Sample Nursing Paper on Application of Palliative Approach in Nursing Practice

Application of Palliative Approach in Nursing Practice

Part A – Descriptive questions:

  1. Discuss ways an enrolled nurse could identify needs of the person in palliative care, and their family or carers, when providing palliative care support to them. Include in your response examples of specific assessment tools a nurse may use and common needs and preferences they must identify (Bolt et al, 2019).
  2. Start a Conversation

In order to discover the needs and desires of a dying patient, it is essential to start a conversation with them or even with their families and caregivers.

Sometimes the information is subjective, which simply means that it originates in the patient’s thinking, such as when the patient wishes to spend one final moment with his or her granddaughter.

This kind of request could not be fulfilled in the absence of contact.

Some patients choose to avoid conversation during this time.

Because of this, family members and caregivers are the finest sources of knowledge, therefore communication should be started in a respectful manner.

  1. Keep an eye out for symptoms and signs

In order to improve quality of life even for a final time, it is crucial for nurses to immediately manage any discomfort experienced by patients who are in the late stages of their illness. A grimace, defensive behavior, or even screaming in pain are a few of the obvious symptoms of pain. Sometimes the patient’s body language, such as changes in appetite or sleeping patterns, should be observed by the nurse because it may not always be the underlying condition that is causing the discomfort.

the following common assessment tools could be used:

1) A pain scale should be used, with 1 denoting the mildest discomfort and 5 denoting the most severe.

2) Glasgow Coma Scale: This instrument is used to evaluate the patient’s verbal, motor, and coherency stability.

This neurologic evaluation is useful for determining the patient’s general prognosis for recovery.

3) Daily Activities



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  1. Explore and discuss legislation on advance care planning, advance care directives and notification of a death in your State/Territory in relation to a person admitted in a hospice/aged care facility/ hospital setting.

Include in your responses an enrolled nurse’s role in applying the legislation (Dowling, 2012).

My role in this circumstance is that of an Enrolled Nurse. Working within the roles and responsibilities of the multidisciplinary team is crucial when preparing palliative care. I have a duty of care to patients, thus I must be aware of all the arrangements that need to be made as well as the patient’s physical, spiritual, legal, and environmental facets. I would thus consult the multidisciplinary team when planning palliative care in order to take anything into consideration. The legal record of the planned care is called an advance care directive.

  1. The person specifies what actions can be taken for their welfare if they are unable to identify whether they are unwell or not in this document, which is also known as the living will.
  2. A patient can give someone legal authority to make decisions regarding their care and operations through the use of an enduring attorney power.
  • In this situation, you will designate a close friend or family member to make decisions regarding your care and procedures if you are unable to do so yourself.
  1. A person has the right to refuse drugs, thus they should refuse therapy if they are unable to seek medical attention.
  2. If a patient skips their medication, it needs to be reported.



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  1. Discuss diverse cultural, religious and spiritual factors underpinning the person’s choices at end-of-life using appropriate examples. How is this understanding vital in providing nursing care?

Spiritual activities, especially faith, might become increasingly significant to someone as they get closer to the end of their existence. Spiritual needs are connected to physical, mental, and social requirements (Nishimura et al, 2022).

Therefore, moral assessment and treatment are crucial while providing care for persons who have a terminal illness.

According to a new research report, doctors of different religions or non-religious doctors make decisions that could result in death more quickly, for instance, with every Catholic, Muslim, or Hindu doctor. If the doctor treating the patient shares the same faith, the patient will feel at ease and there may even be a certain amount of connection in the doctor’s heart. It shares the same religion, then.

When all is said and done, culture takes on many different roles and involves beliefs that vary from culture to culture. Some people feel that if they believe in an afterlife, death is more tolerable than living.

All of this knowledge is crucial to the practice of nursing staff because it allows them to calm patients by being familiar with how people of all faiths behave, their mannerisms, and speech patterns. This will undoubtedly relieve psychological tension from the patient’s mind.





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  1. Discuss the following ethical and legal issues related to a palliative care approach:
    • Decisions regarding advance care directives
    • Conflicts that may occur in relation to personal values and decisions made by or for the person ▪ Organ donation
    • Request for autopsy

How could each of these ethical and legal issues affect your nursing practice?

At the end of life, there might be challenging ethical issues. Example of ethical dilemma in palliative care is:


  • How to talk to family members about a loved one’s potential death in a timely manner.
  • Deciding whether to stop using ineffective drug alternatives and informing the patient and their families.
  • Treatment planning in advance

The freedom of patients to make decisions and the ability to refuse care, as well as the denial of life-sustaining treatments like nutrition and hydration, decisions on “no code,” medical futility, and assisted suicide, are other issues that need to be addressed.

We must keep the following ethical principles in mind while making decisions about advance care directives:

Your end-of-life care includes an advance care directive, which is crucial. Your advance care plan is formalized by an advance care directive. The directive may include information on a replacement decision-maker as well as all of your needs, values, and preferences for your future care (Saulnier et al, 2018).

An advance care directive is a crucial component of end-of-life care. An advance care order formally establishes your advance care plan. Your directive may also include information about a new decision-maker in addition to your values, goals, and preferences for your future medical care.

A clear advance care directive can only be made if the maker is older than 18 and capable of making decisions. A person’s willingness to make regular decisions on subjects like: Legal affairs Matters involving medical/health services

Financial matters and personal matters

Conflicts that may arise in regard to the person’s decisions and personal values.

If particular personal beliefs are at odds with the organizational expectations of a firm or institution, personal principles may get in the way of decision-making. Such individual ideas might be ingrained in religious practices or a family custom that disapproved of or supported a particular ideology.

For the company, this might be unimportant, but the subtlety of the idea could have unintended consequences, such conflict with the institutional or corporate framework. A leader should be certain that any ethical choices they make are based on organizational standards rather than their own religious beliefs before making them.

There are several cults who do not permit organ donation due to their beliefs. We must respect their personal beliefs or moral standards. Nobody should be forced to make decisions on their behalf. The main moral concerns with organ donation by living relatives are the possibility of undue control, emotional coercion, and intimidation. On the other side, the live, unrelated donor is genetically unrelated to the receiver.

Regardless of their individual beliefs and traditions, certain religions prohibit autopsy. We must respect their convictions.

Any member of the deceased person’s family or close friend may request an autopsy, but it is crucial that the request is properly approved. Some autopsy examinations are also required by law since they fall under the purview of a coroner, judge of the peace, or medical examiner. In order to avoid any legal action and adhere to the institution’s policy, nurses need to have a firm understanding of legal and ethical issues. The five most frequent and demanding ethical and health care challenges are: defending patient rights; maintaining confidentiality; obtaining informed permission to treatment; staffing patterns; and advanced care planning.

Because I or we as nurses must complete several years of preparation and professional instruction before we can become registered nurses, these ethical and legal questions have an impact on my nursing career. However, dealing with actual ethical nursing issues can be much more challenging than solving abstract problems in textbooks. As nurses, we can learn how to handle moral quandaries at work as we acquire experience and interact with patients more. Despite our high feelings of empathy for nurses, it will motivate us to set ethical boundaries with each of our patients early in our employment.








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  1. Briefly describe the hydration and nutrition requirements of an adult patient during palliative care and at end-of-life. Discuss ways a nurse could address the hydration and nutrition requirements of the patient when providing palliative care or end of life care (Baillie, et al 2018).

Nutrition and Hydration: Those who are nearing the end of their lives typically lose their appetites and rarely eat or drink. Cachexia is a frequent and poor predictive sign in patients with heart failure, and anorexia-cachexia syndrome frequently occurs in patients with advanced malignancy.

People who are nearing the end of their lives typically experience appetite loss and rarely eat or drink. Cachexia is a frequent and poor predictive sign in patients with heart failure, and anorexia-cachexia syndrome frequently occurs in patients with advanced malignancy. While reducing oral intake naturally and losing weight as a result is quite popular, ice chips, hard candy, swabs, popsicles, or mint-flavored mouthwash may also work.

In response, patients’ families also ask for additional enteral or parenteral nutrition. Giving tube feedings to patients with advanced dementia is also known as aspirating them; this increases the risk of choking; aspiration and dyspnoea, ascites, oedema, and effusions can escalate; as a nurse, we should reduce anxiety and clarify the significance of end-of-life; try and listen to their language to ease their discomfort; avoid aspiration by sucking content that can 8increase the risk of choking.

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  1. Discuss the use of syringe driver and intima sub-cut lines in administering analgesic medications for a patient receiving palliative care or end of life care. Include in your answer:
    • Examples of analgesics administered using a syringe driver or intima sub-cut lines.
    • Indications and
    • for use of syringe drivers in administration of pain medication.
    • Indications for intima sub cut lines for pain relief, anti-nausea and steroid injections.
    • Role of an enrolled nurse in administering medications via a syringe driver or intima sub-cut lines.

For patients with severe illnesses, palliative care, often known as end-of-life care, is a type of specialist care intended to improve quality of life and lessen symptoms. These individuals require ongoing care, frequently for pain management. It would be advantageous for nurses and patients to have the best approach to take medications by using a sub-cut device and syringe drivers because continuous pharmaceuticals require constant supervision (Dabscheck).

An Intima sub-cut is a non-needle indwelling subcutaneous catheter device. Drugs are administered subcutaneously for either continual infusion or bolus dosages.

An Intima sub-cut is a non-needle indwelling subcutaneous catheter device. Drugs are administered subcutaneously for either continual infusion or bolus dosages.

One drug that is administered by a syringe driver is diamorphine. It is an opioid of the painkiller variety. Instructions for using the syringe driver and sub-cut lines are provided for patients who experience persistent nausea and vomiting, intractable pain, drowsiness or coma, difficulty swallowing, and intestinal obstruction. Instructions for using the syringe driver and sub-cut lines are provided for patients who experience persistent nausea and vomiting, intractable pain, drowsiness or coma, difficulty swallowing, and intestinal obstruction. We will not utilize the syringe driver and sub-cut row if the patients do not provide their consent; instead, we will use one of the other methods for prescribing medications and avoiding associated risks associated with drug infusion.

When utilizing this device, it is our responsibility as enrolled nurses to make sure the medications are administered to the correct patient with the proper prescription, site management for indicators of discomfort, redness, or pain, and leakage.

Treat the skin firmly to elevate the subcutaneous tissue. With the cannula, augment and remove the skin.

When using a BD Saf-T-Intima, remove the stylet and be sure to keep the device in place while doing so to prevent accidental ejection of the entire device from the patient.

The extension tubing is changed when the cannula is changed.

Create a circle at the point where the tubing is attached to the skin to prevent dislodging if the tubing is unintentionally removed.




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  1. Discuss common non-pharmaceutical and complementary care in pain management for a patient receiving palliative care or end of life care using examples (Siefert et al, 2021).

Various non-pharmaceutical techniques for managing pain include: – massage; positioning; hot and cold therapy; and using electrical stimulation.

Muscles gradually relaxing as a result of acupuncture. Additionally, a number of complementary care practices include psychological alleviation that can be achieved in a variety of ways, such as with the aid of an amusing activity. They recognize and strongly believe in the process, and as a result, a greater portion of their difficulty is alleviated through various cultural and religious means.

By engaging others in discussion, investing in the task yourself, and other complementary pain management techniques, he or she can block out the discomfort they are feeling.






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  1. Discuss the impact of loss and grief on the person receiving palliative care and their family or carers. How could a nurse manage these impacts?

Mourning – After observing the suffering a loved one is experiencing, the family is in mourning.

Depression: Family members frequently experience depression as a result of their inability to express their feelings and refusal to consider the needs of a loved one who is suffering.

A sense of loss—The patient might feel as though they have missed out on all the people and things they have loved in their lives. The loss of a loved one leaves the family feeling very angry and melancholy (Petursdottir et al,2020).

Stress – After there are no longer any, people may worry about how the family will manage.

The patient’s family is in grief as a result of seeing the suffering that their loved one is through. If family members don’t express their emotions, they frequently descend into hopelessness and continue to worry about the loved one who is in need. After losing a loved one, people frequently worry about how they will cope. It can call for financial management.




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  1. Discuss the impact of loss and grief on nurses and other team members. How could they manage these impacts?

Grief is an emotional reaction to the passing of a loved one or close friend (Esplen et al, 2022).

The following are the repercussions of loss and grief:

When grieving over a patient’s passing, nurses are more prone to go missing, and their mourning typically lasts for two to three weeks.

The nurses and other staff members are beginning to feel worn out and demotivated. This is due to the profound emotional anguish that surrounds a person’s passing.

The remorse of the relatives of a deceased patient also causes the nurses to lose focus.

Particularly if the death was unexpected, the nurses begin to feel surprised, numb, and in disbelief.

The following can be done to control this outcome:

Many instances of death have involved the “letting go” notion. This involves a process that leads to the realization of a loved one’s approaching death, with some relief from the intense emotional pressures that are typically felt before this understanding.

Four qualities are involved in this concept:

A shift of perspective or a crucial turning point

Recognizing that a loved one has passed away while still making efforts to save them; understanding the physical and emotional losses that accompany death; and allowing the process of eventual death to occur by refusing to hinder or delay it.



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  1. Identify and briefly describe three (3) relevant resources available to those requiring grief and bereavement support in your State or Territory.

The resources accessible to people in need of sorrow and bereavement care

Appex, a well-known community referral service, connects victims of private trauma with round-the-clock care. Any of the lifeline programs offer rehabilitation, preventive, and deprivation services (Pearce et al, 2021).

A non-profit organization called Bethlehem-it is mandated to increase awareness and knowledge of depression and anxiety. The group aims to more effectively address prevalent informational and mental health difficulties while dealing with grief and death.

Amaco Alliance : This organization works to promote clinical and public education in the areas of trauma, loss, and grief. They assist those who require some extra time by offering no-cost bereavement assistance over the phone or in person.



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  1. Discuss own role and responsibilities as an enrolled nurse in palliative care provision.


Enrolled nurses’ duties and obligations in palliative care

  • They make sure that patients follow the instructions and schedules for their medications (Mitchell et al, 2020).
  • Providing guidance and leadership to the care personnel.
  • Coordinating the provision of services by GPs, allied health, palliative care teams, and teams providing acute care.
  • Conducting needs assessments, planning, and assessing treatment.





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  1. Discuss role and responsibilities of doctors, registered nurses and personal care assistants/nursing assistants in palliative care provision (Shore et al, 2022).


Role and duties of doctors in palliative care:

  • They offers care and assistance when you and your loved ones are struggling to deal with a chronic disease.
  • Palliative care physicians prioritize minimizing or eliminating pain and enhancing patients’ quality of life, whereas other medical professionals focus on your overall health or treating your illness or disease.




Case Study A:


Alfred, 68 years old, is admitted in your palliative care setting following the recent diagnosis of signet ring cell carcinoma which has affected his intestine, stomach and lungs. Alfred appears tired and extremely upset.


  1. What is signet ring cell carcinoma? Discuss the potential needs of Alfred in relation to the pathological changes associated with this condition (Machlowska et al, 2019).

A very aggressive, uncommon form of mucin-forming adenocarcinoma is called signet ring cell carcinoma (SRCC). The histologic presence of the signet ring cells identifies it as an epithelial cancer. Although it can develop in a number of other hepatic sites, signet-ring carcinoma is more frequently found in the gastrointestinal tract, particularly the stomach. The tiny salivary glands of seven patients were recently shown to contain it; the hard palate and the spot where the hard and soft palates meet are the most often affected areas. These tumors typically appear as slow-growing, asymptomatic lumps without invading the bone beneath. These are unencapsulated tumors, and their growth patterns range from tiny, distributed nested hypocellular regions, microcystic foci, and single infiltrating cell regions to narrow parallel stranded hypercellular areas and linking cords.

The preferred course of treatment for SRCC of the stomach is stomach cancer removal. There is no chemotherapeutic combination that is demonstrably better than others, however the most effective regimens include 5-Fluorouracil (5-FU), Cisplatin, and/or Etoposide.

An accurate and thorough assessment of the causes of the underlying pain constitutes the fundamental theory of pain management. Keep in mind that there are numerous causes of different symptoms and that individuals may have discomfort in more than one area.




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  1. Discuss the assessment you must perform on Alfred. Include in your response the role of impeccable palliative care assessment (Virdun et al, 2021).


Palliative care is a type of medical care that focuses on the person rather than just their illness. The goal is to prevent or cure the symptoms of the condition and hasten its recovery, in addition to the related psychological, social, and moral difficulties.

Oncologists advise chemotherapy in one of two situations. Chemotherapy will completely eradicate the cancer in some tumors, with a good chance that it won’t return. Some types of lymphoma, leukemia, and testicular cancer are examples, among others. Chemotherapy is not an option for the treatment of some metastasized tumors.

However, chemotherapy can help lessen cancer, improve or completely eliminate uncomfortable cancer-related side effects over time, and extend your life. In these circumstances, the use of chemotherapy is referred to as palliative chemotherapy.

At the end of life, physical discomfort is a sad component of many health conditions.

Even though pain is a typical indication, not everybody getting palliative care assistance will feel it. As a result, treating pain should address its psychological, social, spiritual, and physical dimensions.

In addition to providing nursing support by determining, planning, and meeting people’s requirements, a nurse’s role also includes making people feel comfortable, offering them emotional support, and relieving caregivers.



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  1. Identify and discuss the application of any three (3) principles of palliative care and the palliative approach in undertaking holistic assessment of Alfred (Nevin et al, 2019).

The Fundamentals of Palliative Care:

Palliative care is more than just a stage that a patient goes through by themselves in a hospital. It is a notion ingrained in both their general care and the support provided by their family.


Affirms life as a natural process and takes death into consideration; neither hastens nor slows death; provides pain and other disturbing indicators of relief; integrates clinical and moral aspects of care.

Provides a system of care to help people live as fully as possible before dying. Provides a system of counseling to help patients’ families cope with the patient’s condition and their own bereavement.

A person receiving palliative care simply indicates that they are towards the end of their life and that a lot of focus is being placed on keeping them healthy so they can enjoy their remaining time on this world by focusing on the quality of life rather than the number of days.

The World Health Organization defines palliative care as the active, comprehensive care provided to patients whose illnesses do not respond to curative therapy. It is crucial to control discomfort, additional problems, and psychological, social, and spiritual problems. The optimum quality of life for patients and their families is what palliative care aims to provide. Palliative care may feel like a terrifying pro

Due to the complexity and layers of suffering, there is no one solution. Physical pain cannot be treated separately from the physiology and concerns associated with it. Contrarily, emotional trauma is challenging to overcome independent of physical experience.


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  1. Discuss the timing and frequency of assessment of pain in this scenario.

The three most used tools for gauging pain intensity are verbal rating scales, numerical rating scales, and visual analog scales. The Visual Descriptor Scales rate the intensity of the pain using common phrases (Carpenter et al, 2022).

The fact that pain evaluation is done in a particular style every day is its most crucial component.

The policies and procedures of the hospital or unit should be expressly referenced in the test criteria.

Our patient needs to be evaluated every hour since he is in excruciating agony.

The use of pressure relievers and hourly pain scale measurements are also recommended.







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  1. You observed that Alfred is struggling to follow instructions even after explaining procedures and care aspects in detail on every occasion. He appeared lost and forgetful. This is frustrating you. How should you respond to this situation and why?

As a health care provider, we must first and foremost respond professionally in this circumstance (Bolt, et al, 2021).

It’s crucial to provide a dying person the freedom to express their thoughts, make their own decisions, and maintain their independence as much as possible in order to help them get over their anger.

Avoid taking things personally. These patients are in great pain, and it is our responsibility as experts to recognize their circumstances and provide for them.





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Case Study B:


You have been caring for Barb, a 72-year- old woman with advanced breast cancer and multiple metastases. Barb complains of pain in her abdomen, feeling bloated, very uncomfortable and generally unwell. Due to pain and shortness of breath, her mobility is limited to short distances using a rollator.

Medication ordered for pain relief includes MS Contin 50mg twice daily and paracetamol 1000mg four times a day. She also has an order for Morphine 2.5-5mg 4/24 prn. It has been two hours since Barb’s last dose of Subcut Morphine 2.5mg and her pain has not reduced at all.

The RN asks you to take Barb’s observations, assess her pain and symptoms, and discuss a suggested plan of care. The completed assessment indicates that Barb is constipated. This is exacerbating her pain.


  1. What are the likely causes of Barb’s constipation?

Constipation is brought on by morphine and breast cancer (Forootan et al, 2018)




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  1. Discuss an EN’s role in prevention and management of constipation (McIlfatrick et al, 2019).

Stop using morphine, consume 20 grams of dietary fiber daily, encourage patients to exercise, and 15-20 minutes of walking each day will prevent constipation.




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  1. Barb tells you that she would like to use something other than drugs to manage her pain. What pain management strategies should you implement in this situation? (Nallani et al, 2021).


routine that includes physical treatment, yoga, and regular exercise.



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Case Study C:


Assume that a person you care for has views, beliefs and needs in relation to their lifestyle, social context and emotional and spiritual choices that contradict your beliefs and interests.


How should you react to the client’s needs in this situation when providing care and support to the person?


As healthcare professionals, we might encounter a range of patients. These customers require treatment, which we can give them. When we encounter a consumer that holds a different opinion from ours or one that is similar to ours, we should respect that as being their own point of view. Maintaining one’s values is a fundamental action in all spheres of employment. However, if the conviction can jeopardize the patient’s welfare, as is the case with certain patients who refuse to undergo certain medical procedures for ethical or religious reasons, we should make an effort to explain to them that we are not prejudiced (Balfour et al, 2022).





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Case Study D:


The registered nurse asked you to liaise with Mathew, an adult receiving palliative care in your setting, and his wife and daughter who are currently with him, to explore if they have any concerns and issues they would like to discuss in relation to their spiritual and cultural background.

  1. Identify three (3) questions you should ask Mathew and his family to explore any concerns and issues they may have in relation to their spiritual and cultural background.

Prior to making any decisions, it’s important to take into account the cultural and spiritual beliefs of the people in your care. Then, after talking about their moral and cultural background, you might talk about any concerns or troubles they might be having. Any concerns you might have could be related to the family’s spiritual need (Chen et al, 2018).

You can ask the patient if he typically participates in religious rituals like church attendance or other religious rituals, or if he wants to follow any religious guidance. “Tie up loose ends” (tie up loose ends). It is vital to offer the patient spiritual care in any scenario.

Views and customs vary depending on the patient’s environment. Respecting the patient’s cultural beliefs and preferences is essential.




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  1. Discuss appropriate strategies that may assist in conversations with Mathew and his family around spiritual care and spiritual and cultural issues. Include in your answer the importance of facilitating such conversations (Chicca & Shellenbarger, 2018).

When conversing with the family, one good tactic is to ask open-ended questions. This is essential to ensure that you don’t overtax the family. Keep in mind that the focus of end-of-life therapy is the patient and their requirements. Constructive feedback and listening is another method that is modifiable. For the family, it is crucial to feel taken into account and to know that their wishes are being taken seriously. Empathy is the final and possibly most significant quality. Being ability to put oneself in the patient’s or family’s position is crucial for providing effective palliative care in any setting.



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  1. Mathew’s wife shared a concern that one of the staff members at the facility had approached them multiple times asking for an opportunity to pray for them. The colleague sounded like a gospel preacher and Mathew was upset at this colleague’s approach as his beliefs were different. He didn’t want to voice his concern and annoy anyone during these last days of his life.

How should you respond to this situation?

You must first assure Matthew that his feelings are valid and that it is acceptable for him to be incensed by such a plan. Then you must keep telling him and his family that you are looking into it. You should also ask Matthew if he wants to attend any church services or if there is a minister or chaplain he would like to speak with at this time. Whatever the situation, always keep compassion and empathy in mind.



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Case Study E:


James was unconscious and in his end-of-life phase. He had experienced noisy and rattly breathing since this morning and his family members were concerned about this change in his breathing.

How should you respond to family members who are concerned about James’ noisy and rattly breathing? Include in your response what other strategies you should implement in this situation to manage James’ noisy and rattly breathing (Muraro et al, 2022).

It is a well-known fact that people experience rattling and loud breathing as they near the end of their lives. At this point, as healthcare professionals, we should be able to explain the patient’s condition to the family. Although the patient’s family is involved in this case, we are able to fully inform them of what is causing the patient’s noisy coughing, which is a buildup of secretions in the patient’s airway. While we shouldn’t offer them false hope that things will turn out OK, we should begin right now to strengthen their lungs and airways. To start, we may use pharmacologic or non-pharmacological therapy.





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Case Study F:


One of the patients in your clinical setting is in his end-of-life care and his daughter is experiencing normal grief reactions.


  1. Discuss the emotional support you should provide to the person’s daughter in this situation.


Death and grief are both weird concepts. We feel so helpless when someone close to us passes away suddenly. As a person working in an office setting, we might experience tragedy firsthand or act as a safety net for grieving families (van et al, 2020).

We should continue to show compassion to not only our patients but also their individual families. We should keep the most practical level of mental toughness. Understanding the features of grievances can help each loved one address them more effectively.




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  1. When the patient passed away, you observed that another family member was going through complicated bereavement. The family member displayed intense yearning for the deceased, excessive guilt and remorse, anger etcetera. Outline options available for referral for individualised support in this complicated bereavement situation. How will you discuss these options with the family member?

As a nurse, we must foster trust and provide the son who experienced natural grieving permission to express their feelings in a trusting, nonjudgmental, and compassionate environment. The nurse must make accommodations for the son in order to help her develop and employ effective coping mechanisms in order to deal with her grief. If there are any community services that can be utilised, the nurse must make referrals.

The inability of a client to go forward in the grieving process is a sign of complicated bereavement. They don’t alter even after a long period of time. They struggle to recover from the loss or resume their regular lives since their thoughts are so absorbing. Similar to other family members, these folks frequently need assistance and services.

Using techniques to communicate with persons who are grieving can help them demonstrate empathy and open relationships.




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  1. Consider if you were the nurse caring for the person and his family on the day he died. How would you ensure positive coping and stay healthy, mentally and physically? Include in your response physical, social and inner self-care strategies and discuss why these self-care strategies are important.


A grieving entity might experience pain as a whole. Here are some advice for nurses on how to deal with different types of misery:

They might experience unexplained exhaustion, insomnia, and decreased appetite.

It might provide a sense of continuity across a routine. As a nurse, you take into account that patients should eat three wholesome meals a day even when they are not hungry. The level of energy will also be stabilized by getting a decent night’s sleep on a regular basis. A snooze or a snack will do much to provide warmth.

In terms of mental health, they could experience unexplained fatigue, sleeplessness, and poor appetite.

It will give a routine a sense of coherence throughout.

A grieving family member could feel completely numb or overtaken by their emotions. Always remember to show them compassion, consideration, and enthusiasm. Slowly but surely, encourage them to diligently pursue pleasure. Encourage them to work out so they can anticipate watching their favorite TV, reading a book, or taking a hot bath.

With the aid of social services, recovery can be facilitated. Help them locate organizations that will support them during their challenging times and share the same goals. Send them to a qualified psychiatrist for assistance, and make sure there is no shame associated with doing so.


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Balfour, M. E., Hahn Stephenson, A., Delany-Brumsey, A., Winsky, J., & Goldman, M. L. (2022). Cops, clinicians, or both? collaborative approaches to responding to behavioral health emergencies. Psychiatric Services73(6), 658-669.

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Bolt, S. R., van der Steen, J. T., Schols, J. M., Zwakhalen, S. M., Pieters, S., & Meijers, J. M. (2019). Nursing staff needs in providing palliative care for people with dementia at home or in long-term care facilities: A scoping review. International journal of nursing studies96, 143-152.

Bolt, S. R., van der Steen, J. T., Mujezinović, I., Janssen, D. J., Schols, J. M., Zwakhalen, S. M., … & Meijers, J. M. (2021). Practical nursing recommendations for palliative care for people with dementia living in long-term care facilities during the COVID-19 pandemic: A rapid scoping review. International journal of nursing studies113, 103781.

Carpenter, C. R., Griffey, R. T., Mills, A., Doering, M., Oliveira J. e Silva, L., Bellolio, F., … & Broder, J. S. (2022). Repeat computed tomography in recurrent abdominal pain: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department. Academic Emergency Medicine29(5), 630-648.

Chen, J., Lin, Y., Yan, J., Wu, Y., & Hu, R. (2018). The effects of spiritual care on quality of life and spiritual well-being among patients with terminal illness: a systematic review. Palliative medicine32(7), 1167-1179.

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Dabscheck, A. Paediatric Cancer Pain. Training Manual on Paediatric Palliative Care, 34.

Dowling, D. M. (2012). Mr Peter Dowling MP Chair Health and Community Services Committee Parliament House Brisbane Qld 4000.

Esplen, M. J., Wong, J., & Vachon, M. L. (2022). Supporting Resilience and the Management of Grief and Loss among Nurses: Qualitative Themes from a Continuing Education Program. Journal of Hospice and Palliative Care25(2), 55-65.

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McIlfatrick, S., Muldrew, D. H., Beck, E., Carduff, E., Clarke, M., Finucane, A., … & Hasson, F. (2019). Examining constipation assessment and management of patients with advanced cancer receiving specialist palliative care: a multi-site retrospective case note review of clinical practice. BMC palliative care18(1), 1-10.

Machlowska, J., Pucułek, M., Sitarz, M., Terlecki, P., Maciejewski, R., & Sitarz, R. (2019). State of the art for gastric signet ring cell carcinoma: from classification, prognosis, and genomic characteristics to specified treatments. Cancer management and research11, 2151.

Mitchell, S., Maynard, V., Lyons, V., Jones, N., & Gardiner, C. (2020). The role and response of primary healthcare services in the delivery of palliative care in epidemics and pandemics: a rapid review to inform practice and service delivery during the COVID-19 pandemic. Palliative Medicine34(9), 1182-1192.

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Nallani, R., Fox, C. C., Sykes, K. J., Surprise, J. K., Fox, C. E., Reschke, A. D., … & Villwock, J. A. (2021). Pain Management and Education for Ambulatory Surgery: A Qualitative Study of Perioperative Nurses. Journal of Surgical Research260, 419-427.

Nevin, M., Smith, V., & Hynes, G. (2019). Non-specialist palliative care: a principle-based concept analysis. Palliative Medicine33(6), 634-649.

Nishimura, M., Dening, K. H., Sampson, E. L., de Oliveira Vidal, E. I., de Abreu, W. C., Kaasalainen, S., … & van der Steen, J. T. (2022). Cross-cultural conceptualization of a good end of life with dementia: a qualitative study. BMC Palliative Care21(1), 1-18.

Petursdottir, A. B., Sigurdardottir, V., Rayens, M. K., & Svavarsdottir, E. K. (2020). The impact of receiving a family-oriented therapeutic conversation intervention before and during bereavement among family cancer caregivers: a nonrandomized trial. Journal of Hospice & Palliative Nursing22(5), 383-391.

Saulnier, K. M., Cinà, M., Chan, B., Pelletier, S., Dorval, M., & Joly, Y. (2018). Communication of genetic information in the palliative care context: Ethical and legal issues. Medical Law International18(4), 219-240.

Shore, C. B., Maben, J., Mold, F., Winkley, K., Cook, A., & Stenner, K. (2022). Delegation of medication administration from registered nurses to non-registered support workers in community care settings: a systematic review with critical interpretive synthesis. International Journal of Nursing Studies126, 104121.

Siefert, M. L., Rosenbloom, S., Ercolano, E., & Boucher, J. (2021). Chronic Disease Management Models, Pain Management, and Palliative Care. Role Development for the Nurse Practitioner369(24), 187.

Pearce, C., Honey, J. R., Lovick, R., Creamer, N. Z., Henry, C., Langford, A., … & Barclay, S. (2021). ‘A silent epidemic of grief’: a survey of bereavement care provision in the UK and Ireland during the COVID-19 pandemic. BMJ open11(3), e046872.

van der Velden, P. G., Contino, C., Das, M., van Loon, P., & Bosmans, M. W. (2020). Anxiety and depression symptoms, and lack of emotional support among the general population before and during the COVID-19 pandemic. A prospective national study on prevalence and risk factors. Journal of affective disorders277, 540-548.

Virdun, C., Luckett, T., Davidson, P. M., Lorenz, K., & Phillips, J. (2021). Generating key practice points that enable optimal palliative care in acute hospitals: Results from the OPAL project’s mid-point meta-inference. International Journal of Nursing Studies Advances3, 100035.