End of Life Issues

To establish a favorable relationship between a nurse and patient, which is replaced with a term called trust, ethical principles, such as dignity and autonomy (Rich & Butts, 2008) serve as a baseline for trust. If those are not respected, nursing environment may turn dysfunctional where the nurse focuses more on the illness versus the patient. In this situation, the relation between them tends to be dry, which means that a nurse is not interested in a patient except for treatment of the illness.

However, there are lots of meanings on a patient who is treated by a nurse along those ethical principles. The trust between them can be established upon following those ethical principles. A patient as a human is more open in such circumstances with nurses who respect a patient and deals with him or her as a whole person. This approach makes it possible for nurses to make some attempts, such as providing compassion and bi-communication to their patients.

These features in nursing clinical are functional upon the ethical principles, such as dignity and autonomy through respect. This approach can be applied for all age groups because all people have wisdom which can be used to cope with something wrong, such as illnesses. Nurses need to locate it in a patient through the compassion and bi-communication. These tactics reflect on nursing interventions as a form of cooperation between a nurse and a patient. Hence, quality of care goes up as a result of the collaboration. The collaboration between them is a proof of trust which is a powerful factor in moving toward well-being, not only for a patient but also a nurse in the health care system.

Possessing these ethical principles in nursing work is a challenge because the busy daily-routines in dealing with the lives of patients puts those concepts away. Qualification of nurses, therefore, has importance to keep an attitude as a professional nurse who has a capacity all the time to pursue nursing ethics. The capacity of a nurse who realizes and activates those principles depends on the nurse. Not only the education in nursing ethics but also their life experience as a human influences the capacity in terms of how unique every human is. This qualification is necessary to build up a functional trust between a nurse and a patient, which could produce fruitful outcomes, such as the well-being of patients.

A life span is limited in a human who might think about how he or she should live out their life, especially if he or she is being considered as part of the older generation. They may wish to finish their lives surrounded by their families. However, a situation where they are in a long-term care facility, such as a nursing home may not be an ideal place for their expectations because of issues that affect the quality of care which also leads us to a fundamental point, such as nursing ethics. In these long-term care facilities, an ethical principle, such as dignity is easily forgotten by nurses whose practice consciously or unconsciously becomes harmful to the vulnerable generation.

The nurses are educated in an ideal relationship between a nurse and patient in nursing schools. However, the nature of long-term care facilities for nurses, such as lower benefits and educational opportunities lower their motivations to sustain or improve ideal principles in ethics. What's more, with the venerable generation, the nurses take an advantage of this nature. If those principles are undermined in the type of facilities, the environment becomes favorable for abuse or negligence to the population. Especially, the nurses are in a position which could lean in either way of abusive or non-abusive because they are caring for the patients directly.

Once the facility becomes an abusive environment, it sticks to the facility as a culture which has resistance to any coping powers to be against. Thus, the abusive environment might let the nurses be unaware of the nursing ethics to the patients. The principle, the dignity, should be functional with respect from the nurses to patients. It gives an opportunity of how an old patient should be able to live out his or her life as it is imagined. This approach corresponds to cultural competency in nursing clinical in which a nurse responds to a patient's cultural need, such as religious preferences in care. This attitude is a proof that a nurse is competent in nursing ethics. However, the consciousness of the nurses sometimes become low not only with the low motivation but also with their daily routines which might erase the importance to follow the ethical principles.

Improvement from an organizational change is required to provide adequate end of life care to their patients. Eventually the change goes to a positive effect, such as in quality of life for the older generation.