To Comfort Always: A Nurse's Guide to End-of-Life Care
Caring for patients at the end of life's journey is challenging, but rewarding. To Comfort Always: A Nurse's Guide to End-of-Life Care prepares nurses to care for dying patients and their families by providing a primer that is both practical and insightful. From emotional needs such as relief of suffering to physical needs such as relief of pain, To Comfort Always supplies nurses what they need to know to deliver holistic, effective care. Linda Norlander brings her expertise in end-of-life...
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Caring for patients at the end of life s journey is challenging, but rewarding. To Comfort Always: A Nurse s Guide to End-of-Life Care prepares nurses to care for dying patients and their families by providing a primer that is both practical and insightful. From emotional needs such as relief of suffering to physical needs such as relief of pain, To Comfort Always supplies nurses what they need to know to deliver holistic, effective care. Linda Norlander brings her expertise in end-of-life care to this book that will serve as a valuable resource for nurses committed to comforting patients and families at one of life s most moving passages.
Dedication iiiAcknowledgements ivAbout the Author vIntroduction xChapter 1 Where to BeginIntroduction 1Guiding Principles of End of Life Care 2Core Nursing Responsibilities: Skilled Clinician, Advocate, and Guide 4What Do Patients and Families Want for Care at the End of Life? 5When Do We Start Providing End of Life Care? 6A Team Approach 7Chapter 2 Advance Care PlanningThe Courageous Conversation 11Skilled Clinician: Understanding the Elements of Advance Care Planning 12Advance Directives 15A Note on DNR/DNI Status and POLST Forms 16Advocating in Advance Care Planning: Making Sure Wishes Are Honored 16Guiding in Advance Care Planning: Recognizing the Common Barriers 17Common Questions Patients Ask About Advance Directives 19Cultural Considerations in Advance Care Planning 20Chapter 3 Pain Management: It's More Than Knowing the MedsListening to the Patient's Pain 23Skilled Clinician: Assessment and Management of Pain 25Advocating: Ensuring That the Patient's Pain Relief Goals Are Met 29Guiding Patients and Families: Addressing Common Fears 31Know the Resources 33Chapter 4 Physical Symptom ManagementCommon Symptoms 35Skilled Clinician: Assessment and Management of Common Symptoms 36Advocating: Linking the Needs of the Patient and Family to the Health Care System 43Guiding Patients and Families: Preparing, Listening, and Assuring 44Chapter 5 Suffering: It's Not Just the PainWhat Is Suffering at the End of Life? 47Skilled Clinician: Assessing Suffering 48Advocating for Patients: Ensuring a Holistic View 52Guiding Patients and Families: Start with Yourself 53Chapter 6 Active Dying: The Final Days and HoursActive Dying: What Does It Mean? 57Skilled Clinician: Assessing and Intervening When Death Is Near 58Advocating for Both the Patient and Family: Communication Is the Key 63Guiding: Walking That Difficult Path 64A Note on Withdrawing Life-Sustaining or Life-Extending Treatment 65Chapter 7 After the Death: The Long Journey to the CarWhat Happens after a Patient Dies? 67Skilled Clinician: Understanding Grief 68Advocating for the Family: Accommodating Their Comfort Needs 69Guiding the Family: Accepting the Loss 70Self Care 73Chapter 8 When a Child Is Dying: Pediatric End of LifeChildren Die, Too 75Skilled Clinician: Assessing and Intervening in the Care of Children 77Advocating for Children: Meeting the Needs of Both the Patient and the Family 80Guiding Children and Families: Understanding the Needs of the Child 82Chapter 9 Cultural Sensitivity: Looking through Different EyesMaking Room for Cultural Diversity 85Understand Your Own Beliefs 87Listen to the Patients 88Avoid Stereotyping and Making Assumptions 89Use Trained Medical Interpreters 89Use Community Resources 90Advocating for Patients and Families 91Chapter 10 HospiceA Philosophy of Care 95Who Qualifies for Hospice Care? 96How Do I Approach Patients and Families about Hospice Care? 97The Hospice Medicare Benefit 98Advocating for Your Patients 100Chapter 11 Ethical Issues in End-of-Life CareHealth Care Ethics 104Common Ethical Dilemmas and Conflicts 105Role of the Skilled Clinician in Difficult Decisions 106Advocate: Making Sure Wishes Are Honored 107Guide 108What about a Nurse's Personal Ethics, Beliefs, and Values? 109Ethics and Culture 109Chapter 12 A Final Note: Taking CareBurning Brightly, Burning Dimly 113Living in the Present Moment 114The Joy and the Laughter 115A Final Note 115Index 117
