Palliative Care as an End of Life Issue is APN

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Palliative Care as an End of Life Issue is APN Essay

Introducfamily’sliative care refers to the care of patients with a progressive illness, which is advanced. The approach improves the patient and the family’s quality of life if they are facing life-threatening illnesses. The approach relief and prevents suffering via earlier identification, assessment, and treatment of pain. Other than pain and various symptoms management, the care also aims at providing spiritual, psychological, and social supports to patients and families to achieve a better quality of life. The development of hospices and cancer palliative care has grown in areas such as the UK after the first world hospice was opened in the year 1967 in London. Currently, the end of life care and palliative care are the areas of research which are growing worldwide. Furthermore, palliative care leads to life affirmation and supports the process of dying throughout the illness of the patient. Palliative Care as an End of Life Issue is APN Essay.There are also some palliative care key components, such as nontraditional therapies, family involvement, and spirituality. This paper will discuss palliative care as an end of life issue is APN.



There is a need to discuss the palliative care approach since it an urgent health priority. Older people are prone to various illnesses, and they need care, and thus, palliative care is needed for a better quality of living to such people in the world. The aging demographic is increasing since there is a steady increase in people who are 65 years in the European region of WHO. The ground of the older people represents an approximate of 15% of the European region population (Hall, 2011). By the year 2050, there is some estimation which is indicating that a greater than a quarter of the European population will be 65 years even older.

A discussion of palliative care is needed due to the changing patterns of diseases. Traditionally palliative care has been offered to the people living with cancer, but people who are older than 85 years are likely to die because of cardiovascular disorder than cancer (Hall, 2011). Palliative Care as an End of Life Issue is APN Essay. To meet the older people’s needs in the coming future requires improvement in palliative care access also to include people dying from diseases and not only cancer and also those who are multiple illness victims. Palliative care should also be discussed to meet the complex needs of older people. When the disease of the patient is progressing, and the need for care are changing, there is a need to have a free conversation with them and the families is crucial. The discussion may include the understanding and the expectation of the patient about their current prognosis and treatment. There should be a discussion of the issue to know it’s essential and impacts.

Background history

Palliative care started focusing on caring for the dying patient. There was the first articulation of ideas by Dr. Cicely concerning modern hospital care in the early 195os based on the observation of patients who were dying. According to the doctor, an interdisciplinary team can relieve the dying patient pain, and the concept of the team is at the palliative care core. During the year the 1960s, Elizabeth Ross wanted people to be treated with honest communication, openness, and respect at the end of life. In the year 1974, a surgical oncologist Dr. Balfour Mount in a hospital in Canada invented palliative care term to prevent the adverse connotations in the French culture of the word hospice and introduced the inventions of Dr. Saunders into the teaching hospitals. Palliative Care as an End of Life Issue is APN Essay.

In the year 1997, the medicine report institute, “Approaching Death: improving care at the end of life,” acknowledged the glaring deficiencies at the end of life care in America. Receiving support from Foundation of Robert Wood Johnson and the Open Society of George Soro, there was the launch of the efforts aimed at bringing palliative care in mainstream medicine and nursing. There was also the project for clinical demonstration, palliative, and end of life care content review of the core textbooks, the awareness of the consumers, and the NIH state conference. In the year 2004, there was the release of the guidelines for quality palliative care. By approaching the year 2006, there were 57 fellowship programs for palliative care with about 100 trainees.

During the year 2006, there was recognition of the subspecialty of palliative and hospice medicine by the American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education. Palliative Care as an End of Life Issue is APN Essay. The palliative medicine is the continuance of the struggle to the acceptance of the life its term, openly, and honestly. Putting it in the place of the academic medicine, it will make the physicians of the coming future generations gain the skills in the palliative medicine while they advance their knowledge in this field and fulfill the requirements of the patients and their families.

Exploration and analysis


The quality of care which palliative care receives is depending on the skills and knowledge in end of life care and symptoms management. Currently, nurses who lack palliative care education are prohibited from practicing in the specialty of palliative care. The education in nursing palliative care aids the nurses in improving their knowledge and skills, provision of optimal pain competent assessment, and the management of the symptoms, which leads to the improvement of the practice of nursing. The few opportunities for the nursing palliative education and variability for the education of the nurses and the training are some of the reasons why the nurses are not prepared for the provision of palliative care. The lack of education in palliative care by the nurse will lead to the creation of the unconnected links between the scientific approach to care and the patient-centered focus of the care. Palliative Care as an End of Life Issue is APN Essay.


Adams et al. (2011) examined the APNs role in palliative care, which is an end of life care for the students in the field of nursing. According to the end of life, care is a part of the role of the APNs role, which sensitive because it involves both the patient and the family members. The manifestation of the effects of the APN is via being brokers, advocates, and supporters of the patient who lacks the knowledge and skills of managing their conditions (Adams at al., 2011). The APNs possess the expertise and the skills to teach the members of the family on the ways of treating the patient at the end of life care with dignity.

According to Cleary(2016), there is a discussion that regardless of the palliative care program’s growth, the expansion of such programs in the society lacks the major care providers such as the nurses’ practitioners to provide palliative care. There is also an explanation that the victims of chronic life have the probability of living several years with the symptoms increase, and the quality of life decreases. Furthermore, there is an explanation of how palliative care is integrated into primary care and a discussion of the benefit of this because the provider of primary care has a relationship that is established with the patient (Cleary, 2016).

Kolowes (2015) discusses the impact of the APNs to the end of life care by offering the patient and the families with prognostic information, which is ongoing. In the article, the APNs is crucial professional in the preparation of the patient and the families in the process of making decisions which are critical at the end of life care. Palliative Care as an End of Life Issue is APN Essay. In particular, the APNs acts as the counselor to the patient and the families at the end of life care (Kolowes, 2015). The role has the effect of preparing the patient and families and makes them appreciate a disease which life-threatening as a normal occurrence and hence make them accept the current situation that they are facing. The article also highlights the effect of providing information about the trajectory and prognosis of a disease so that there is an improvement in communication among all the palliative end of life care players.

The gerontological APNs affect the elderly end of life care via providing the needed support by the patient to assure that they have comfortable and self-determined death. The positive impact of APNs on the end of life care includes spiritual, social, and emotional support to the end of life care patients. The APNs also promotes the patient’s quality of life at the end of life care through the offering of counseling to the patient (Herderson, 2014). APNs also promote coordination and communication of the care in patients with dangerous diseases such as cancer. There is also the importance of gerontological APNs in the management of symptoms in the patient who are at the end of life care.

Patients with advanced cancer have extreme paint, with 80% prevalence among the last stages of palliative patients. These patients need opioids for their treatments. During the last weeks of life, the pain to the patients is widely prevalent even regardless of the setting under which the patients are being managed (Nezar, Abdallah & Nusairat, 2016). The management of pain in the population with advanced and serious illness should be taken into consideration within a broader model of palliative care. Furthermore, the palliative care key domains are the symptoms and the pain control, which needs to be combined with other strategies to approach the patient with a life-threatening illness. Palliative Care as an End of Life Issue is APN Essay.


Palliative care is relevant in the nursing education practice due to various reasons which will be of the benefits is that through the palliative nursing education there is the provision of knowledge and skills to understand and recognize the end of life experience, symptoms and pain management, advance care planning, and goals of care. Beliefs, personal values, and cultural influences can affect the ability of a person to get a better understanding of the end of life issues. Through education, there is the maintenance of the emotions and knowledge balance in decision making via self-reflection and critical thinking to make relational decisions. Through education in palliative care, the nurses will gain knowledge, reflect, interpret and reinterpret their experience and be able to communicate their emotions to constrict a feeling of empathy and respect that stimulates a positive learning transformation.

Another significant benefit of palliative to the advanced practice nursing is the improvement of the emotional and the physical symptoms and the caregiver and the patient (Kavalieratos et al., 2016). With the main goal of providing support to the quality of life of the patient, palliative care emphasizes the illness management or symptoms that are related to the treatment. Similarly, the aim of palliative care is the management of proactive symptoms through the use of quality and comprehensive treatments, and the nurses will benefit from the aim. There is the production of some earlier models for the management of symptoms by the nurses, and hence these models lead in the translation of evidence-based strategy of symptom management in practice. Palliative Care as an End of Life Issue is APN Essay.

Through palliative care nursing education, nurses can gain some relevant skills as they can make accurate assessments. The assessments are a result of the nurses having the ability to develop a plan for dealing with side effects and symptoms. The common involved issues are anxiety, dyspnea, lethargy, vomiting, and nausea. The palliative care nurse has the responsibility for the implementation of the technique for the minimization of these issues, which are causing troubles. The benefit of these is that the family and the patient are made more relaxed and comfortable.

The nurses who are receiving education on the nursing practices will be able to offer a conversation about the end of life issues to the patient. There is some importance to having such discussions. The discussions related to the end of life will make the patient satisfied with the care that they are receiving. There is the end of life steadfast focus on the nurses who are working in palliative care. The hallmark of palliative care is the 24 hours availability. The aim of the availability focused on managing pain, symptoms, and side effects and also offering family support. The palliative care nurses will possess excellent listening skills since the focus is not only on the pain and the various symptoms but also on the guidance, counseling, and compassionate listening. Through these roles, they promote and provide the highest patient and family quality of life.


Through palliative education care in advanced practice nursing, the nurses receive education on how to take care of the patient at various levels of the illness stages. However, their roles in there are no more emphasis on the nurse role in dealing with the families and the patients at the end of life. The lack of palliative care nursing education has the probability of bringing low self-esteem, low self-confidence, and the uncertainty felt in the performance of the assigned task due to fear that the care may be inappropriate. Palliative Care as an End of Life Issue is APN Essay. The nurses who do not have training and knowledge in the field of palliative care are likely to be overwhelmed. Honoring the wishes of the patient and understanding the preference of the family to the care to their patients can also be difficult in handling. With knowledge in palliative care, there can be the effective provision of the care with respect and dignity with the honor of both the wishes of the family and the patient. If the nurses can receive the required training and education in the caring of the dying patient, there will be the development of positive attitudes, and thus the probability of the nurse withdrawing from the end of life patient care will be less.

In conclusion, there is a need for the nurses to able to provide palliative care for the management of the patient symptom and the improvement of the quality of life of the patient. The crucial elements to deliver resonate for palliative care, together with the important elements of the practice of nursing, are communication, symptoms management, and advocacy. The nurses providing care must have an affirmation of their crucial roles in the provision of palliative care without considering their setting role, or education. As the palliative care, pervasiveness continues all over the world, and the evidence gives a demonstration of its importance for the families and the patients. In the provision of palliative care, the nurse must give a better demonstration. Through the increase in research, support and education, there can be a collaboration of the nurses and the clinical partners to continue addressing the palliative care goals for the families and the patient. Palliative Care as an End of Life Issue is APN Essay.