discussion 2 – End of Life Care
Florida National University
Advanced Family Practicum III
Jacqueline Alonso DNP, Family ARNP
The ability to provide primary palliative care is a skill set that nurse practitioners should acquire, develop, and refine. Primary palliative care skills include thorough and effective symptom assessment and management, initiating and guiding conversations around advance care planning, and completing medical directives that guide care with life-limiting/life-threatening illness (Wheeler, 2016). Although sometimes confused with hospice, it’s important to remember hospice is a specific type of palliative care designed to address the needs of those who have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care. (IPC, 2018).
As frontline clinicians, APRNs, along with their RN colleagues, spend the most time with patients at their bedside. All APRNs must have fundamental palliative care skills. This includes understanding illness trajectories from diagnosis to death, appropriate assessment and management of pain, particularly in the current opioid misuse epidemic b (Dahlin & Coyne, 2019).
The most recognized area of leadership for APRNs is Clinical Care. To be successful, APRNs must understand the diagnosis and the natural course of illnesses and diseases along with the critical decision-making points to manage and treat these conditions from diagnosis to end-of-life care, based on best available evidence. APRNs are in a key position to deliver collaborative interdisciplinary palliative care for patients with serious illness and move palliative care upstream to caring for populations across the lifespan and across the health care continuum (Dahlin & Coyne, 2019).
In palliative care, when presenting with a symptom complaint, disease progression must always be considered. Disease progression needs to be identified to help with the ongoing goals-of-care discussions. Often-cited symptoms include pain, breathlessness, fatigue, anorexia, nausea/vomiting, constipation, depression, dry mouth, and sleep disturbance (Wheeler, 2016)
In a perfect palliative care world, advance directives for care at end of life would be documented, medical powers of attorney would be named, and these documents would be shared with all health care providers. The reality is that this does not happen, and many hospitalizations are for a crisis when decisions need to be made and there has not been an open and honest discussion of the illness trajectory. NPs enter into these discussions without an agenda for what are the “correct” decisions. The desired outcome is to have the patient understand the issues and make informed choices based on their goals and their definition of quality of life. NPs need to be prepared to discuss disease trajectory, realistic interventions, and prognosis. Palliative care advocates that advance care planning be documented and revisited with subsequent changes in health status (Wheeler, 2016).
Dahlin, C., & Coyne, P. (2019). The palliative APRN leader. Annals of Palliative Medicine, 8(1), S30-S38. doi:10.21037/apm.2018.06.03
IPC. (2018). Palliative Care: The Next Frontier for APRNs? Retrieved from CSU Institute of Palliative Care: https://csupalliativecare.org/palliative-care-aprns/
Wheeler, M. (2016). Primary Palliative Care for Every Nurse Practitioner. The Journal for Nurse Practitioners, 12(10), 647-653. Retrieved from https://www.npjournal.org/article/S1555-4155(16)30503-7/pdf
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
Ace Writing Center has stood as the world’s leading custom essay writing services providers. Once you enter all the details in the order form under the place order button, the rest is up to us.
At Ace Writing Center, Nowadays, students normally have extremely busy schedules. You will note that some of them have to take on some evening or weekend jobs in order to get some income that can help them to sustain in college or in the university. This can deny them a chance to write all the essays given. Others usually get bombarded with a lot of work by their lecturers. This can still delay such students from working on all their essays. However, some of them usually try to work on all these essays but end up delivering their work late. This can prevent them from graduating since most lecturers are strict on deadlines. If you want to write a business essay, the wise way is to hire an outstanding essay writing service like us, so that you can get the best results. If you are keen, you will note that many companies usually overcharge their customers. Some of them are there only to make money. And in reality, they really don’t care to build a long term commitment with students. You should not choose such companies. You should take your time and choose a reliable company to work with. Ace Writing Center is the ultimate solution for you. We have been offering our writing service for more than 7 years. This is a clear indication that you will get quality essay writing service. We have a wide range of writers who can work on any business essay that you might have. We believe in doing extensive research so that we can provide quality work to all our clients. .
Admission and Business Papers
Have you ever had to write an admission essay for college? The majority of students face the same issues when applying to a university or college and many in such situations decide they need professional help to cope with this matter. They get in a situation when the deadline keeps coming closer but lack motivation to start because they are just not sure if their writing skills are strong enough. We have a solution for you! Ace Writing Center is the best admission essay writing service with a large professional team and years of experience in providing high-quality papers to students of all levels and faculties. The mission of our team is to help students make their dreams of entering a good college come true and that’s what we offer!.
Editing and Proofreading
Sometimes all the words for your paper just flow out of your mind and into your fingers. You type quickly at your keyboard and there they are, your beautiful words right there on the screen. But you have no idea how to polish it up. You may be wishing there was a paper writing service that offered this type of writing service. Look no more! Here at Ace Writing Center, we offer you an editing and proofreading option that you can't find anywhere else..
College Essay Writing
In case you are familiar Ace Writing Center, you know the way to distinguish a better company from a cheap one exactly. First of all, poor service website does not have a sufficient support. We think support team is an essential part of success; it has to answer all clients’ questions and be a connecting link between clients and their writers. On our web-service you will get answers about anything you need and your writer will receive all your instructions, assignments and requirements exactly and swiftly. A writing service that we run has got a flexible pricing system that will save you from senseless wastes and many bonus systems that let you sparing money for something important for you.