The main idea of palliative care is integrating a holistic approach when nurses do everything possible to improve the quality of human life, even if death is inevitable. It is expected to offer comfort and understanding to patients and their families. According to Murray (2020), a dying person should be defined as a unit of care. Therefore, my responsibility as a caregiver who prefers a person-centered approach is to develop my best qualities and knowledge. Following the principles of a commonly used humanistic nursing theory, I cannot ignore the person’s call for help and the necessity to meet health-related needs of patients (Pereira et al., 2018). My experience shows that not many people believe in physical, spiritual, or emotional comfort while dying, but I, as a nurse, know that my participation matters. Attention to detail, empathy, and leadership are the main qualities for me to provide a dying person, family, and friends with comfort.
I would never demonstrate uncertainty or unnecessary hope in the patient’s case. It is hard to accept that death is coming, and sometimes people try to find additional sources or opinions to change the situation or avoid the inevitability. My task is to maintain emotional control, and gathering all the details about the condition would be effective. Spiritual comfort is closely related to empathy and the necessity to end all disagreements and make peace with life. Finally, physical comfort is my direct responsibility, and the development of leadership skills is vital because they help manage pain, solve problems, observe symptoms, and make decisions. My strength is my confidence that I am the correct person to help and support the patient and the family. I am observant and know when a person needs assistance even without asking for it.
Communication/Adaptability
It is not always easy for a nurse to find the necessary words or support a dying person. However, communication plays an important role in a palliative care approach, and nurses should know what words to use and what phrases are better to avoid. For example, Ekberg et al. (2021) recommend not to mention such words as “death” or “dying” directly but consider alternatives like “pass away” and “probably.” The humanistic nursing theory underlines the worth of relationships, communication, and suffering (Borda et al., 2019; Pereira et al., 2018). Therefore, talking about pain and the end of life is normal, but there must be a right moment. I have a clear vision of how death occurs, but my patients do not. I do not need to impose my opinion or attitudes but stay an active listener and an intelligent companion who is ready to share knowledge when necessary. I would take some time and learn my patients’ religious and cultural backgrounds to comprehend their moods and expectations. My strong quality is unobtrusiveness but the possibility of being where I am needed and saying what the person wants to hear.
Relationships
The relationships with team members and family members determine my contribution to the patient’s condition. Some dying individuals prefer to inform a small group of people about the inevitability, while others want to see many experts who offer the most appropriate care (Murray, 2020). I think that it is a personal choice, and both options may be approved. My participation in palliative care involves communication with other healthcare providers to exchange information about the patient. Bandura’s social cognitive theory is effective for understanding death as it focuses on external and internal social factors that affect human behaviors (Borda et al., 2019). On the one hand, I would rely on my emotional intelligence, team-building skills, and respect to demonstrate my readiness for cooperation. On the other hand, I would never forget about self-confidence, critical thinking, and problem-solving because other people may evaluate my level of professionalism. Almost the same situation happens when I develop relationships with the patient’s family. I want to offer my patients and their families the best options, but I have to examine the environment and learn people’s preferences and expectations first to understand how I can help.
Reflection
Relying on my personal experiences and awareness of the topic, I understand that some areas should be developed and improved to become a more confident and effective end-of-life care provider. First, I need to strengthen my observational skills and critical thinking. It is wrong to believe that all patients and their families have the same attitude and understanding of death and dying. Therefore, identifying the most effective approach for cooperation is my main responsibility, and gathering information from patients is obligatory. Second, I want to learn new ways of cooperation with other care providers. Although end-of-life care is usually patient-centered, my task is to support the system and exchange information with other employees. This decision is made because I am not the only one who meets the patient and family members. Thus, I need to minimize risks and provide clear information. To achieve these improvements, I plan to read more scientific literature, watch case studies, and participate in forum discussions where different situations are discussed.
References
Borda, M. F., Ramirez-Pereira, M., Nurczyk, S., & Diaz-Videla, V. (2019). Nursing models and theories: Support for palliative care. Enfermería: Cuidados Humanizados, 8(2).
Ekberg, S., Parry, R., Land, V., Ekberg, K., Pino, M., Antaki, C., Jenkins, L., & Whittaker, B. (2021). Communicating with patients and families about illness progression and end of life: A review of studies using direct observation of clinical practice. BMC Palliative Care, 20(1).
Murray, K. (2020). Integrating a palliative approach: Essentials for personal support workers (2nd ed.). Life and Death Matters.
Pereira, A., Ferreira, A., & Martins, J. (2018). Nursing theories in palliative care investigation: A review. Hospice & Palliative Medicine International Journal, 2(4), 231-234.