Principles of nursing
INTRODUCTION
According to King, end-of-life-care can be explained as the well-being keeping for an individual with an extreme condition that is advancing, escalating, and has no known treatment. End of life care needs various resolutions that revolve around palliative care queries, patients’ freedom of nursing, the medical exploration of the ethics and efficiency of unique or dangerous mediations, and the principles and effectiveness regarding constant sequence medical involvement. Also, the end of life involves the distribution and budgeting of resources in healthcare facilities and national medical programs. These resolutions are instructed by practical, medical deliberations, economic aspects, and also moral philosophy.
Palliative care is a deception used to ameliorate the standard of the well-being of patients and their relatives concerning the life terminal disease, by the control and alleviation of suffering. The care is done through prime recognition and faultless evaluation and medication of pain and various concerns related. Palliative care aids in alleviating pain and different traumatizing signs, attest existence and sees death as a natural step in the cycle of life. It incorporates the psychological and spiritual concepts of a patient’s well-being keeping. Palliative care assists in aiding patients live purposefully as they can and provides a support anchor for the patient relatives to manage their member’s sickness and manage their grief.
According to Coyle and Paice, 2015 providing palliative care strongly relies on the nurses’ possession of strong interactive abilities and clinical proficiency, as well as being informed through acclaim for the patient and moral standards of self-governance, beneficence, altruism, and impartiality. The sterling, warm and passionate connection of a nurse to her or his patient is a healing connection and a synergy of state-of-art impersonal skills with loyalty to the patient, the potential to listen and be available during the suffering and distress period, as well as conversing efficaciously. Nurses are deeply involved in the well-being keeping for patients at the end of their existence. They can describe in technical ways the situation to the patient after the doctor is done with the patient. Besides, nurses carry out their duties supporting the patients, due to their numerous interactions that enhance their awareness of the patients’ needs, ailing signs, and past medical records.
Understanding of Intellectual Disability and the Nurses’ Role in Providing EOLC
The United Nations Development Program approximates that eighty percent of individuals with dysfunction conditions come from low-income economies. Different persons have distinct potentials that evolve at their own pace. Certain persons may find learning and comprehension of ideas complicated due to Intellectual Disability (ID). Intellectual Disability refers to a person’s situation of various challenges in apprehension potentiality and expertise, as well as conversing, communal as personal hygiene maintenance abilities. These challenges occur to infants before they are of age or before birth, where they are characterized with slow maturity and comprehension than healthy growing children. A person is deemed intellectually disable if their IQ is below 70 to 75, where a person faces challenges in developing abilities to maintain their well-being, work, live or interact with others. The ID concern evolves before the adulthood age (Scior, 2016). Regardless it is good to note that intellectual disability is very different from mental sickness and is not contagious. Intellectual disability can result from ailments, brain issues, or injuries, but in some cases, the causes are undiscovered. In situations like the Down syndrome, Fetal Alcohol Syndrome, Fragile X syndrome, congenital disabilities, and infections often arise before birth and others immediately after a child is born. The frequent causes of ID are abnormal genetics absorbed from the parents or misconceptions due to the mixing of genes like the phenylketonuria (PKU). Pregnancy impediments and complications during delivery are also a common cause of ID, due to poor development of the fetus. If an infant lacks enough oxygen during birth or concerns in the course of labor can also cause ID. Also, ailments or poison exposure like whooping cough, measles, or meningitis can cause intellectual disabilities (Faull & Blankley, 2015). The palliative nurse’s primary obligations are to lengthen the quality of ailing patient’s existence with their families, by controlling, infant recognition and evaluation of pain and possible issues regardless of their interpersonal, emotional, psychological or spiritual nature. The nurses are responsible for monitoring patients, controlling pain, administering medication, managing gadgets, and giving patients individual care, like bathing and dressing (Atkins et al., 2020). Palliative care’s main objective is to support patients to live as actively as they can and maintain dignity and alternatives through the end of life.
Barriers to Effective EOLC and their Minimizations
According to Ferrell & Coyle, 2015 nursing working under palliative care are faced with challenges in dispensing maximum their palliative keeping and end of life care to their patients due to insufficient and lack of proficiency in both palliative care and end of life care. Communication challenges and inadequate facilities, consisting of practitioners, medicines, and medical equipment, are also common. For nurses to effectively perform their duties at the end of life care, transparent and improved programs from the state authorities are required to support the doctors and nurses in evolving their skills. Enough facilities and medical equipment should be increased, and the introduction of teaching and training programs should be implemented for nurses to develop their working experience (Kissane et al., 2017). Palliative care and topics linked with the end of life should be incorporated in nursing courses to have a clear comprehension of their patients’ handling. The authorities also have a crucial responsibility in maintaining equilibrium. They disperse the health workers with sufficient knowledge of various facilities and those involved in palliative care of EOLC. Encouragement of interdisciplinary collaboration among health facilities, centers, and regional communities by the governing authorities to empower end of life care nurses with more proficiency (Kissane et al., 2017).
Ethical and Legal Requirements in EOLC
Nurses often become witnesses to the conflicting and challenging decisions involved with EOLC patients and their families concerning the emotional circumstances. Nurses have their specific and unique norms, principles, and customs to adhere to, although certain things they do not rhyme with those of patients’ believes, cultures, or desires, resulting in internal disputes within the nurses. Nevertheless, of all mediations and treatments, nurses need to dedicate their efforts in supporting the patient to consider the benefits and challenges of the arbitration, instead of dwelling on the intervention alone (Macauley, 2018). Nurses require comprehension of the concerns that can emerge in the course of life resolutions to prepare for the outcome properly and have an idea of what to do in the situations. They should possess a primary understanding of palliative care’s nature and the principles of attention available in the standard of professional Nursing Practice from the Australian Nursing Association. And, the nurses can reference from the Code of Ethics for Nurses with Interpretive (Browne et al., 2018). The primary ethical standard applied outlines for nurses and chiropractors in the keeping, and patients’ resolution is justice, beneficence, autonomy, and nonmaleficence. These ethics ensures that the patients’ freedom is safeguarded as required by the primary moral standards.
Intellectual Disabilities and the National Palliative Care Standards.
Palliative care should steer its primary objective in catering to the needs, desires, and principles of patients, their families, and professions. An individual and family-oriented attitude to end-of-life-care thrive on successful communication, combined and cooperated resolution processes, and individual autarchy foundations. As individuals with intellectual dysfunctions life expectancy increases, they often diminish due to old age ailing like cancer. As a result, intelligent dysfunctioning persons will need excellent personal care services at the end of their lives (Martzo & Sherman, 2018). The National Palliative Care Standards distinctively illuminate and stimulate inspiration for a compassionate and necessary professional palliative care. The principals identify the essence of is individual-oriented and within the acceptable age gap and require distinct attention due to the vulnerability. The standards are critical to the professional palliative care services with a sole practitioner and more extensive services that are more resourced with detailed investigations and training responsibilities. There are universal prescriptive principles that include inspirational aspects that aid the services with developing capacity and potential.
It is evident that with good cooperation from palliative care centers and intellectual dysfunction centers, persons with intellectual disabilities usually experience the best end of life assistance. The national palliative standards ensure the palliative caregivers provide the best possible care without going against the patients’ will. An establishment of the responsible co-ordinators of the attention is outlined (Martzo & Sherman, 2018).
CONCLUSION
The essential obligations and responsibilities consist of being available, which allows nurses a crucial role in palliative care and presents opportunities for becoming a supervisor of care for patients and their families, together with various health caregivers. Taking care of intelligent disabled patients requires dedication, time, and good-hearted attitudes from the nurses with a high level of understanding. Health expertise is needed to be focused on comprehending the person’s conversations to confirm the correct symptoms and indications for precise diagnosis and handle the subject concerns with a more humanitarian attitude. Also, they need to comprehend of consent problems, and to ensure the certainty of the patients’ involvement in all resolutions by cooperating with the patients’ relatives, carers and supporters, communicate appropriately and work together. The patient is the essential person in the care facility centers; thus, it is critical to give excellent palliative attention.
The nurse is the connections between the various divisions of health care, amongst different experts and between patients and their relatives, which contributes to certifying that standard attention is given to the individual patient. Allow personalized designed end of life care to patients with intellectual disabilities and life-threatening illnesses and their families, and the nurses require more proficiency in primary nursing. Situations challenge nurses in practical, relational, and ethical angles of care and make requirements on their role in a detailed manner subject to the health practice: Nurses need knowledge and training, counseling and assistance to fulfill their responsibilities.
References
Atkins, K., Lacey, S. D., Ripperger, B., & Ripperger, R. (2020). Ethics and law for Australian nurses. Cambridge University Press.
Browne, C., Wall, P., Batt, S., & Bennett, R. (2018). Understanding perceptions of nursing professional identity in students entering an Australian undergraduate nursing degree. Nurse Education in Practice, 32, 90-96. https://doi.org/10.1016/j.nepr.2018.07.006
Coyle, N., & Paice, J. A. (2015). Oxford textbook of palliative nursing. Oxford University Press, USA.
Faull, C., & Blankley, K. (2015). Palliative care. Oxford University Press, USA.
Ferrell, B. R., & Coyle, N. (2015). Oxford textbook of palliative nursing. https://doi.org/10.1093/med/9780199332342.001.0001
King, G. (2017). Providing quality care at the end of life. A Textbook of Community Nursing, 267-288. https://doi.org/10.1201/9781315157207-14
Kissane, D. W., Bultz, B. D., Butow, P. N., Noble, S., Bylund, C. L., Clinical Reader, and Palliative Medicine Consultant Simon Noble, & Wilkinson, S. (2017). Oxford textbook of communication in oncology and palliative care. Oxford University Press.
Macauley, R. C. (2018). Ethics in palliative care. Oxford Medicine Online. https://doi.org/10.1093/med/9780199313945.001.0001
Martzo, F. M., & Sherman, D. W. (2018). Palliative care nursing: Quality care to the end of life (5th ed.). Springer Publishing Company.
Scior, K. (2016). Toward understanding intellectual disability stigma: Introduction. Intellectual Disability and Stigma, 3-13. https://doi.org/10.1057/978-1-137-52499-7_1