NURSING150SCHOLARLYASSIGNMENT:JOURNALARTICLEREVIEW

InthearticleFamilyPreparednessandEndofLifeSupportBeforetheDeathof
aNursingHomeResident,theauthorKathleenDavidsoncreatesathoroughlayout
toward sufficient care for patients nearing the end of their life. She discusses the
importance of proper care for patients during such a delicate time; providing clear
interventions a nurse can provide to ensure continuous following of professional
standards. The article concluded with a heavy regard toward the preparedness level
neededbyallfamilymembersandsignificantotherswithanattachmenttothenursing
homeresidentnearingtheendoftheirlife.StatingthatProfessionalnursesmustplaya
keyroleinenhancingeffortstosupportolderadultsattheendoflife,aswellastheir
families. Since dealing with death is something I personally am concerned of when
decidingtobecomeanurse,IfeelIcanbenefitfromthesekeypointsmadefromthe
article in discussion towards end of life care; staff development, Family Member
RecognitionofDiseaseProgression/DyingTrajectoryandDyingProcess,andSending
SympathyCards.
As a student nurse I understand the importance of building a therapeutic
relationshipwithyourpatients,howeversomethingthattroublesmeisthetopicofdeath.
Ihadchosenthisarticleinhopesofhelpingtopreparemyselffortherealitythatispeople
willcomeandgoandthatitisaprocessoflifethatImustunderstandandlearntodeal
with.InthearticleFamilyPreparednessandendoflifesupportonekeyimplication
wasstaffdevelopment.IfounditreassuringthateducationissomethingIcanlooktogo

towhentryingtobettermypracticesasanurse.Asstatedinthearticle,Thetrainingof
nursinghomestaff,improvethestandardofEOLcareforresidentsandtheirfamily
members.(FamilyPreparednessandEndoflifecare,Par5)Itgoesontotalkaboutthe
differentstaffeducationtopicsthatwillbeabletohelpfurtheronesunderstandingon
howtodeliversuccessfulandconsistentcareforpeoplenearingtheendoftheirlife.
Sometopicsmayinclude;communicationskillsspecifictopreparingfamilymembers
forthedyingtrajectory,death,andbereavement;CulturallysensitiveEOLcaring;andthe
useofopioidandnonopioidmedicationsfornursinghomeresidentswithoutacancer
diagnosis.(FamilyPreparednessandEndofLifecare,Par.5)ThesearethingsIcan
educatemyselfontohelpmakemefeelmorecomfortablewhendealingpatientsnearing
death.Icertainlyagreethatstaffdevelopmentissomethingthatcanaideveryonewhen
providingendoflifecaretopatients.AnarticleIusedfromtheCNOwebsitestatesthe
goalofendoflifecareisto,improvethequalityoflivinganddying,andminimize
unnecessary suffering. It encompasses the physical, spiritual, social, psychosocial,
culturalandemotionaldimensionsofclientcare(GuidingDecisionsofEndoflifecare,
Glossary)Inrelevancetostaffdeveloping,thiscanhelpallnursesachievethisgoalby
educatingthemtowardsgivingsufficientgoalmeetingcare.Thiswillhelppreparenurses
insuchawaythattheywillbecapableofmeetingtheseneeds.Aswell,thiscanbea
focalpointastowhatIshouldtryandworkontohelpmakemyselfmorecomfortable
withprovidingendoflifecare.Iwillbeginbyresearchingthetopicsprovided.
AnotherimplicationprovidedfromthearticleisFamilyMemberRecognitionof
Disease Progression, Dying Trajectory and Dying Process. Along with the

communication of health care professionals, family caregivers need to be helped to

recognizedifferentsignsandsymptoms.Thisissotheyrecognizeforthemselvesthe
progressivedeteriorationoftheirlovedoneassignalingEOL.(Forbeset.al.,2000)This
process helps in the communication of preparing family members that the patient is
nearingtheirendoflife.Itopensupthetopicfordiscussionallowingthenewstobesaid
withouttheintentofstrictlytellingthemtheirfamilymemberisgoingtodie.Ithelps
deliver the news with purpose making it easier to accept due to the lack of sudden
infraction. RNscanhelpbydiscussingwithfamilycaregiverstheindicatorsofthe
trajectoryofdying.(FamilyPreparednessandEndoflife,Par9)Thisisanexampleof
howonecouldeducateafamilycaregiver.Thishelpsmefeelmorecomfortablewhen
havingtodealwithdeathbecauseonethingImcautiousof;ishavingtorefrainfrom
usingendoflifeeuphemismswhenspeakingtofamily.Sothisimplicationprovidesme
witharoutetohelppreparefamilymemberstothecomingofdeath,withouthavingto
tellthemdirectlythatthepatientisdying.Ourtextbookspeaksabouthospicecareplans
forpatientsnearingdeath,where Itsmultidisciplinaryapproachinvolvingphysicians,
nurses,socialworkers,pharmacists,andpastoralcarestaffiscrucial.Hospicenurses
workinhospitals,freestanding hospices,orthe home,caringforpatient andfamily
duringtheterminalphaseofillness,atthetimeofdeath,andbeyondintheformof
bereavementcounselingtothefamilyandsupportnetwork.(Potter25)Thiscareplanis
an example of how Family Member Recognition of Disease Progression, Dying
TrajectoryandDyingProcesshelpsinprovidingsufficientcareforpatientsnearingdeath
duetothecounselingthatisprovidedtothefamilyandsupportnetwork.

Thelastnursingimplicationissendingsympathycards.Thishelpsmerefrain
fromseeingeachpatientasajobbutmoreasahumanbeingandonamorehumanelevel.
Thisprocessistakenplaceafterthedeathofnursinghomeresident,sendingasympathy
cardsignedbyfrontlinecarestaffthatknewtheresident(FamilyPreparednessandEnd
of Life, Par 13) This implication helps provide condolences to help with the final
supplementingofthetherapeuticrelationshipestablished.Thisalsobenefitsthefamily
aswellasfamilymembershaveindicatedtheyvaluethatstaffmemberstookthetimeto
signthecardandincludecommentsandremembrancesabouttheresident(Davidson,
1999;Hutchinson,1995)
Afterreadingthearticleandresearchingsupplementaryinformation,Iwasableto
gain knowledge on how to provide proper end of life care, as well as feel more
comfortablewhendealingwiththetopicofdeath.IrealizethatitwillbesomethingImay
beuncomfortablewithinthefuturebutIfeelmoreequippedandpreparedtohandleeach
situation.Iamgoingtotaketheseimplicationslearnedfromthisarticleandincorporate
themintomynursingpracticestohelpmakemeabetternurse,Iunderstandthatitisa
growingprocesssoIamgoingtobewillingtoputthetimeandefforttomakesureIcan
givetheendoflifecareIcan.InmyeffortstocompletethisassignmentIhopeothers
readthisarticleaswellbecauseitisveryinsightfulespeciallyifyoutooshareaconcern
whendealingwithdeath.

WorkCited

Davidson, K.M. (edited by D.P. Schoenfelder). (2011). Evidence-Based Practice

Guideline: Family
Potter, Patricia, Anne Perry, Janet Ross-Kerr, Marilynn Wood, Barbara Astle,
Wendy Duggleby. Canadian Fundamentals of Nursing, 5th Edition. Mosby Canada, 2014.
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Davidson, K.M. (2009). Evidence-based practice guideline. Family preparedness
and end of life support before the death of a nursing home resident. Iowa City: University
of Iowa Gerontological Nursing Interventions Research Center, Research Translation
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Lobel, Jules. "Bypassing the Security Council: Ambiguous
Authorizations to Use Force, Cease-Fires and the Iraqi Inspection
Regime." The American Journal of International Law 93.1 (1999): 12454. Web.
Davidson, K.M. (1999). [Bereaved family members survey following the death
of a nursing home resident]. Unpublished data.
Forbes, S., Bern-Klug, M., & Gessert, C. (2000). End-of-life
decision making for nursing home residents with dementia. Journal of
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