What Spirituality Does to Nursing Care at the End of Life

What Spirituality Does to Nursing Care at the End of Life
Advanced nursing practice has made a big difference in improving health care to meet the needs of patients, which are always changing. Because of this improvement, nurses can do important medical chores that doctors used to do. This has made it easier for more people to get medical care. Woo et al. (2017) say that for a nurse to work as an advanced care practitioner, she must be able to show that she has extra core skills in clinical practice, research, education, and leadership or management. Advanced practice nurses (APNs) need to know a lot about theory and study in order to give their patients good care. APNs do almost the same things as registered nurses, but they have a lot more freedom to make clinical choices and decide how their patients will be treated.

What’s Interesting?

There are four key areas where advanced practice nurses work: research, teaching, clinical practice, and management or leadership. My area of interest is the field of clinical practice, which is about giving direct care to patients. Clinical practice nurses take care of patients and talk to the public. They often act as a link between doctors and patients or their families. In the United States, each state decides what an advanced clinical practice nurse can do. Even though each state has its own rules, advanced practice nurses do things like diagnose patients, order tests, give out medicines, keep patient records, and send patients to the right places (Woo et al., 2017). APNs can work as a certified nurse practitioner, a certified registered nurse anesthetist, a certified nurse-midwife, or a clinical nurse specialist after they finish the advanced nursing practice degree. I want to work as a clinical nurse specialist in palliative care after I finish my advanced practice nursing degree.

Clinical Problem

Millions of people die every year in the U.S., and most of them die in hospitals. Even though some people die quickly, most die after a long time of having a chronic illness. Chronic illnesses are diseases that last for more than a year and make it hard to do things or need to be treated all the time. Recent research (Mistry et al., 2015) shows that more than half of all Americans have at least one long-term illness, and that number is growing. During this time, patients need special care, such as end-of-life care, to help them deal with their illnesses. End-of-life care, also called palliative care, is coordinated by a team and focuses on the patient’s comfort when a fix is no longer possible (Sonemanghkara et al., 2019). With this kind of care, people can live well and die with honor. End-of-life care is also a way to include the patient’s family in the care and answer their questions. Care is one of the most important things that can be done at the end of someone’s life. The goal of this care is to help the patient feel at peace and to comfort the family as they prepare for the worst.

As part of hospice and palliative care, spiritual support helps people make a good shift from life to death. (Finocchiaro, 2017) Evidence-based practice shows that care and compassion are the most important things when working with patients who are dying. Most spiritual care is given by hospital pastors and other religious leaders in the area. The advanced nurse practitioner helps make sure that these leaders are available based on what the patient and their family need. During end-of-life care, the wrong spiritual support could do more harm than good, so the APN needs to do regular spiritual assessments before recommending it.

PICOT Question

How well does spiritual care (I) compared to no spiritual care (C) help terminally sick adults with chronic conditions die with dignity and peace (O) during end-of-life nursing care (T)?

Adults with chronic illnesses who are nearing the end of their lives are the main focus. The majority of people who need spiritual care and family help are from this group.

The intervention is to provide spiritual care by using hospital chaplains and neighborhood religious leaders, depending on what the patient wants.

The other option is to not give spiritual help and just keep giving regular nursing care.

The goal of the intervention is to help the person die in a peaceful and dignified way while giving the family mental support.

Time: The spiritual help will happen when the nursing care at the end of life is being given in nursing homes or hospitals.

Concern about the clinical issue

End-of-life care for patients is a big part of a nurse’s job. This includes having sensitive talks with the patient, figuring out what the patient needs, and helping the family. I’m interested in caring for people at the end of their lives because it includes giving high-quality nursing care. Many people don’t realize that death is a process that needs sensitive care for the people who are going through it. These people often feel lost, confused, and like they don’t know what to do about the end of their lives. The nurse needs to be sensitive when taking care of the patient’s health issues and helping the patient’s family. Most of all, I’m interested in caring for people at the end of their lives because they need spiritual help. It’s very important to know how to improve mental care for the patient, because that makes for a more peaceful death.

The growing number of chronic diseases around the world has made people pay more attention to palliative and end-of-life care. More than half of all deaths each year are caused by illnesses like heart disease, cancer, stroke, diabetes, and chronic obstructive pulmonary disease. Chronic diseases are the cause of seven out of ten deaths in the United States (Mistry et al., 2015). Each year, these illnesses kill more than 1.7 million people. Because there are more and more people with long-term illnesses, nurses need to be ready to help with palliative and end-of-life care. To care for this special group of people, you need to know what they need, how to talk to them in a good way, and what the benefits are of giving end-of-life nursing care.

How it relates to the world we live in now

Spiritual care at the end of life is important to society because it helps families, friends, and workers in real ways. People who are getting on in years often feel alone, and end-of-life care can help with that. End-of-life care can sometimes be used as a way to make someone live longer. Sonemanghkara et al. (2019) say that this method is also important for improving the quality of life for people who are sick and helping them find peace. Spiritual care at the end of life can help the person let go of regrets and feel less afraid of dying.

Changes in Practice Based on Evidence

At the end of life, a person’s religious views are often put to the test, and spirituality becomes more important. Many people want to die peacefully, which can mean believing in God and hoping for endless life. Studies show that a patient’s faith is very important in helping them deal with their illness by giving them hope (Finocchiaro, 2017). Even people who didn’t believe in spirituality before tend to find value in their lives as they near the end. Spirituality can be different from religion because it is affected by things like society and personal experiences. Even though there are many ways to be spiritual, end-of-life spiritual care helps the dying person feel closer to their family and less afraid and worried.

When a person is nearing the end of their life, their family and doctors focus on making them as comfortable as possible. In many places, nurses tend to focus on the patient’s basic needs, like controlling pain and taking care of symptoms like constipation and shortness of breath. This way of thinking needs to change, because psychologically, death is not the end of life. (Sonemanghkara et al., 2019) Spiritual care makes sure that the patient leaves the family at peace, takes care of family problems, and makes family members less afraid. The nurse takes this chance to talk to the counselors about how to help the patient and his or her family deal with their feelings.Relevance to Nurse with DNP

The Doctor of Nursing Practice (DNP) faculty is a key part of preparing nurses to take on jobs in palliative care. Woo et al. (2017) say that these nurses are trained to use evidence-based treatment to meet the physical, emotional, and spiritual needs of their patients and their families. Through study, the DNP nurse can work to improve care for patients at the end of their lives. Research on the value of spiritual care can help other doctors and nurses learn how to best care for people who are dying. The nurse can also help make policy at all levels to make sure that all people with terminal illnesses get spiritual care.

Plan for Getting the Word Out

I plan to use discussion forums and social media sites to share what I’ve learned during this project. I will talk about what I know about spiritual care for people who are dying on our online discussion board. I will make sure to answer my classmates’ questions and back up my answers with proof. Second, I will use social media like Facebook, Twitter, and LinkedIn to share what I know with students and other health care workers. Once my idea is approved, I’ll ask permission to put it in one of the nursing journals so that students and other health care workers can find it easily.

References

Finocchiaro D. N. (2017). Supporting the patient’s spiritual needs at the end of life. Nursing, 46(5), 56–59. https://doi.org/10.1097/01.NURSE.0000482263.86390.b9

Mistry, B., Bainbridge, D., Bryant, D., Toyofuku, S. T., & Seow, H. (2015). What matters most for end-of-life care? Perspectives from community-based palliative care providers and administrators. BMJ Open, 5(6). http://dx.doi.org/10.1136/bmjopen-2014-007492

Sonemanghkara, R., Rozo, J. A., & Stutsman, S. (2019). The Nurse-Chaplain-Family Spiritual Care Triad: A Qualitative Study. Journal of Christian Nursing : Aquarterly Publication of Nurses Christian Fellowship, 36(2), 112–118. https://doi.org/10.1097/CNJ.0000000000000592

Woo, B. F. Y., Lee, J. X. Y., & San Tam, W. W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15(1), 1-22. https://doi.org/10.1186/s12960-017-0237-9

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