End-of-life care is the healthcare of people who are in the final time of their lives. This may include the terminally ill, critically ill, such as those in advanced stages of incurable diseases and other cases the old. This calls for elaborate decisions to be made in the patients' determination of their ailments, life, and the ethical interventions. It involves the distribution of resources in medicals facilities through consideration of technical, medical and ethics of an economy. The role of the nurse cannot be underestimated in the end-of-life decision making of a patient with the patients' families. The end-of-life policy did not come as a one-off, but through legislation through a medical case that happened (Detering et al., 2010). These policies have had both positive and negative impact on the treatment decisions of patients in end-of-life care. The regulations set have had a wide effect on the nurse-patient relationship thereby resulting in varied outcomes. The decision-making process in the end-of-life care has been influenced by various ethical considerations hence influencing the policy decision. A person nearing the end of their life may experience unmet needs such as emotional support, communication, and respect thereby such policies and the set ethics come handy in end-of-life scenarios.
Patients who are nearing the end of their life can access the services of a nurse. Nurses are tasked with the responsibility of providing care to end-of-life patients. The care may include supporting the patients, and their families through recognition and adaptation of the patient's coming death. Nurses are also tasked with identifying the patients' symptoms, administering medications, and giving the patients' and their families the needed comfort so that they can understand and adapt the impending outcome. Nurses have a critical role to play in end-of-life care; this includes being aware that death is near, and relaying that information to the patients’ families, collaborating with other healthcare teams to ensure management of symptoms and offer support to patients and their families (Sulmasy, 2002). It is with this that the duty of a nurse in end-of-life care is important and should be taken into detail to ensure patients and their families are prepared for the eventuality that may come.
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There was need to bring about an end-of-life care policy through a legislation for patients who were dying with advanced age, and to provide guidelines for minimizing medical interventions that were not termed wise, while improving the care quality of those dying within an ethical procedure trough professional, patient, and family concessional process. The end-of-life healthcare policies were formulated through the adoption of the hospice concept. This was in response to a case which was brought before the US supreme which held that physicians were not obliged to terminate the life of a patient art the family's request but through clear and upright procedures. This led to various states to adopt their legislation that would stipulate the policies to be adopted to deal with end-of-life patients. There is much legal and ethical agreement about those nearing the end of their lives, it with this that the outright legislations were adopted to give room for the patient’s life to end in full agreement of the family and the best medical procedures.
The policies regarding the healthcare practices about end-of-life care decisions have proved to be positive as they have had no negative issue in the political side since their adoption in various states starting with Oregon as the districts and medical facilities have benefited from the policies. The policies have loosened the barriers that existed to patients in need of services and the financial capabilities in hospitals and other medical facilities (Sulmasy, 2002). The policies have also come handy in the care and the attention given to patients and their families by communication through care, advice and psychological needs to the patients. This goes a great extent to show that, since their adoption, the policies have played a critical role in the advancement and treatment of decisions made by medical practitioners, end-of-life patients, and their families.
End-of-life regulation comes with their fair share of effects on the patient outcomes. The regulations may vary from advice and the way the communicated messages are relayed from the patient to the nurse (Sprung et al., 2004). The controls regarded give a feeling of responsibility to the nurse who will be accountable for any eventuality. The nurse patient-relationship should not be intimate as this will create a distance between the nurse and the patient thereby minimizing chances of responsibility and guilt arising. In case of the death of a patient.
In end-of-life care, patients are given the autonomy which grants them the right to control the way they want to be treated by their preferences (Karnik & Kanekar, 2016). The practitioners have to work for the good of the patients by controlling their ego. Ethics dictates the nurse to provide extensive information treatment to the patient and the family to avoid any harm to the patient. Before making decisions, practitioners have to consider the distribution of justice equally in cases where the situations may be futile.
Conclusion
It is without denial that patient in end-of-life cares require adequate attention to keep their mind and those of their families in good shape as they are in the critical stage. The needs of the patients should be considered by those handling them, like nurses, through elaborate communication measures which are guided by the laid policies and the stipulated ethics which influence the relationship between the practitioners and the patient. This is so because they are guided by ethics which play a vital role in the lives of end-of-life patients.
References
Karnik, S., & Kanekar, A. (2016, May). Ethical Issues Surrounding End-of-Life Care: A Narrative Review. In Healthcare (Vol. 4, No. 2, p. 24). Multidisciplinary Digital Publishing Institute.
Sprung, C. L., Cohen, S. L., Sjokvist, P., Baras, M., Bulow, H. H., Hovilehto, S., ... & Schobersberger, W. (2003). End-of-life practices in European intensive care units: the Ethicus Study. Jama, 290(6), 790-797.
Sulmasy, D. P. (2002). A biopsychosocial-spiritual model for the care of patients at the end of life. The gerontologist, 42(suppl_3), 24-33.
Detering, K. M., Hancock, A. D., Reade, M. C., & Silvester, W. (2010). The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. Bmj, 340, c1345.
