End of life in acute care

In today’s society, now we have seen many great advances in medicine, science and technology which have led to an aging population with chronic diseases. Often, these problems require frequent or long-term hospitalizations within the emergency room. With this in mind, selections have to be made that include discussing end-of-life care goals with patients and their families. As nurses, we must work hard to offer high value end of life provide these patients with emergency room care when death is imminent.

Although many patients would like to die at home, the reality is that almost all will die in intensive care facilities or other health care facilities. For years, end of life Critical care has made great strides in implementing specialist practices corresponding to palliative care.¹ However, what a couple of healthcare organization that doesn’t use such specialization? end of life care provided?

The first step to the flexibility to plan and ensure well-being end of life Care involves the patient, family and nursing staff accepting death.¹ All energetic life-sustaining medications should then be discontinued. These medications include, but are usually not limited to: intravenous fluids, antibiotics, insulin, steroids, and blood pressure medications, but intravenous access have to be maintained to manage the medication. end of life medicines. Typically within the intensive care unit before transferring the patient to hospice or if the patient is waiting for a hospice bed, the usual appropriate medical procedure for transferring the patient to hospice end of life care begins. A bolus of morphine and/or a muscle relaxant corresponding to Ativan is run. These medicines are administered end of life cases to cut back any anxiety you might feel and to alleviate the sensation of shortness of breath. It may be very essential to keep in mind that the administration of those drugs isn’t intended to cause death, but to assist the patient relieve the symptoms that always accompany dying.

A continuous infusion of morphine is then initiated and the dose titrated to the patient’s comfort. Medicines are sometimes given to assist the patient’s secretions (corresponding to levsin). Basic nursing care corresponding to oral care, turning and repositioning the patient also needs to be continued.

With life comes death. As good as we’re as health care staff, as a occupation now we have yet to forestall anyone from dying. We kept people alive longer, but everyone dies sooner or later. Much of this understanding mustn’t be about when, but how. In the occupation, when patient care transitions to end of life watch out, we can’t allow them to down. We often begin to fail a dying patient when the health care team fails to offer what they need. If death results from a disease process or hospital admission, then as a health care system we’re failing the patient by not ensuring a very good death. It is solely inconceivable to cure everyone, but what we will do as a occupation and as patient advocates is to make sure that the patient dies comfortably of their final journey of life.

Reference
Bloomer, M., Moss, C., & Cross, W. (2011). End-of-life care in acute hospitals: an integrated review of the literature. (3), 165-173.