Assignment Help | Describe the role of the nurse in end-of-life decision making with patients and their families.

Your manager asked you to prepare an article for a community newsletter for a local retirement village. The editor wants you to talk about the laws, policies, and choices surrounding end-of-life health care decisions

Preparation

Search the Capella library and the Internet for scholarly and professional peer-reviewed articles on end-of-life care. You will need at least three articles to use as support for your work on this assessment.

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Directions

Write an article of 750–1,000 words (3–4 pages) that discusses the laws, policies, and choices surrounding end-of-life health care decisions. Address the following in your article:

Describe the role of the nurse in end-of-life decision making with patients and their families.
Explain the legislation that generated end-of-life health care policies. Was the legislation an outcome of a specific medical case?
Identify the primary policies regarding current health care practices related to end-of-life health care decisions. How to these policies affect treatment decisions?
Explain the effect of end-of-life regulations and controls on patient outcomes. What effect does this have on the nurse-patient relationship?
Describe the ethical considerations that have influenced policy decisions in regard to end-of-life decisions.
Additional Requirements

Your article should meet the following requirements:

Written communication: Written communication should be free of errors that detract from the overall message.
References: Cite a minimum of three resources; a majority of these should be peer-reviewed sources. Your reference list should be appropriate to the body of literature available on this topic that has been published in the past 5 years.
APA format: Resources and citations should be formatted according to current APA style and formatting.
Length: 750–1,000 words or 3–4 typed, double-spaced pages, excluding title page and reference page. Use Microsoft Word to complete the assessment.
Font and font size: Times New Roman, 12-point.

Criterion #1 – Consider multiple roles of the nurse as he or she participates in the patient’s care. The ANA position statement provides some valuable information, as do the Hebert and Adams articles. Adams also suggests strategies that would help meet the “Distinguished” level requirement.

2. Criterion #2/#4 – Note that advance directives are neither policies nor laws, simply documents. A good discussion that will address both of these criteria would include an explanation of the Patient Self-Determination Act, which is a federal policy/law. A great article that explains the PSDA and the historical basis for its passage is:

Duke, G., Yarbrough, S., & Pang, K. (2009). The Patient Self-Determination Act: 20 years revisited. Journal of Nursing Law, 13(4), 114-123.

Other policies and laws that you might wish to address include Death with Dignity, MOLST/POLST and the Uniform Health Care Decisions Act.

3. Criterion #3 – Consider the regulations and controls (Medicare and Medicaid) that made hospice and palliative care widely available, and focus on “Quality of Life” outcomes such as pain, anxiety, stress, feelings of dignity and control/autonomy, overall satisfaction with care and others. The Aoun, Nakano and Lewis articles provide great information that addresses these issues.

4. Criterion #5 – Any time you’re asked to address ethical issues, it’s always appropriate to incorporate the 4 basic biomedical ethical principles of beneficence, non-maleficence, justice and respect for autonomy. Think about how these ethical principles have guided the development of various laws and policies related to EOL decisions and care, particularly the PSDA. Some students have found the information in Chapter 13 of the Norlander book to be helpful. You may also wish to review the ethical issues discussed in the Aacharya article from Assessment 2 and consider how they have impacted policy.

RESOURCES:
Library Resources
The following e-books or articles from the Capella University Library are linked directly in this course:

Norlander, L. (2014). To comfort always: A nurse’s guide to end-of-life care (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
Hebert, K., Moore, H., & Rooney, J. (2011). The nurse advocate in end-of-life care. The Ochsner Journal, 11(4), 325–329.
Lewis, K. (2013). How nurses can help ease patient transitions to end of life care. Nursing Older People, 25(8), 22–26.
Lund, S., Richardson, A., & May, C. (2015). Barriers to advance care planning at the end of life: An explanatory systematic review of implementation studies. PLoS One, 10(2).
Aoun, S., O’Connor, M., Skett, K., Deas, K., & Smith, J. (2012). Do models of care designed for terminally ill ‘home alone’ people improve their end-of-life experience? A patient perspective. Health & Social Care in the Community, 20(6), 599–606.
Nakano, K., Sato, K., Katayama, H., & Miyashita, M. (2013). Living with pleasure in daily life at the end of life: Recommended care strategy for cancer patients from the perspective of physicians and nurses. Palliative & Supportive Care, 11(5), 405–413.
Adams, J. A., Bailey, D. E., Jr., Anderson, R. A., & Docherty, S. L. (2011). Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice, 2011.

MODEL ANSWER

Planning for End-of-life is a critical stage that creates a platform for discussion for both the patient, nurse, family, and friends. Being the primary care providers, nurses play a fundamental role in communicating the decision reached regarding the medicalization to use as well as give advice on the emotional, physical, and psychological states of the patients. In EOL care, nurses play the supporter role by demonstrating empathy and creating a trusting relationship with patients, family members/friends, and physicians as they evaluate EOL decisions (Adams et al., 2011). The nurse also facilitates the flow of information between the family members, patients, and the medical team. ANA identify that it is the responsibility of nurses to ensure they recognize the symptoms portrayed by patients, take appropriate measures in their scope of practice to provide medications as well as come up with other measures for alleviating suffering. Nurses are effective patient advocates. Advocacy involves many facets of care such as giving the necessary support to patients and their families/friends, pain management, culturally sensitive practices, as well as making ethical decisions (Hebert et al., 2011). Nurses also collaborate with other multidisciplinary teams to ensure …

 Together with other healthcare team members, nurses have to ensure that symptoms are optimally managed and the patient, as well as the family, receive the needed support. Nurses, therefore, possess the ability to know whether a patient respond to medication or not. For this reason, they are better placed to facilitate end-of-life decision making. They also explain some decisions made by the healthcare teams in language that the …

Primary Policies Defining Current Healthcare Practices

Patient Self-Determination Act (PSDA) provides some of the policies regarding end-of-life care decision. For instance, PSDA stipulates that the primary mandate of EOL care ought to be based on patient care that is of high quality and culturally sensitive (Duke, Yarbrough & Pang, 2009). Secondly, it is the duty of family physicians to continue providing both psychological and spiritual needs of a patient on a death bed through advanced directive discussion as well as end-of-life planning. In addition, alleviation of pain and any form of physical destruction …

Effect of EOL Regulations The transition from curative to palliative care is usually a trying moment for physicians, patients, and the family members, because EOL or hospice care may be perceived as failure or negligence of healthcare providers or giving up of patients (Lewis, 2013). Therefore, the existence of government-run programs such as Medicare and Medicaid have improved the accessibility and affordability of hospice and palliative care.  The programs help to improve patients’ outcome and promote quality of life by making it possible for care…