Page 14 - TheAlaskaNurseOctNov2018

Nursing Advocacy and Communication:

CREATING AN END-OF-LIFE PLAN OF CARE

By LiNda duwa, aNP, aChPm

There are some things in life that we can change, and Depending on the situation, the time left can vary from
there are others that we can’t. Death and the loss and hours to days, weeks and sometimes even months. Death
bereavement that follows are experiences that we may might come sooner than we anticipate, or it may come
all have at some point in our lives. “In this era of high- later. The conversation we have about end-of-life with
technology medicine, people have come to see cutting- patients and families will impact many peoples’ lives.
edge advances and medical miracles as the norm. Each
“What people need most on this journey is not the
new advance, however, pushes the boundary between life
promise of the next new technology but rather a guide
and death into murky territory where patients are largely
to help navigate this dark forest in which they will
bewildered and the goals are less clear.” (Volandes, 2015)
undoubtedly find themselves.” (Volandes, 2015) When
There is a culture that exists in the hospital environment
we approach families to have an end-of-life discussion,
that is very different from the culture that exists outside the
we should be ready for the challenges that may present
hospital. We have seen and experienced life-saving events,
themselves. Good communication is a tool that can be
as well as unexpected and expected deaths. These events
used to help patients and their families. How we approach
can affect how we view the end-of-life experience.
end-of-life discussions can negatively or positively affect
As nurses and healthcare providers, we cannot predict the conversation and potentially impact the plan of care.
exactly when or how a patient is going to die. We can only
Our conversation with the patient and family should
provide the best information, based on our own research,
include listening to what the patient and family have to say
knowledge and experience, about what may happen.
and answering any questions that they may have. Listening
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