The Importance Of Holistic Nursing Approach In Palliative Care

Defining Palliative Care

Discuss About The Nursing Theory To Hospice And Palliative.

Nursing can be considered as a profession that is centered on providing compassionate care to the sick and ailing. It is the noble profession where one has to provide support and assistance to the Individuals suffering from. Hence, the nursing professionals have to be compassionate and empathetic at all times, resilience and sympathy is the key to nursing care competence. It has to be mentioned in this context that this is a professional with the grave responsibility of the health, well-being and safety of the different patients. A single mistake or error can result in fatal consequences and can even cost the patients their lives (Carter, Levetown & Friebert, 2013).

That is the reason the nursing profession needs to go through continuous professional development for enhancement of competence and skills to serve the patients better. Although there are various tools and frameworks in the disposal of the nursing workforce in the present day scenario, however the most significant tool provided to the nurses is the reflection framework (Cockell & McSherry, 2012). Reflection can be considered as one of the best practice fireworks to explore and understand the competence and scope of practice of a professional. In healthcare,  or nursing care most importantly, reflection allows the nurse to contemplate the clinical decisions made in the patient care scenario,  discover the strengths and weaknesses of his or her own practice and build upon the strength in the future along with working on the weaknesses to improve the particular skills. This assignment will reflect on the holistic approach to palliative care and how the effectiveness and empathy of the care provided is impacted by the personal values and beliefs of the nursing professional providing palliative care.

According to Gallison, Xu, Jurgens and Boyle (2013), palliative care can be defined as the care approach taken that improves the quality of the living of the patients that are facing life threatening illnesses or diseases. Hence it can be mentioned that palliative care can be defined as the concept of care planning through the process of prevention or relief of the suffering of the patient by early identification, impassable assessment, timely pain management and addressing physical, spiritual and psychosocial issues facing the critically ill. Critical illness often has a grave impact on the psychological and emotional health of the patent as well, and hence, the impact of impending death can have a significant impact on the health and wellbeing of the different patients. In my own opinion, the concept of palliative care can be best aligned with holistic care approaches, taking into consideration the concept of emotional health and wellbeing into the scenario.

Holistic Care in Palliative Care

As per the Izumi, Nagae, Sakurai and Imamura (2012), holistic care can be defined as the nursing care that focuses on overall healing of a patient, holistic nursing takes the aid of “mind-body-spirit-emotion-environment” approach to the care. The therapeutic relationship between a nurse and the patient receiving care in the holistic nursing approach is based principles and modalities of holistic healing. In this care approach, the interaction among the nurse and the patient is compassionate and sympathetic; the care planning and implementation procedure takes into consideration the physical, emotional, social, economic, and spiritual needs of the person requiring the end of life care or assistance. According to the Keall, Clayton and Butow (2014), it has to be acknowledged in this essay that chronic illnesses or prolonged stay in the health care facility while dealing with any morbid life threatening condition can alter the response to illness. The impact of any chronic condition can alter the perception of health, well being and even life. According to the McCourt, Power and Glackin (2013), the psychological burden of death is extreme on the psyche of the different individuals dealing with chronic illnesses or end of life stage is extreme. Along with that, the inability to meet the different self care needs and the chronic pain of the end of life diseases like cancer has a significant impact on the will to live among the palliative patients. In such conditions, the patients require emotional and spiritual assistance more than the technical aspects of care on order to spend the last few days of their life with comfort and peace. Here the application of the holistic care approaches can provide the palliative care scenario with the compassion to meet the psychological needs of the patients as well (Ronaldson, Hayes, Aggar, Green & Carey, 2012).

Along with the implementation of holistic care approaches, the impact of personal values and beliefs are also significant on the palliative care scenario. Personal values and beliefs of a nursing individual undoubtedly have a significant impact on the positive health outcome of the terminally ill patients as well. First and foremost, it has to be mentioned in this context that cultural values and principles have a significant role in the nurse interactions with the terminally ill patients. According to the Phelps et al. (2012), the caring attitude of the nursing professional providing care to the terminally ill needs to be sensitive, exhibiting concern for the impact of the suffering the patient is going through. If the personal values of the nurse is judgmental or disregarding the cultural background of the patient, the palliative care is incomplete and ineffective. Communication approach is another very important aspect of palliative care, it has to be mentioned that a terminally ill patient already is going through acute suffering and hence the psychological burden of chronic illness and the impending death can alter the responsiveness of the patients. In this case the nurse providing palliative care needs to employ effective therapeutic communication techniques in order to calm the patient and help him or her pass through this phase with compassionate understanding and shared decision making (White, 2014). Now, if the personal values and principles of the nursing individual are not compassionate or empathetic by nature, the care approach and quality provided to the terminally ill patients will be hampered.

Impact of Personal Values and Beliefs

Hence, I would like to mention that palliative care is a domain of health care delivery that encompasses a whole spectrum of care, it emphasizes on medical, nursing, psychological, social, cultural and spiritual health and wellbeing of the terminally ill patient. It takes into consideration that the patient comfortable, peaceful, content and relieved of any physical or psychosocial burden or pain. Hence, with the amalgamation of so many dimensions of care into one care directive, the concept of holistic care that emphasizes not just on the physical aspects of health, but the emotional and spiritual aspects of health and wellbeing, is extremely important in palliative care. However, the holistic care approaches can only be effective if the caring individual has personal values and beliefs that align with the different palliative care standards, both holistic and traditional (Wu & Volker, 2012).

I would like to conclude, that the palliative care nurses are responsible for the wellbeing and peach of terminally ill patients who have been suffering with a long term disease. These health care professionals are the key facilitators of ensuring the last few days of months of a dying patient is peaceful, content and dignified. Hence, the application of holistic nursing approach according to me is a necessity on both professional and moral grounds; so that the suffering of these frail patients can be minimized. Along with that, I believe that palliative nurses will also have to focus on the impact of their personal values, opinion and beliefs to ensure that their care approaches are compassionate and empathetic as possible.

References:

Carter, B. S., Levetown, management., & Friebert, S. E. (Eds.). (2013). Palliative care for infants, children, and adolescents: a practical handbook. JHU Press. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=WaAzS1GlvCMC&oi=fnd&pg=PT2&dq=palliatibe+care+and+holistic+nursing+&ots=94h6v0X-9o&sig=xk76cAP9CtA1ZJP_9I6y9eyOXNw&redir_esc=y#v=onepage&q=palliatibe%20care%20and%20holistic%20nursing&f=false

Cockell, N., & McSherry, W. (2012). Spiritual care in nursing: an overview of published international research. Journal of Nursing Management, 20(8), 958-969. Doi: 10.1111/j.1365-2834.2012.01450

Gallison, B. S., Xu, Y., Jurgens, C. Y., & Boyle, S. M. (2013). Acute care nurses’ spiritual care practices. Journal of Holistic Nursing, 31(2), 95-103. Doi: 10.1177/0898010112464121

Izumi, S., Nagae, H., Sakurai, C., & Imamura, E. (2012). Defining end-of-life care from perspectives of nursing ethics. Nursing ethics, 19(5), 608-618. Doi: 10.1177/0969733011436205

Keall, R., Clayton, J. M., & Butow, P. (2014). How do Australian palliative care nurses address existential and spiritual concerns? Facilitators, barriers and strategies. Journal of clinical nursing, 23(21-22), 3197-3205. Doi: 10.1111/jocn.12566

McCourt, R., Power, J. J., & Glackin, M. (2013). General nurses' experiences of end-of-life care in the acute hospital setting: a literature review. International journal of palliative nursing, 19(10), 510-516.Doi: 10.12968/ijpn.2013.19.10.510

Phelps, A. C., Lauderdale, K. E., Alcorn, S., Dillinger, J., Balboni, M. T., Van Wert, M., ... & Balboni, T. A. (2012). Addressing spirituality within the care of patients at the end of life: perspectives of patients with advanced cancer, oncologists, and oncology nurses. Journal of Clinical Oncology, 30(20), 2538. doi:  10.1200/JCO.2011.40.3766

Ronaldson, S., Hayes, L., Aggar, C., Green, J., & Carey, M. (2012). Spirituality and spiritual caring: nurses’ perspectives and practice in palliative and acute care environments. Journal of Clinical Nursing, 21(15?16), 2126-2135. Doi: 10.1111/j.1365-2702.2012.04180.

White, L. (2014). Mindfulness in nursing: An evolutionary concept analysis. Journal of advanced nursing, Accounting, 282-294. Doi: 10.1111/jan.12182

Wu, H. L., & Volker, D. L. (2012). Humanistic Nursing Theory: application to hospice and palliative care. Journal of advanced nursing, 68(2), 471-479. Doi: 10.1111/j.1365-2648.2011.05770