UBC Graduate Research

Nurses' role in a dignified death for patients with end stage chronic obstructive pulmonary disease : an integrative literature review Pannu, Kamaldeep


As a critical care nurse, I have witnessed gaps in front line nurses’ consistent inclusion in palliative care discussions with patients and families within interdisciplinary team context. This integrative literature review examines the factors contributing to front line nurses’ inconsistent involvement in palliative care decision-making process specific to patients with chronic conditions in their final stage of life such as patients with end stage Chronic Obstructive Pulmonary Disease (COPD), and within a palliative care framework. These factors were envisioned from the health care professionals, as well as from the patient perspectives. Health care professionals related barriers include bedside nurses’ lack of training in end of life care, and attending doctor’s inconsistent preference for inclusion of nurses in palliative care discussions. Patient related factors include lack of communication about goals of care with patients and families. Findings drawn from this review informs recommendations to break barriers intruding frontline staff nurses’ consistent inclusion in palliative care discussions. Findings from other grey literature have also been included to synthesize the recommendations to break the barriers to successful involvement of nurses in palliative care decisions. Recommendations focused on nurses’ training and education in the context of their work environment to improve the successful involvement of nurses in PC decision-making process in acute care settings, with the goal of enhancing quality PC care. The conceptual framework of a palliative approach is utilized to underpin the arguments and integrative literature review for this project paper. Key words of Palliative Care (PC), End-of-life care (EOLC), palliative approach, PC decision-making process, PC discussions, bedside nurses and attending doctors have been used throughout this paper.

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