Palliative Care Nursing: Providing Comfort and Dignity in End-of-Life Care

When people reach the point where healthcare treatments will no longer cure their condition or treat their symptoms, end-of-life care becomes a critical part of the healthcare experience. The final stages of life are different for each individual, depending on their age, current health, and any medical conditions they have been diagnosed with throughout their lifetime. Nurses provide physical comfort and emotional support, requiring skills in communication, advocacy, and therapeutic interventions that prioritize patient dignity.

By taking a patient-centered approach to end-of-life care, nurses can provide patients as well as their caregivers with the support they need during this transitional period.

Understanding Palliative Care

The Mayo Clinic defines palliative care as a medical specialty that focuses on providing patients with pain relief and comfort as they manage chronic or life-threatening illnesses. While not all patients receiving palliative care are in the latter stages of life, many find that palliative care plays a vital role in end-of-life care. With an emphasis on physical pain relief and emotional support, palliative care can provide patients with the comfort they need to manage serious diagnoses and chronic illnesses.

Definition and Core Principles

According to the International Association for Hospice and Palliative Care, these are the core principles of palliative care:

Providing patients and caregivers with compassionate communication.
Creating pain management strategies that take into account the personal needs and preferences of the individual patient.
Offering emotional support, such as grief counseling, to improve the mental health of patients and caregivers.
Prioritizing spiritual care in nursing and recognizing the importance of holistic treatment within palliative care.
Keeping ethical considerations in mind ensures each patient receives the compassionate and dignified care they deserve.

Differences Between Palliative and Hospice Care

Palliative care and hospice care are often used interchangeably, but the reality of the matter is that these two types of care are distinctly different. When it comes to hospice vs. palliative care, it's important to note that hospice care is available to patients who have a terminal illness and who have less than six months to live. Palliative care is available to any patient who has been diagnosed with a serious or life-threatening illness, even if they have a more positive prognosis. However, hospice and palliative care are crucial to holistic end-of-life care for patients.

The Role of a Palliative Care Nurse

Palliative care nurses are specialized nurses who work as part of palliative care teams and who provide patients with end-of-life care. They may work in hospitals, long-term care facilities, or doctor's offices, and they may work with patients of all ages and stages of life.

Responsibilities and Key Competencies

Palliative care nurses work closely with patients as well as their caregivers, requiring them to adopt a well-rounded approach to end-of-life care. Some of the primary responsibilities of palliative care nurses include:

Providing patients with basic medical care, with an emphasis on chronic pain relief.
Assessing the psychological well-being of their patients and providing emotional support when necessary.
Communicating regularly with family members and sharing information about family caregiver resources can help during this time.
Adhering to all palliative care guidelines and nursing best practices.

Importance of Compassionate Care

Palliative care nurses often work closely with their patients to help them with advanced care planning and to provide them with the support they need during this difficult time. As a result, compassionate care is critical. Palliative care nurses must prioritize cultural sensitivity, and they must be aware of the needs and preferences of the patient to provide them with the comfort and support that they need as they navigate their life-threatening illness.

Emotional Support for Patients

In addition to emphasizing the importance of pain management in palliative care, palliative care nurses must also adopt a holistic approach that includes emotional support for patients. By offering compassionate care and personalized support, palliative care nurses can significantly impact the quality of life of their patients at a critical time in their lives.

Addressing Psychological and Spiritual Needs

Because palliative care nurses work closely with their patients, they have a unique opportunity to assess their emotional well-being and address their psychological and spiritual needs. By recognizing the role that spirituality plays in a person's life, nurses can provide patients with a personalized experience that feels comfortable and supportive.

Techniques for Reducing Stress and Anxiety

Palliative care nurses can work to reduce stress and anxiety for patients as well as their caregivers by:

Creating a calming environment. For example, nurses can turn the lights down low and play soft music for patients trying to rest and relax while receiving treatment.
Patients should be allowed to share their experiences and concerns. For instance, nurses can offer bereavement support to patients and caregivers who have received a terminal diagnosis.

Physical Care and Pain Management

Patients who have been diagnosed with a chronic or life-threatening illness often deal with high levels of pain. Examples of conditions that are incredibly painful include cancer, heart disease, kidney disease, and stroke. As a result, physical care and pain management are essential components of any palliative care treatment plan.

Comprehensive Symptom Control

The ultimate goal of palliative care is to reduce pain and control the symptoms of chronic or life-threatening illnesses. Palliative care nurses often work closely with a team of healthcare providers to ensure that their patients can remain comfortable and protect their dignity as they navigate these long-term illnesses.

Promoting Comfort and Mobility

In addition to managing pain and controlling symptoms, palliative care nurses often work to improve the overall comfort and dignity of their patients. By creating a calm and comfortable clinical environment, nurses can help patients feel more relaxed and at ease while they receive treatment. In addition, palliative care nurses work to keep their patients as mobile and independent as possible, which significantly improves the confidence of their patients.

Communication Strategies

Compassionate communication plays a vital role in palliative care nursing. Not only do palliative care nurses have to work closely with patients as they receive end-of-life care, but they also have to relay vital information to family members and caregivers. By being aware of the best nursing practices and providing patients as well as their families with timely, accurate and compassionate information, nurses can improve their patient relationships and subsequently improve overall outcomes.

Engaging in Difficult Conversations

Difficult conversations are commonplace in palliative care nursing, as nurses often have to share disappointing or devastating information with patients, family members, and caregivers.

Nurses can navigate difficult conversations about end-of-life planning and life-threatening diagnoses by:

Practicing self-reflection before you have the conversation so you are in the right frame of mind.
Starting the conversation directly and avoiding small talk.
Being as compassionate and empathetic as possible when delivering difficult information.
Recognizing if the conversation is not going well, and calling for support if needed.

Cultural Sensitivity and Individual Preferences

Palliative care nurses work with a wide range of patients, all of whom have different backgrounds, belief systems, and cultural traditions. Practicing cultural sensitivity and prioritizing individual preferences when communicating with patients and family members can help you build stronger and more effective relationships with your patients.

Supporting Families and Caregivers

Palliative care takes a comprehensive approach to patient care, often requiring nurses to offer support and guidance to family members and caregivers. Supporting families and caregivers can be difficult, particularly as they are often experiencing a wide range of emotions related to the health and well-being of their loved one.

Providing Emotional and Practical Guidance

Research published in the Heart & Lung medical journal provides a list of tips that can provide palliative care nurses with practical guidance for providing family members with grief counseling and emotional support:

Build a rapport with family members by engaging them in conversation, learning more about them, and sharing more about your experience as a nurse.
Offer emotional support when family members feel scared, stressed, or overwhelmed.
Provide family members with timely and accurate information that helps them feel confident in the care that their loved one is receiving.
Support family members and caregivers during the decision-making process.

Coordinating Ongoing Care and Resources

Nurses can help bridge the gap between clinical treatment and ongoing support. By sharing information about family caregiver resources and advocating for the needs of your patient, you can guide families as they navigate this journey with their loved ones.

Discover the Importance of Empathy in Nursing at Indiana Wesleyan University

Those called to be nurses know that they are responsible for more than just providing patients with basic bedside care — they recognize that they need to offer emotional support to their patients, who are often navigating painful and daunting circumstances. At Indiana Wesleyan University, our Division of Pre-Licensure Nursing offers a wide range of nursing degree programs, all of which adopt a multidisciplinary approach to nursing and which emphasize empathy in healthcare. Suppose you are interested in providing compassionate nursing care to your patients. In that case, you will find that our evidence-based curriculum and Christ-centered education approach are the perfect fit for you.

Find your program today and request more information about campus life at Indiana Wesleyan University.

Sources

https://www.indwes.edu/academics/cas/school-of-nursing-and-health-sciences/division-of-pre-licensure-nursing/

https://www.indwes.edu/find-your-program

https://www.indwes.edu/contact/rfi-online

https://www.mayoclinic.org/tests-procedures/palliative-care/about/pac-20384637

https://www.humancareny.com/blog/understanding-end-of-life-care

https://www.nia.nih.gov/health/end-life/providing-care-and-comfort-end-life

https://pmc.ncbi.nlm.nih.gov/articles/PMC4847835/

https://iahpc.org/resources/publications/getting-started/principles-of-palliative-care/

https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/nurses-roles-and-responsibilities-in-providing-care-and-support-at-the-end-of-life/

https://www.indeed.com/career-advice/finding-a-job/what-is-palliative-care-nurse