NR305-10247: Health Assessment for the Practicing RN #8

Week 8: Discussion: Reflection on End of Life Care (Graded)

Purpose

The purpose of this reflection is for learners to apply this week’s lesson on assessment at end of life to past practice experiences, and to consider how knowledge gained this week might shape future practice.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

  • CO 2: Differentiate between normal and abnormal health assessment findings. (PO 4)
  • CO 3: Describe physical, psychosocial, cultural, and spiritual influences on an individual’s health status. (PO 1)
  • CO 6: Demonstrate professional behavior and caring during patient interactions. (POs 6, 7)

Due Date

  • During the assigned week (Sunday the start of the assigned week through Saturday the end of the assigned week):

    • Posts in the discussion at least two times, and
    • Posts in the discussion on two different days

Total Points Possible

50 points

Directions

  • Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed. In reflections students:
    • Demonstrate understanding of concepts for the week
    • Engage in meaningful dialogue with classmates and/or instructor
    • Express opinions clearly and logically, in a professional manner
  • Use the rubric on this page as you compose your answers.
  • Scholarly sources are NOT required for this reflection
  • Best Practices include:
    • Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.
    • Enter the reflection often during the week to read and learn from posts.
    • Select different classmates for your reply each week.

 Reflection

Share with your classmates a time when you cared for a patient at the end of their life. This may be a time when you assisted the patient (or their support system) with decisions related to end of life care; or a time when you were present for the death of a patient.

  • What were your observations related to this experience?
  • Do you believe it was a peaceful death?
  • What went well?
  • Can you think of anything that could have made the experience better for the patient and/or family?

Grading

To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions.

SAMPLE SOLUTION

Hi class, 

My first job out of nursing school was in a nursing home. I was working on a more medically complex facility floor where we had g-tubes, tracheostomies, wounds, dialysis, terminally ill, and patients on Hospice. I cared for a patient with chronic HIV for about 3 months when he entered the last stage- AIDS. He was severely malnourished, unable to absorb nutrition, and most of his organs were at the end stages. The hardest thing was that this patient had no family or loved ones. Since I was his regular nurse for quite some time, I’ve built a trusting relationship with a patient. He was a big reader and would always find me at the nursing station and talk to me about the books he was reading. From the time he got signed up for hospice, it only took 4 days for him to pass. The day he passed, I remember coming on the first shift and getting a report that he seemed to be fading slowly, he was getting all comfort measures- Morphine, Ativan, oxygen etc. When entered his room during the rounds, he asked me if he could have some more pain medication and if I could sit with him for a little bit and read to him. I checked with my supervisor and asked if she and another nurse could cover my med pass so I could sit with him for some time since he really had no one. My amazing team pulled it together and took care of my other residents while I sat with him, holding his hand until he passed about 2 hours later. 

Even though I know he was in pain, I believe I was able to provide him with some peace and comfort by staying with him and reading to him. I was able to show him people cared about him, even if I was not his family. The only thing I can think would have made this experience better for him would’ve been if he had some family or friends and was surrounded by them during his passing, but unfortunately, he did not. As a nurse, I felt my duty was not only to make his transition as easy as possible physically but also emotionally.Â