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End of life care nursing is the provision of treatment to dying patients, either at home or in institutional settings. The nature of nursing care changes as patients near the end of their lives and treatment is designed to be palliative rather than curative. Goals include keeping the patient comfortable and respecting expressed wishes about care, rather than attempting to enact a recovery. Patients who do start responding to treatment may be transitioned to a more appropriate nursing service so they receive the level of care they need.
This aspect of the nursing profession includes not just caring for patients, but also family members. Nurses who work with dying patients may need to communicate with family to explain what is happening, provide information, and support people who aren’t sure about how to interact with the patient. Like other nurses, specialists in this field advocate for their patients with doctors and other medical professionals, and help interpret medical information for families so they have a better understanding of the patient’s condition and what kind of treatment is being provided. They also need to exercise sensitivity and care as they work with grieving families.
Patients with terminal illnesses may need pain management to remain comfortable, along with supportive treatment to stay hydrated and get adequate nutrition. End of life care nursing can include respect for advance directives, documents laying out the patient’s specific wishes in the event of particular medical complications. Nurses may be asked not to provide respiratory support, for example, keeping patients off ventilators and not initiating cardiopulmonary resuscitation if the patient experiences a medical crisis. These documents ask for basic supportive care without aggressive medical interventions to allow the patient to die comfortably.
Training in end of life care nursing is available for care providers who want to refine their skills in this area. This can include workshops, classes, and professional courses. Nurses interested in working with dying patients can also elect to work on wards where patients receive palliative care to get practical experience and mentoring from other nursing professionals.
Some end of life care nursing takes place at home. Patients may feel more comfortable in their own environments as they near death, and nurses may stop by periodically or temporarily live in with the patient. Other nurses work in settings like hospitals, nursing homes, and hospice facilities for patients who need institutional care. The end of life care nursing work environment can be stressful. Nurses can benefit from counseling and other support as they work with their patients.