The Role of Nurses in Palliative Care

Nurses play a major role in the context of pain management. However, they must learn to acquire new skills when it comes to terminally ill patients and clients with fatal conditions (Macintyre & Schug, 2007). A dying patient needs more than a typical pain management program. In the case of elderly patients suffering from fatal conditions pain management must be enhanced using palliative care. Barriers exist and challenges abound with regards to effective deliver of palliative care, the best way to deal with it is to increase the capability of nurses and they must learn to acquire new skills and in order to improve their efficiency with regards to delivery of palliative care.

The Role of Nurses in Palliative Care
Pain management comes in several stages. The first stage is all about the assessment of pain. The second stage is the understanding what the different reactions to pain. Patients have different pain thresholds. The third stage deals with the patients perception of the type of pain they are suffering (., 2008, p.1). The fourth and final stage, which is known as pain behaviour, focuses on the various behavioural expressions that people with painful conditions exhibit (MacLellan, 2006, p.3). In most cases, nurses are able to deal with pain successfully with the effective use of pain relievers if needed. In many cases, patients recover as expected (Fosnocht & Swanson, 2007, p.791-792; Hager & Brockopp, 2007, p.9). However, terminally ill patients have different needs.

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Nurses must be trained to understand that that can result in negative outcomes such as anxiety, depression, hypochondriasis as well as somatisation (Todd, Ducharme, & Choiniere, 2007). Problems in pain management must encourage nurses to improve their assessment methodologies. They need to acquire the ability to determine patients emotional status before they embark on treating these painful conditions. This is usually considered in a case wherein a patient appears to be extremely depressed, demands high level of opioids, ignores examination procedures or is totally non-compliant (Price, Fogh & Glynn, 2007, p.12).

This kind of behavioural characteristic is common in patients with acute painful conditions and such conditions point to the onset of a , which is multidimensional and requires a level of expertise to achieve correct diagnosis (Fosnocht & Swanson, 2007, p.791-792).

The Importance of Education, Training, and Experience
Nurses must be able to deal with different types of pain but when it comes to terminally ill patients, a different skill-set is needed. Ill-equipped nurses can contribute to barriers in effective pain management and it can be broken down into three major parts:

insufficient knowledge;
lack of skills when it comes to basic palliative care techniques; and
lack of skills when it comes to standard assessments (., 2008, p.1986).
Insufficient knowledge with regards to effective and efficient pain management strategies would result in underutilization because the focus is usually on the use of aggressive interferences that does not guarantee ability to prolong life but simply add more pain and suffering to the lives of patients and their families (Deandrea et al., 2008, p.1986). They have to understand that palliative care is medical care focused on relief of suffering and support for the best possible quality of life for patients facing serious, life-threatening illness and their families (Hong et al., 2010, p.854).


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