Abstract
The role of the nurse is often associated with healing and helping bring people back to health. While this is a large aspect of the nursing profession, the nurse also cares for patients who are dying. The care delivered at this time revolves around the comfort of the patient, as well as ensuring that all of the patient's needs are met, including any cultural or spiritual needs. In order for the care of the patient to transition from curative to comfort measures, it is necessary for a diagnosis of dying to be made. This diagnosis should then be communicated with the patient and family. When the diagnosis of death is not communicated in a timely manner, it has been found that the patient's do not receive quality end of life care. This diagnosis surpasses all other diagnoses and shifts the focus towards the comfort and well-being of the patient. Care at the end of life includes pain management, discontinuation of routine vital signs and laboratory tests and coordinating care with other professionals to ensure the best quality care is being offered. Since the end of life is a new experience for most, it is important that the nurse informs the patient and the family of interventions that will occur and all resources available to them. Palliative care is a resource that can be implemented along curative measures at any stage of a disease, which assists the patient with pain and symptom management. As the disease course continues and the patient's life expectancy is less than six months, hospice care is a resource that should be offered. The nurse, along with the rest of the care team, should ensure that these resources, along with legal documents such as advanced directives or healthcare proxy forms are available to the patient. At the end of life, the nurse is on the front lines to ensure that the patient is receiving the best quality care possible. This is done by communicating and listening to the patient and developing a therapeutic relationship with them.
Highlights
Diagnosing DyingThe first step in ensuring that the patient at end of his or her life is receiving quality care, involves acknowledging that the patient is dying
There is one thing in life that is absolutely certain: every individual who is born will one day die
Advancements in modern medicine have separated the death from the rest of the living, and we often are not exposed to death until it affects ourselves or a close family member
Summary
The first step in ensuring that the patient at end of his or her life is receiving quality care, involves acknowledging that the patient is dying. In order for a patient to be diagnosed as dying, it is necessary that the multi-professional team involved in the patient’s care all agree that death is probable [7] If this is not found, the patient and family may be unaware that death is imminent. The diagnosis of dying can seem like the healthcare team is losing hope, it is necessary in order for the patient to receive the best quality care This diagnosis creates a certain perspective needed by the patient, family and care team. This diagnosis would limit the amount of invasive procedures being ordered, the frequency of vital signs being taken, and the need for telemetry, glucose, or intake monitoring It would create an environment where the patient’s comfort and emotional needs are the foreground for care. The diagnosis of dying is necessary because it trumps all other diagnoses, and the needs of the patient will be in the foreground of care [8]
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