News From the End Of Life
News From the End Of Life
Nurses: More end-of-life education needed
Less than two in 10 nurses rated their end-of-life training as very adequate, according to a study done by the City of Hope Cancer Center in Duarte, CA. Only 13% rated their end-of-life training in nursing school as "very adequate." Still, 66% said care of the dying today is better than it was five years ago.
Researchers from the City of Hope Cancer Center surveyed over 2,300 oncology and other nurses to determine their views on the status of nursing and health care for dying patients. The survey sought opinions on barriers to effective end-of-life care, end-of-life education, nurses’ knowledge of and effectiveness in providing end-of-life care, and assisted suicide and euthanasia. The results of their study were published in the April issue of Oncology Nursing Forum.
While more than half of the nurses surveyed rated each of nine aspects of their nursing education as inadequate on end-of-life care, all agreed that this is an essential component of nursing education, the study said.
Aspects of compassion
Pain management was the weakest aspect of their end-of-life care education, nurses told researchers. In addition, nurses said they need more instruction in overall end-of-life content and the role/needs of family caregivers.
Nurses said other barriers to effective end-of-life care included:
• managed care;
• lack of continuity of care across settings;
• patients’ and family members’ avoidance of death, and the nurses’ own personal discomfort with death (71%);
• lack of knowledge by health care providers.
Twenty percent of nurses reported having had a request for assisted suicide; however, only 1% said these requests were a very common dilemma. The researchers point out that nurses’ distress and frustration surrounding their day-to-day involvement in unrelieved pain and inadequate care of the dying surfaced as more prevalent themes.
"It is vastly important to hear from nurses, as they make up the largest professional group at the bedside," said Betty Ferrell, PhD, RN, lead author of the study. "And when given an opportunity to voice their opinions, they clearly emphasized their struggles in learning and practicing many aspects of compassionate care for dying patients. It is apparent to us that improved end-of-life care is contingent on better education of nurses and health care professionals."
The researchers called for major educational approaches, policy reform, and consumer demand, as efforts to ensure patients more peaceful deaths. Further, nurses as key caregivers must receive support and guidance in facing the dilemmas encountered in their daily practice of end-of-life care.
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