially the ones maintained by a monastic order. It also means a short period stay for a terminally ill person in a setting as no different from home, setting for either direct care or respite. At early times it was little evaluative research on the modern hospice movement. There is an unchallenged and widely acknowledged hospice movement that is revolutionizing the concept of pain control and symptom management. (Lugton, n.d)
Introduction to Palliative Care Nursing
If we take palliative care from the view of nursing then it is quite obvious that nursing refers to the care of the people whether individual, family or any community by giving them attention so that they can recover and can keep their health sound. Nursing is a way by which the quality of human life can be made better. When we talk about palliative care nursing then it becomes apparent this terminology involves the interaction of nursing with palliative care. The nursing can be involved in the area of palliative care only if they are having a lot of confidence and practice as palliative care requires much more attention and care as compared to the other usual cases. If we talk about the main themes of Palliative Care nursing then the major tenets of Palliative care are spiritual and cultural tenants. In palliative care nursing the nurses can face a lot of situations that are hard to handle as they are going to take care of people who are deadly and seriously ill and are at such a stage that there are fewer chances for them to survive so for such cases the nursing staff should be very much well trained and should be provided with the proper guidelines. The palliative care nursing staff should be given proper training so that they should be able to find out the exact problem of the patient and then can give them the appropriate suggestion. (Palliative care nursing, n.d)
While talking in more depth Palliative care is the striving agent to fulfil the requirement of Physical, sociological, spiritual and social exceptions and needs. Because the nature of culture of different peoples diversifies that’s why palliative care strategies are more diversified in different regions of the world. Palliative care major concern is to satisfy the patient with reference to its spiritual needs. It means that men believe in some good as agents of God and the patient believes are the most key element in his survival. Palliative care is more concerning about the spiritual satisfaction of the patient regarding the disease. In concise we can also define palliative nursing as the activities and therapies regarding the treatment of any life-threatening or life-taking disease which involves both physical and psychological ways is called palliative care nursing. (Palliative care Nursing: Quality, n.d.)
Objects and Beliefs of Palliative Care
The main objective of Palliative care is to satisfy the patient regarding his or her disease. A person who uses to give palliative care mostly a nurse has some objectives to complete. First of all, the person has the duty to affirm that life and getting death is a regular process and nobody has the authority to deny it and it is a universal process. Another main core objective of Palliative care is to satisfy the patient and give him firm belief about death which can not be denied nor postponed. Another objective of Palliative care is to perform Pain management techniques to patients and to avoid other distressing agents from the life of the Patients. Another main objective of Palliative care is the integration of psychological and spiritual aspects of personal care. Another main objective of Palliative nursing is to provide a platform and give opportunities to the patients to live freely and perform their normal activities until their death. It is also the objective of Palliative care Nursing is to provide a support system not only to the patient but to his or her family to take the challenges regarding the period of illness of the patient and to cope with the situation after the death of the patient. These are a few objectives of Palliative Care. Although they seem to be easier to understand and attainable in real its nature is somehow difficult and mostly comes with a tag of maximum load of temperament. (Hospice Palliative Care Nursing Standards of Practice, N.d.)
Integrity of Nursing in Palliative Care
According to the careful analysis, it is observed that the knowledge and resources that are required in palliative care are not up to the mark. Both the fields of nursing and medicine still require a lot of advancements when it comes to palliative care. It is an obvious fact that nursing plays an important role in palliative care nursing as such serious patients need a lot of care and attention that is much more than the normal patients. Quality and promising nursing are essential for providing quality care to the end of life patients. If the nursing staff are provided with all the necessary facilities and provisions as well as training then they can give extraordinary care to the patients who are almost dying. The nursing staff first of all should be well aware of the problem of the patient and should be trained enough that can easily find out the proper treatment for them. The nursing staff should know very well that what is harmful to the patient and what is for the benefit of the patient. There should be strong and appropriate plans built for the care of the patients and these plans should be made by keeping in mind the problem of the patient; his sensitivity, the things that can improve the health and the things that can affect the health in negative ways. If nursing is involved in palliative care then it can surely improve the quality of life of the patients that are serious in their diseases. The nursing staff can play a role by giving them proper comforts for their pains, recognizing their problems and then treating them. The nursing staff should be able to understand the physical, mental, psychological and spiritual nature of the patient and then treat them accordingly. The target of palliative care can be achieved by the nursing staff when they easily understand the problems faced by the patients. Nursing staff can provide very much support to the patients and hence if the patients are getting moral support then they try to have a good life. The strong and effective plan made by the nurses can play a major role in the area of palliative care. Palliative care nursing requires a lot of time by the nursing staff so that they can make understanding with their patients and once the understanding is developed then patients feel satisfaction. (Nursing 211, 2007)
Framework Related to Palliative Care
The main model or the model, which is the source of palliative care, is known as Supporting Model which was designed by Davies & Oberle in 1990. This supportive model clearly defines the framework and general practices for palliative care. According to this framework or model Palliative care has six clinical dimensions. The first dimension is connecting which means that palliative care carriers must have an active connection for the patient and with their family. The second dimension of Palliative care is “Doing For”. It means that palliative care nurses of staff motivate patients and their families to look for bright horizons of life. The third dimension of palliative care is Preserving Integrity means that the palliative staff must provide esteem, motivation and the techniques which are essential for effective management of the personal integrity of the patient and his family. The fourth dimension is Empowering means that Palliative Care staff must empower the patient and their family to accept the challenge of life and to struggle hard to cope with this challenge. The fifth dimension of this framework is Finding Meaning. It means that palliative care carriers must provide the ways and means to the patient and the family for exploring the real essence of life as well as they also have hope and affection for the life to maintain and to be challenged. According to this dimension, this Valuing is the sixth clinical dimension of Palliative care. Valuing involve global aspects of humanity and tranquility. It reflects the worth of all human beings in the eyes of some palliative care carrier.
In conclusion, we can say that Palliative care nursing is although a branch of nursing but with some different attributes. Palliative nursing is concerned about the care which is involved in the management of patient who suffers from a life-threatening or life-taking disease. The nursing technique, which requires in Palliative care, has a unique nature. Palliative care nursing has the management capability to handle and prepare patients for his or her possible death at the end of his or her disease. In concise Palliative care, nursing is an effecting way to manage patients and their families’ morals when the patient knows that he will die as the consequence of his or her life taking disease. (Hospice Palliative Care Nursing Standards of Practice, n.d.)
Major Duties and Role of Nursing in Palliative Care
According to the standards of Palliative care nursing if a nurse who intended to perform palliative care must have some basic responsibilities or roles to perform for effective palliative care. First of all, she must believe that death is a universal process and she has to well promulgate it to the patient. She must believe in the intrinsic nature of life that nobody can deny death or the causes of death. Another important role or the responsibility of a palliative nursing staff is to establish a close connection or relationship with the patient and with family of the patient for the effective treatment of therapies. Along with that a palliative care nurse also has the duty to provide care in such a way that gives a new will to the patient and its family. Along with the care of the patient and for the patient family a palliative care nurse must have the skill to manage the treatment or the therapies regarding patient illness. She must possess effective skills in the Management of Pain and other classics. She must be capable to handle any diverse effect on the patient as a result of the disease. Another important responsibility or the duty of a Palliative Nurse is to provide a new strategy to the patient and patients family. She must provide the approach of struggle to patient and their families. Another important duty of a Palliative care nurse is to provide the platform to the patient in which he or she finds her way easy regarding the realistic approach of life and death. She must provide the motivation and simple boosting techniques to the patient to make his willpower strong and to their families for the situations after the patient’s death. (Nursing 211, n.d.)
Betty Ferrell and Nessa Coyal, Textbook of Palliative Nursing, Oxford University Press US, 2006
Hospice Palliative Care Nursing Standards of Practice. Web.
Jean Lugton, Margaret Kindlen, Palliative Care, Elsevier Health Sciences, 2003
Margaret O Conner Sanchia Aranda, Palliative Care Nursing E-Book, E-Book Mall, 2007
Marianne Matzo, Deborah Witt Sherman, Palliative Care Nursing, Springer Publishing Company, 2006
Max Watson, Caroline Lucas, Andrew Hoy, Ian Back, Oxford Handbook of Palliative Care Oxford University Press US, 2005
Nursing 211: Research final versions, 2007: Nurse’s role in palliative care. Web.