Introduction
End-of-life care involves the care of patients with terminal illnesses like cancer and organ failures in the late stage where the condition is incurable. Medical-surgical nurses have the responsibility of providing end of life for patients with terminal illnesses. To carry out their duties effectively, they will need to be well versed in the strategies and issues concerning end of life and palliative care (Allon & Hanks, 2006).
End of life care course aims at equipping the nurses with information on how best to handle situations common in palliative care. The course will contain five sessions covering the major aspects of end-of-life care. The course will also aim at providing information on ethical issues concerning end-of-life care. End-of-life care involves providing grief support to patients and their family members.
Background of the course
End-of-life-course aims at educating surgical nurses on decision-making in end-of-life cases. The course will cater to the existing education needs of surgical nurses regarding end-of-life care. There are ethical issues involved in palliative care, experimental treatment of the patient, continued medical intervention of the patient and respecting the wishes of the patient. End-of-life care takes into consideration limiting the allocation of hospital resources to such cases while providing care towards the comfort of the patient.
The end of care course will be tailored towards providing information on the best practices in the concerned field. The course aims at developing and enhancing the expertise of medical-surgical nurses in dealing with end-of-life care for improved service delivery (Allon & Hanks, 2006).
Course Outline
The course contains five sessions concerning:
- Nurses’ role in palliative care
- Ethical issues involved in palliative care
- Ethics in continued routine medical intervention
- Key principles of end of life care
- End of life stages
Aim of Course
The main aim of the course is to equip nurses with best practices in end-of-life care and ethical issues involved in dealing with terminally ill patients. This will help to improve the quality of life of terminally ill patients.
Objective of the Course
At the end of the course, the nurses should be capable in:
- Good communication with the patient to enhance the provision of care
- Care planning and assessment for the patient
- Enhancing quality of life of the dying patient
- Upholding ethical issues in medical intervention as per the wishes of the patient
- Proper management of symptoms of the patient to increase comfort
- Understanding the role bioethics can play in renewing life of dying patients.
- Help of the patient in dealing with imminent death.
- Following rules and regulations concerning end of life care.
Course Content
The course will comprise five sessions with the details of the aims and objectives provided below (Ignatavicius & Workman, 2010).
Nurses’ Role on Palliative Care
Aim
The aim of this session is to familiarize the nurses in the best practices and procedures for the improvement of care for dying patients.
Objectives
At the end of the session, the learner should be able to:
- Demonstrate good communication skills in dealing with patients for improvement of palliative care to patients.
- Carefully assess and plan for the palliative care of terminally ill patients.
- Adopt practices suited for best palliative care for the concerned patient.
- Administer drugs and prescriptions to control pain and other discomforts to the patient to increase the quality of life of the patient.
Ethical Issues Involved In Palliative Care
Aim
The session offers an understanding on the ethical issues that may arise while offering palliative care to a patient (Ignatavicius & Workman, 2010).
Objectives
At the end of the session, the learner should be able to:
- The main principles of the ethical issues involved in palliative care
- Provide truthful information to patients regarding their condition explaining the upside and downside to every procedure.
- Demonstrate knowledge on how to act in the best interest of the patient at all times.
Ethical Issues to Continued Medical Intervention
Aim
The aim of this session is to provide direction on how best to deal with situations where decision on whether to withdraw or withhold treatment for a dying patient (Field & Cassel, 1997).
Objectives
At the end of the session, the learner should be able to:
- Provide palliative care without hastening or postponing the death of the patient.
- Follow procedures in obtaining consent of the patient in the eventuality that the patient falls into shock.
- Respect the decision of the patient regarding a medical intervention after explaining the benefits and downside to the procedure (Field & Cassel, 1997).
Key Principles in End of Life Care
Aim
The purpose of this session is to understand the key principles involved in end of life care (Ignatavicius & Workman, 2010).
Objective
At the end of this session, the learner should be able to:
- Demonstrate an understanding of the key principles of end of life care.
- Act on elevating pain and other physical symptoms manifesting in the patient.
- Respect and uphold the right of the patient to refusal of treatment.
- Offer support to the patient in obtaining psychological and spiritual guidance to help deal with the situation (Field & Cassel, 1997).
End of life stages
Aim
The aim of this session will be to familiarise the nurses with the end of life stages that a patient may undergo and how they can deal with a patient at this stage.
Objectives
At the end of the course the patient should be able to:
Identify the symptoms of the end of life stages in a patient.
- Offer care aimed at alleviating pain and discomfort to patients displaying symptoms of end of life stages.
- Provide care to patients in the final advanced stages when death is imminent.
- Demonstrate understanding of the role spiritual comfort can bring peace to the patient and help in acceptance of death.
Content
The session will be presented using PowerPoint slideshows. See appendix 1
Evaluation
Evaluation will carried out for both the course content and the learners’ outcome after completion of the course. The details of the evaluation will be as represented below.
Course Evaluation
At the end of the course, the learners will fill out a feedback form with questions concerning the course (see appendix 1).This will help to evaluate the structure of the course.
Nurses’ Evaluation
Evaluation of the nurses will involve display of competence in the key areas addressed by the course. The instructor will prepare structured guidelines for evaluation of competencies of the participating nurses.
List of Resources
Resources pertaining to the course will include the following:
PowerPoint Presentations
PowerPoint presentation for each lecture will be prepared and printed.
Reference Material
The instructor should provide the learners with a list of preferred reference books for further research.
Handout
The hand out may include the PowerPoint presentations and the list of reference books. The learners need to have access to the hand out at the beginning of the course.
Costs
The nursing department will finance the course and the participating nurses will require no enrolment fee. The table below represents the approximate costs of the course.
Course Schedule
The course will take a day to complete with each session taking up one hour.
Venue
The instructor can conduct the course in a conference room equipped with table, chairs, a projector, and computers for all the learners. The instructor will have to arrange for this prior to commencement of the course. The nurses should have access to the coffee room during breaks.
Reflection
The aim pursue education as the pathway to advancement in my career as a nurse is motivated by the fact that it will offer a platform for transfer of knowledge in my field of study to other nurses. I will be bridging the information gap in nursing care practices that have not been previously catered for the improvement of the nursing profession. The assignment is aimed at bolstering my skills in preparation of coursework and sessions for my fellow nurses. The course has helped me acquire knowledge and develop skills in education assessment needs. I am now capable of planning and implementing courses for continuing nurses. Educational needs assessment strategies will lead to increased support by the nursing department as it is evidence based.
The course has provided guidance on developing material for the course with clear aims and objectives thus improving the learning outcomes of the learners. Overall the course has been beneficial to me as it has provided me the opportunity for growth as a nurse educator (Mahon, 2010).
Appendix 1
Evaluation Form
Please choose the extent to which you agree with the following statement.
- The venue of course offers satisfactory comfort conducive for lecture presentation.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- The instructor offered support to help attend the course.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- There were adequate resources provided for the course.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- The course content is relevant to my line of work.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- Time allocation on each session was satisfactory
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- The teaching methods and strategies employed by the instructor are suited to my learning style.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- I have increased my knowledge in clinical care.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- The evaluation method employed is effective.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
- Attending this course was a wise decision.
- Strongly Disagree
- Disagree
- Neutral
- Agree
- Strongly Agree
Appendix 2
End of Life Stages
Patients display common symptoms when they are close to death. When life sustaining organs of the patient begin to fail, the patient may experience several changes. This may include physical, mental and spiritual aspects of the patient. The symptoms we will discuss are ass listed below:
- Lack of interest in common daily routines
- Loss in energy
- Loss of appetite
- Patient may distance himself from family and loved ones.
- Patient may have problems in swallowing food.
- Laboured breathing
- The patient may become frail with increased sleeping.
- The patient may be exhibit sign of restlessness.
- Loss of bowel control due to weakened muscles.
The focus of the lecture will be in identifying these symptoms and to deal with the causes of the patients in this situation. Common causes may include decreased supply of oxygen to the brain and the whole body. Restlessness may be as a result of pain or lack of enough oxygen to meet the body requirements. At this point it will be advisable to let nature take its course and to provide great care of the patient to alleviate any discomfort in order to improve the quality of life of the dying patient.
Family members may also be called upon for support and to bid farewell to their loved one. Patients will exhibit increased surge of life and may appear to be getting for a while just before they die. The loved ones may have precious time to spend the last moments with the patient and interact for the last time. Spiritual practices can be performed at this time in the presence of family if it is the desire of the patient (Mahon, 2010).
References
Allon, M., & Hanks, G. W. (2006). ABC of palliative care (2nd ed.). Malden, Mass.: BMJ Books/Blackwell Pub.
Field, M. J., & Cassel, C. K. (1997). Approaching death improving care at the end of life. Washington, D.C.: National Academy Press.
Ignatavicius, D. D., & Workman, M. L. (2010). Medical-surgical nursing: patient-centered collaborative care (6th ed.). St. Louis, Mo.: Saunders/Elsevier.
Mahon, M. M. (2010). Palliative care and end of life care. Philadelphia: Saunders/Elsevier.