Pallitive care-can anyone help??

teamrn · Feb 16, 2001

Sam, I've been a hospice nurse for @ 9 years now, and in as much as I don't have a complete knowledge of the bereavement process in my memory and at my fingertips, I feel it is necessary for me to understand that there IS a bereavement process, and its basic concepts. (The details, I leave to LCSWs, chaplains, and bereavement counselors). Hospice is a team approach to care, and the bereavement care is a very important part of that care.

Annie

swmn · Feb 16, 2001

a good knowlege of breavement processes etc in order to deliver sensitive care. Can anyone Help???

Maybe a little. Sam, I have been a hospice volunteer for five years, as well as having had several terminal patients within a year or two of long term care.

Without knowing more specifics about your question, start with something simple like Kubler-Ross' model of the five stages of grief. They are Denial, Anger, Bargaining, Depression, and then Acceptance.

An appropriate intervention for a family member in depression is going to be wasted on someone else in the family who is angry.

At the end of the day, if I can get the family members talking to each other, I know the next time I come on the floor to start another shift they are going to be somewhere else, further down the road toward recovery and acceptance than they were before.

HTH,

Scott

leslie :-D · Feb 16, 2001

Hi Sam10,

I agree with the other posters...that you really need to recognize and acknowledge the particular 'stage' of bereavement they're in. It is important in transitioning them through such a volatile process, so the more experience you have, the more you can help your pts. and their families.

KathyLeighSimms · Nov 9, 2001

Dear Sam and list members, I am currently an RN and also studying at the University at Buffalo to complete a BSN. My clinical experience this semester is related to Hospice/Home care. This discussion posting is a required assignment, and I would like to respond to Sam's question regarding bereavement,and I look forward to future discussions or comments on my response. Thanks so much. Kathy LS.

The role of Hospice is to provide palliative and supportive care to meet the needs of the patient/client and family, arising out of the physical, psychosocial, spiritual and economic stresses that are experienced during the final stages of illness and during bereavement.

If Hospice services are in place,the Hospice nurse is in a unique position to be there for the patient/client and family throughout the stages of illness and anticipatory grieving/bereavement.

I agree with Annie regarding her comment about Hospice members providing a team approach to facilitate the needs of the patient/client and family. Some of the team members include: physician, nurse, pharmacist, social worker, chaplain/spiritual care worker and volunteers. The nurse needs to be aware of the grieving/bereavement process because she/he is in a position to not only provide physical/comfort care, and recognize the impending changes involved in the end stages of illness, but recognize and aid in the emotional and psychosocial aspects of dying in order to deliver sensitive care. Kubler-Ross' 5 stages of grieving are recognized in some individuals in response to a real, perceived or anticipated loss. If the nurse has a knowledge base of these concepts, he/she may be able to facilitate open communication and discussion of the disease and explore the individual's feelings about their disease and impending death. If the individual is able to discuss these issues,then it may give them a sense of relief and help them move toward acceptance and become more prepared for the future.

I hope this was of some help to you. I look forward to sharing and learning more information.

References:

Field, Marilyn J., Cassel, C. (1997) Approaching death: improving care at the end of life. Washington, D.C.: National Academy Press, 1997. [www document] Retrieved: http://www.soros.org/death/what.htm. 11/05/01, 9:23 a.m.

Jones, A. (1997). A 'bonding between strangers': a palliative model of clinical supervision. Journal of Advanced Nursing. 26(5), 1028-1035. [www document] Retrieved: http://gateway1.ovid.com:80/ovidweb.cgi. 11/05/01, 11:29 a.m. To access: type in the title of article.

Townsend, M., C. (1996). Psychiatric mental health nursing: concepts of care. (2nd ed.). Philadelphia: F. A. Davis Company.

Kathleen Leigh Simms

University at Buffalo

School of Nursing

Mags · Nov 10, 2001

Hi Sam.

If this for an assigment don't use Kubbler Ross considered outdated now . Look at work by Murray Parkes.

I am in U.K to + work in P/ Care, so if I can help feel free to E Mail me.

Mags

semstr · Nov 10, 2001

Hi,

since when is Kübler-Ross outdated?

what on earth for? and who is the guru now?

Even the Husebö from Sweden accepts her theories and a lot of other ethical and palliativ thinkers do.

Take care, Renee

rosemadder · Nov 18, 2001

Just finished up unit on death and dying in nursing school and the only person we studied was Kubhler-Ross.

SharonHopson · Dec 3, 2001

:confused: Kubher-Ross outdated? Some of the most wonderful literature ever written. Who is Murray Parks?

Sharon

JW-HLC · Jan 20, 2002

Just checking in on this one to say that you all do a really fantastic job - you are all worth double .... no treble!