The issue for consideration in this change proposal is the-end-of life care for COVID patients. COVID-19 is a new disease which is caused by SARS-CoV-2 (Zhang et al., 2020). It affects the lungs and airways. Its symptoms include shortness of breath, cough, and high temperature. Healthcare providers around the globe are encouraged to maintain preventive and curative care, specifically for vulnerable populations, such as low-income children and the elderly.
The issue is witnessed mainly in the Intensive Care Unit (ICU) setting because it has the resources needed to care for COVID-19 patients. End-of-life care for such patients, according to Hendin et al. (2020), entails “mechanical ventilation of the lungs, respiratory dialysis, extracorporeal membrane oxygenation, hyperbaric oxygenation, and blood filtering” (p. 45). ICU is the most appropriate setting because patients with COVID 19 require specialized treatment.
Description of the Issue
COVID-19 has emerged as one of the deadly pandemics that have resulted in over two million deaths worldwide. According to Yang et al. (2020), about 60 percent of patients admitted to ICU die weekly; most of them die alone in hospitals. Most critically ill patients fear dying alone and, as such, feel the desire to share their experiences or talk to someone. Unfortunately, most of them are denied such privileges due to strict visitor guidelines. Conversations with the care provider occur at the door to the ICU or over the phone as the family members beg to speak to their loved ones before they die. Therefore, the care providers should consider talking to the patients and family members about goals of care.
Effect of the Issue
According to research, the damage caused by COVID-19 is enormous. It is pointed out in studies that “for every one person who dies of the disease, nine close family members are affected” (Rose et al., 2020, p.3). This happens because death comes unexpectedly, and most families are separated from their loved ones. Consequently, most of them are not able to grieve the way they would want to. Similarly, many families lose important sources of financial and social support (Chung et al., 2020). Another essential effect of COVID-19 is that it can lower educational achievement among young people.
Significance and Implication for Nursing
The topic is quite significant because it has led to the shortening of the research and implementation process. It has helped researchers to bypass the administrative barriers by focusing on health before profits (Fernandez et al., 2020). Many solutions have been developed at an extraordinary pace to help save lives. A good example is an Aerosol box created by a Taiwanese physician (Girgis et al., 2020). The topic is also significant because it has generated collaboration across different disciplines. A major implication for nursing practice is that nurses should constantly receive clear, concise, and current information as well as timely access to PPE to improve their safety. Similarly, the issue of adequate staffing is critical to the provision of optimum care.
A Proposed Solution
COVID-19 patients fear dying alone in hospitals and, as such, feel the desire to share their thoughts and talk to others. Therefore, end-of-life care for COVID-19 patients should target the patient and their families. Care providers should ensure the loved one gets the necessary support when dealing with distressing symptoms, such as pain. The patients need to have the right treatment, such as anticipatory medication for symptom management, to ensure they are comfortable in the time they have left. Communication is also an integral part of end-of-life care. The patient should be allowed to communicate with the family by phone or video call (Kennedy et al., 2020). This reduces the trauma associated with the death of a loved one.
Chung, G., Lanier, P., & Ju, P. W. Y. J. (2020). Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (COVID-19) pandemic in Singapore. Journal of Family Violence, 1-12. Web.
Fernandez, R., Lord, H., Halcomb, E., Moxham, L., Middleton, R., Alananzeh, I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies, 1-24. Web.
Girgis, A. M., Aziz, M. N., Gopesh, T. C., Friend, J., Grant, A. M., Sandubrae, J. A., & Banks, D. A. (2020). Novel coronavirus disease 2019 (COVID-19) aerosolization box: Design modifications for patient safety. Journal of Cardiothoracic and Vascular Anesthesia, 34(8), 2274-2276.
Hendin, A., La Rivière, C. G., Williscroft, D. M., O’Connor, E., Hughes, J., & Fischer, L. M. (2020). End-of-life care in the emergency department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19). Canadian Journal of Emergency Medicine, 22(4), 414-417. Web.
Kennedy, N. R., Steinberg, A., Arnold, R. M., Doshi, A. A., White, D. B., DeLair, W., & Elmer, J. (2020). Perspectives on telephone and video communication in the ICU during COVID-19. Annals of the American Thoracic Society, 1-30. Web.
Rose, J., Willner, P., Cooper, V., Langdon, P. E., Murphy, G. H., & StenfertKroese, B. (2020). The effect on and experience of families with a member who has intellectual and developmental disabilities of the COVID-19 pandemic in the UK: Developing an investigation. International Journal of Developmental Disabilities, 1-3. Web.
Yang, X., Yu, Y., Xu, J., Shu, H., Liu, H., Wu, Y., & Shang, Y. (2020). Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. The Lancet Respiratory Medicine, 8(5), 475-481. Web.
Zhang, T., Cui, X., Zhao, X., Wang, J., Zheng, J., Zheng, G., & Xu, Y. (2020). Detectable SARS‐CoV‐2 viral RNA in feces of three children during recovery period of COVID‐19 pneumonia. Journal of Medical Virology, 92(7), 909-914. Web.