End of Life

Nursing considerations at the end of life.

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Hey, welcome to nursing with Dr. Hobbick. And today we're going to talk about nursing and end of life. So it doesn't matter where a nurse works, they're probably going to come in contact with end of life in some way. One of the most important concepts is to understand palliative care and hospice care. Palliative care is care that is focused on a quality of life for patient and family of a person who has a life threatening illness or disease. So a terminal illness. Hospice is a model for quality care for people who are facing a life limiting illness. In other words, someone who is very near the end of life. So all hospice is palliative care. But not all palliative care is hospice care. Now, things that we need to recognize at the end of life, we may have some symptoms of distress, and that is going to be the big thing that you want to treat that you want to try to help your patient with, because I think we can all agree that everybody would like to have a peaceful death. Some other symptoms that our patients might experience our weakness, increased in sleeping anorexia, changes in level of consciousness are vital signs. So we want to try to minimize any pain, minimize weakness, breathlessness, any nausea, vomiting, agitation, delirium, those are the things that we're going to focus on managing. So it is our ethical responsibility to follow the guidelines that are given to us for medication administration. nurses do not kill patients. There's a urban legend out there that hospice nurses kill patients. And that's not true for sure. So we want to just make sure that our patients are limited in the distress that they experience. Other things that you should focus on is spiritual and cultural needs. So make sure that you either help identify the patient's needs, or you figure out what it is that they need, so that we can incorporate that into their care. And then you should be aware of things like a DNR an A and D or a D na are, you should make sure that you're familiar with concepts like withdrawing or withholding life sustaining therapies, and then something like voluntary stopping of eating and drinking. The only other thing to really think about is post mortem care. So we want to make sure that we know if the patient wishes to be an organ donor, all those things I just listed off the DNR and D and all those things we need to know about those, we need to know if there will be an autopsy and we would think about is this a suspicious suspicious case? Or has the patient been admitted in the last 24 hours. And then of course, want to make sure we do documentation according to facility policy. So if the patient is an organ donor, you will contact the organ donor organization and they'll take some information from you, and let you know whether or not the patient is an organ donor or is a candidate and what you should do to prepare that. The other thing to think about is actually caring for the body. So we want to make sure the patient is clean and ready for the patient patients family to see them in case they want some time we want if the patient needs to have specific people care for their body, we want that to happen. And then we would contact either the funeral home funeral director or more personnel to take care of the body. So that is end of life. course it's a lot more complex than that. But I hope you enjoyed this little snippet and I'll see you next time on nursing with Dr. Hobbick.