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There are various definitions of the term ‘palliative care’.

Health care professionals

have an inclination to utilise the term interchangeably with ‘end-of-life’ care or

‘hospice care’, but presently many claim that palliative care should be incorporated

with curative care, starting soon after a patient is diagnosed with a potentially life-

threatening illness (Polit and Beck, 2014). Indeed, the World Health Organisation

(2017) define palliative care as “early identification and impeccable assessment and

treatment of pain and other problems, physical, psychosocial and spiritual.”

The ability to provide palliative care is a skill set that nurse practitioners should

acquire, develop, and refine. The relief of suffering – physical, emotional and spiritual

– leads to even better patient outcomes and increased patient satisfaction (Chan et al.,

2015). But nurses in palliative care are not only expected to present thorough and

effective symptom assessments and management and complete medical directives that

guide care with life-limiting/life-threatening illness. One of the most important roles

also include being a support, not only for the patient but for his or her respective

family also. Popejoy et al. (2009) describe nurses’ actively involving patients in end-

of-life planning and provide examples of allowing and encouraing family to stay or

sleep at the bedside as means of emotional support measures for both the dying

patients and their family relatives.

Equally as important as the distressing physical symptoms are issues related to

spsiritual or emotional distress. Knowing whether the patient considers religion or

spirituality important to them and asking if they feel supported is included in the

spiritual assessment. Palliative care can involve asking the patient if they have

specific religious or spiritual beliefs that can be incorporated into the plan of care, if
they are supported in a faith community, and whether they need connection and

support (National Insitute for Health and Care Excellence, 2014). Spiritual advisors

should be referred to when these needs surpass the nurse’s skills. Emotional support

involves supporting and encouraing traditional, cultural or religious practices and

spending time with patients to provide psychological support (Mak et al., 2013).

Emotionally supportive relationships seem to rely on the nature of the interpersonal

interactions between patient and nurse (Nelson et al., 2010). Indeed, communication

is one of the most important aspects of nursing care in improving outcomes for

patients with palliative care and their families who are experiencing psychological

and emotional distress. It is implied that nurses have invalulable opportunities to help

decrease disorders and emotional problems (Walker and Deacon, 2015). Initially, this

seems to involve nurses familiarising themselves with patients’ experiences, in order

to get to know them and be able to work collaboratively with them. Palliative care

nurses develop asupportive relationship through connecting with patients (World

Health Organization, 2015).

There also suggests a relationship between the provision foe motional care and

support and other nursing activities, such as comfort and enabling others to act for

themselves through empowerment (Polit and Beck, 2014). Nurses who communicate

emotional support in a variety of ways during comforting interactions, both verbally

(affirming statements, reassurance, empathy, encouragement, sympathy and

commiseration) and non-verbally (touch, increasing proximity), have been noted to

create an atmosphere of acceptance to help patients endure experiences of physical or

emotional distress (Mak et al, 2013).


Certainly, the stages of illness and level of symptom distress may also influence

provision of emotional care and support. There is a link between symptom distress

and the number of interventions classified as emotionally caring (Nelson et al., 2010).

Patients with high levels of symptom distress receive more interventions focusing on

providing psychological and emotional care.

In conclusion, nurses in all fields care for people with serious or potentially life-

threatening illness. While the priority of palliative care is to prevent and relieve

suffering, nurses have an opportunity to offer a supportive role to patients in palliative

care. This relief of physical, emotional and spiritual suffering can lead to improved

patient outcomes and can also increase patient satisfaction during a trying period of

their lives.
References:

Chan, W., Tin, A. and Wong K (2015) ‘Coping with existential and emotional

challenges: development and validation of the self-competence in death work scale’,

Journal of Pain & Symptom Management, 50(1), pp. 99–107.

Mak, W., Chiang, L. and Chui, T. (2013) ‘Experiences and perceptions of nurses

caring for dying patients and families in the acute medical admission setting’,

International Journal of Palliative Nursing, 19(9), pp. 423–431.

National Institute for Health and Care Excellence (2014) End of Life Care for Adults.

Available at: https://www.nice.org.uk/guidance/qs13/chapter/Quality-statement-5-

Holistic-support-social-practical-and-emotional (Accessed 29 November 2017).

Nelson, E., Puntillo, A., Pronovost, J., Walker, S., McAdam, L., Ilaoa, D. and Penrod,

J. (2010) ‘In their own words: patients and families define high-quality palliative care

in the intensive care unit’, Critical Care Medicine, 38(3), pp. 808–818.

Polit, D. and Beck, C. (2014) Essentials of Nursing Research: Appraising Evidence

for Nursing Practice. Philadelphia: Lippincott Williams & Wilkins.

Popejoy, L., Cheyney, L., Beck, M. and Antal, L. (2009) ‘Intensive care unit nurse

perceptions of caring for the dying’, Journal of Hospice and Palliative Nursing, 11(3),

pp. 179–186.
Walker, W. and Deacon, K. (2015) ‘Nurses’ experience of caring for the suddenly

bereaved in adult acute and critical care settings, and provisions of person-centred

care: a qualitative study’, Intensive & Critical Care Nursing, 33(1), pp. 39–47.

World Health Organization (2017) Cancer: WHO Definition of Palliative care.

Available at: http://www.who.int/cancer/palliative/definition/en/ (Accsessed 29

November 2017).

World Health Organization (2015) Health Systems and Services: The Role of Acute

Care. Available at: http://www.who.int/bulletin/volumes/91/5/12-1126 64/en/

(Accessed 29 November 2017).