CPD reflective account Advance care planning was discussed in the article. Such planning is a voluntary process that enables individuals to document their preferences and decisions regarding acceptance or denial of specific treatments or investigations when nearing the end of life. Advance care planning honours the person’s choice of where he or she wishes to die. The majority of people wish to be cared for and die at home, however more than half die in hospital.
ISTOCK
Honouring patient choice
End of life care A CPD article reminded Rose Gallacher of the need for dignity and respect when caring for people who are dying End of life care is challenging, rewarding and a privileged experience, irrespective of where death occurs – in a hospital, care home, hospice, prison or at home. The CPD article was a reminder that death is a deeply personal and social experience, and one where individuals must be afforded dignity and respect. People who are dying should be referred to as individuals or persons, and not as patients. The CPD article emphasised the importance of early recognition that death is approaching. Physiological changes such as reduced hydration and nutritional needs may be observed, and peripheral body areas may change in colour or temperature. The person may become psychologically distressed, restless or agitated, withdrawn or disinterested, and may call out or drift in and out of consciousness. Distressing and common symptoms such as pain,
nausea, increased respiratory tract secretions, fatigue or constipation should be managed effectively. I reflected on the uniqueness of the psychological and spiritual wellbeing of a person who is dying and the complexity of the issues that may contribute towards threatening the person’s spiritual integrity. I found the recommendation in the article to ask the person what makes him or her smile, or what in his or her life provides a source of hope and meaning, useful in promoting spiritual wellbeing.
This reflective account is based on NS738 Sherwen E (2014) Improving end of life care for adults. Nursing Standard. 28, 32, 51-57.
Conflicts may arise with regard to the person’s choice of next of kin. It was interesting that principle nine of the 12 principles of a good death states that the person who is dying has control over who he or she wishes to be present and share the end with. Death is an individual and spiritual event unique to everyone. End of life care is challenging and rewarding for healthcare professionals, and it does not stop at the point of death. After death, care should involve healthcare professionals sensitively managing the deceased person’s spiritual or cultural wishes and returning personal possessions to loved ones. After death, nursing staff should support and compassionately communicate and empathise with loved ones. Emotional involvement ensures that loved ones are left with good memories to assist them with the grieving process NS Rose Gallacher is a staff nurse at the Royal Alexandra Hospital, Paisley, Scotland
Write your own reflective account You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. Turn to page 50 for this week’s article and on page 61 you can find out how to present and submit your reflective account.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
60 march 11 :: vol 29RCNi.com no 28 :: 2015 STANDARD Downloaded from by ${individualUser.displayName} on Dec 10, 2016. For personal use only. NoNURSING other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
ISTOCK
Honouring patient choice
End of life care A CPD article reminded Rose Gallacher of the need for dignity and respect when caring for people who are dying End of life care is challenging, rewarding and a privileged experience, irrespective of where death occurs – in a hospital, care home, hospice, prison or at home. The CPD article was a reminder that death is a deeply personal and social experience, and one where individuals must be afforded dignity and respect. People who are dying should be referred to as individuals or persons, and not as patients. The CPD article emphasised the importance of early recognition that death is approaching. Physiological changes such as reduced hydration and nutritional needs may be observed, and peripheral body areas may change in colour or temperature. The person may become psychologically distressed, restless or agitated, withdrawn or disinterested, and may call out or drift in and out of consciousness. Distressing and common symptoms such as pain,
nausea, increased respiratory tract secretions, fatigue or constipation should be managed effectively. I reflected on the uniqueness of the psychological and spiritual wellbeing of a person who is dying and the complexity of the issues that may contribute towards threatening the person’s spiritual integrity. I found the recommendation in the article to ask the person what makes him or her smile, or what in his or her life provides a source of hope and meaning, useful in promoting spiritual wellbeing.
This reflective account is based on NS738 Sherwen E (2014) Improving end of life care for adults. Nursing Standard. 28, 32, 51-57.
Conflicts may arise with regard to the person’s choice of next of kin. It was interesting that principle nine of the 12 principles of a good death states that the person who is dying has control over who he or she wishes to be present and share the end with. Death is an individual and spiritual event unique to everyone. End of life care is challenging and rewarding for healthcare professionals, and it does not stop at the point of death. After death, care should involve healthcare professionals sensitively managing the deceased person’s spiritual or cultural wishes and returning personal possessions to loved ones. After death, nursing staff should support and compassionately communicate and empathise with loved ones. Emotional involvement ensures that loved ones are left with good memories to assist them with the grieving process NS Rose Gallacher is a staff nurse at the Royal Alexandra Hospital, Paisley, Scotland
Write your own reflective account You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. Turn to page 50 for this week’s article and on page 61 you can find out how to present and submit your reflective account.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
60 march 11 :: vol 29RCNi.com no 28 :: 2015 STANDARD Downloaded from by ${individualUser.displayName} on Dec 10, 2016. For personal use only. NoNURSING other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
