scholarly journals The Slippery Slope Syndrome

2021 ◽  
pp. 1-14
Author(s):  
Eric Vermeer
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
Ethics Committee ◽  
Slippery Slope ◽  
Mental Illnesses ◽  
Psychiatric Services ◽  
The Past ◽  
Difficult Situations ◽  
Nursing Teams

AbstractFor more than 20 years I have practiced nursing, first in oncology services, then in palliative care. As a teacher and psychotherapist for the past 10 years, I have had the opportunity to continue working with nursing students in palliative care and psychiatric services, as well as to supervise nursing teams. An ethicist by training, I belong to an ethics committee in a neuropsychiatric hospital. Wearing these different hats gives me the great privilege of encountering patients at the end of life or who suffer from mental illnesses as well as nurses and students who face difficult situations, and to review in the ethics committee clinical situations involving great suffering.The question of euthanasia comes up very regularly and occasions numerous discussions that are both emotional and engaging.

scholarly journals End of life breast cancer care in women with severe mental illnesses

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Guillaume Fond ◽  
Vanessa Pauly ◽  
Audrey Duba ◽  
Sebastien Salas ◽  
Marie Viprey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Palliative Care ◽  
Health Disparities ◽  
Major Depression ◽  
End Of Life ◽  
High Intensity ◽  
Bipolar Disorders ◽  
Mental Illnesses ◽  
Targeted Interventions ◽  
Eol Care

AbstractLittle is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities.

scholarly journals The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review

2018 ◽  
Vol 35 (8) ◽  
pp. 1140-1154 ◽  
Author(s):  
Madison B. Smith ◽  
Tamara G. R. Macieira ◽  
Michael D. Bumbach ◽  
Susan J. Garbutt ◽  
Sandra W. Citty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
Communication Skills ◽  
End Of Life Care ◽  
Learning Experiences ◽  
Life Care ◽  
Simulation Based ◽  
End Of Life Communication

Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.

scholarly journals Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey

2019 ◽  
Vol 74 ◽  
pp. 7-14 ◽  
Author(s):  
Maria Dimoula ◽  
Grigorios Kotronoulas ◽  
Stylianos Katsaragakis ◽  
Maria Christou ◽  
Stavroula Sgourou ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing

Palliative care knowledge and self-awareness in active and observing undergraduate nursing students after end-of-life simulation

2020 ◽  
Vol 26 (3) ◽  
pp. 133-142
Author(s):  
Amanda J Kirkpatrick ◽  
Mary Ann Cantrell ◽  
Suzanne C Smeltzer
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
Repeated Measure ◽  
Self Awareness ◽  
Undergraduate Nursing ◽  
Test Study ◽  
Before And After ◽  
Post Test ◽  
Quasi Experimental

Aim: The purpose of this quasi-experimental one-group repeated measure (pre-test/post-test) study was to determine the effect of an end-of-life (EoL) simulation-based experience (SBE) on active and observer nursing students' palliative care knowledge and self-awareness. Background: Baccalaureate nursing (BSN) graduates must demonstrate competence in EoL care; however, gaining EoL experience is challenging given constraints on nursing faculty and clinical sites. Research also is needed to determine whether similar outcomes are achieved by active and observer participants after EoL SBE. Method: Senior-level BSN students' palliative care knowledge and self-awareness of active and observer participants were measured before and after an EoL SBE. Results: Knowledge and self-awareness increased (P<0.001) post-SBE in all participants, with equivalent post-test scores (P≥0.248) for active (Mattitude=130.1; Mknowledge=80.5) and observer (Mattitude=128.3; Mknowledge=77.9) participants. Conclusion: EoL SBE is an effective method for increasing student palliative care competence. Student observers benefit as much as active participants on knowledge and self-awareness outcomes.

I Won’t Let You!

2020 ◽  
pp. 53-58
Author(s):  
Elissa G. Miller
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Treatment Plan ◽  
Ethics Committee ◽  
Palliative Care Team ◽  
Care Team ◽  
Medical Providers ◽  
Goals Of Care ◽  
Patient Families ◽  
Hospital Ethics

Conflicts between patient families and medical providers arise frequently. Providers and families may disagree about a patient’s prognosis, the use of life-sustaining medical treatment, the treatment plan, and other issues. Such conflicts may be exacerbated at end of life, especially at end of life for a pediatric patient. Working through such conflicts is a common role for the palliative care team. As with much of the team’s work, it relies on establishing goals of care and partnering with families to resolve conflict as well as engaging the hospital ethics committee when conflict persists. This chapter discusses the multiple ways conflicts may arise in caring for a dying child and makes recommendations for how to resolve them.

Hospice Palliative Care Volunteers’ Experiences With Unusual End-of-Life Phenomena

2016 ◽  
Vol 77 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Stephen Claxton-Oldfield ◽  
Alexie Dunnett
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Family Member ◽  
Volunteer Training ◽  
The Past ◽  
Dying Patients ◽  
Life Phenomena ◽  
Hospice Palliative Care

Forty-five Canadian hospice palliative care volunteers responded to a survey examining whether they had witnessed or been told about any unusual end-of-life phenomena (EOLP) in their work with dying patients and their families in the past year. The most commonly witnessed EOLP were patients talking to or reaching out their hands toward deceased relatives or friends (34%), occurrences of terminal lucidity (33%), and patients seemingly getting ready for a trip or journey (28%). At least a third of the volunteers indicated that a patient or a patient’s family member had told them about visions or dreams of deceased relatives or friends (47% and 44%, respectively), seeing beautiful places or colors or hearing wonderful music (38%), terminal lucidity (38%), and deathbed coincidences (33%). The majority of volunteers were accepting of spiritual explanations for EOLP and rejecting of scientific or medical ones. Ninety-six percent of the volunteers felt that information about EOLP should be included as part of their volunteer training.

scholarly journals Awareness and Attitude of Undergraduate Nursing Students at King Saud bin Abdul-Aziz University Regarding Palliative Care

2021 ◽  
Vol 3 (3) ◽  
pp. 14
Author(s):  
Mona H. Afifi ◽  
Reema H. Alharby ◽  
Haya A. T. Alanizy
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
End Of Life ◽  
Nursing Care ◽  
Terminally Ill ◽  
Response Analysis ◽  
Negative Attitudes ◽  
Convenience Sample ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing

Context: Palliative care (PC) is a form of care that aims to enhance the life quality of patients and their families who are dealing with the effects of the life-threatening disease by preventing and alleviating distress by early detection, accurate evaluation, and management of pain and other physical, psychosocial, and spiritual issues. Aim: This study aimed to assess the awareness and attitude of undergraduate nursing students at King Saud bin Abdul-Aziz University regarding palliative care. Methods: A descriptive cross-sectional design was utilized to achieve the aim of this study. The study was conducted at the College of Nursing - Riyadh, affiliated to King Saud bi Abdul-Aziz University. A convenience sample of 273 nursing students from level five to level eight voluntarily participated in this study. Data were collected by using two tools. A self-reported questionnaire was designed to assess the students' awareness of palliative care. Frommelt Attitude Towards Care of the Dying (FATCOD) Scale was adopted to measure participants’ attitudes toward providing care to dying patients. Results: The results show that about 36.3% of nursing students were in the age group of 21 years old, and 73% were in the sixth academic level. 75.5% of the nursing students were not aware of palliative care, 30.30% knew about PC from the elective course. 96.33% of students had no experience caring for terminally ill patients and their family members previously. The students' response analysis of PC definition revealed that 89.74 of them could not define it correctly, 41% could not know the aim from PC, 43% of students identified the need of terminally ill to reduce the physical suffering. The students' attitudes toward palliative care showed a swing between positive and negative attitudes. As 81% of students believe that giving nursing care to the dying person is a worthwhile learning experience, 65.5% agreed about nursing care for the patient's family should continue throughout grief and bereavement. In comparison, 77.3% would hope the person they cared for dies when they are not present, and 41.5% of the students believe that they would be uncomfortable talking about impending death with the dying person, and 40.9% were uncertain about this. Conclusion: Knowledge about palliative care among undergraduate nursing students remained relatively poor overall. Attitude toward end-of-life care shows a swing between positive and negative attitudes yet still reflected an evident lack of comfort in dealing with death and dying. Structured courses in palliative care are recommended as a core part of undergraduate nursing education. The suggested course should encompass basic professional skills, symptom control, patient-centered communication, ethical issues, decision-making at the end of life, whole-person care, and interdisciplinary work.

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