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Clinical review

Fatigure and depression in patients with advanced metastatic disease

Published: 2009 Vol: 3 No: 2
Author(s):
Patricia O’Regan, Josephine Hegarty
Patients with advanced cancer often experience symptoms that impact negatively on their quality of life in the final phase of the disease process. Such symptoms include fatigue and depression. Fatigue is common in patients with advanced cancer. Depression is also a significant symptom among palliative care patients and patients with advanced metastatic disease. Both symptoms may prove difficult...
Editorial

Emulating a role model will improve communication skills

Published: 2008 Vol: 2 No: 4
Author(s):
Jo Hockley
In the last three editorials, the theme of communication has been explored. Issues discussed include how nurses deal with complaints, engage in the process of ‘being there’ for patients and families, or communicate the importance of end-of-life care (EoLC) strategies to their colleagues, encouraging them to take an active role in planning EoLC. Effective communication skills underpin the...
Editorial

Care of the dying is not an option but a nursing necessity

Published: 2007 Vol: 1 No: 1
Author(s):
Penny Hansford, Vicky Robinson, Helen Scott
Nurses are the professionals who deliver the majority of care to dying people. About six out of 10 people die in acute hospital settings, with only two dying in their home and a further two dying in care homes. However, for most people in the UK, the last year of life will be spent at home.
Editorial

Hygiene care for dying people is a symptom management issue

Published: 2007 Vol: 1 No: 2
Author(s):
Vicky Robinson
One Saturday I visited a dying patient at home. I was accompanied by a medical colleague. The patient had been discharged from hospital a week previously following an abdominal paracentesis (removal of excess fluid from the peritoneal cavity (ascites) by inserting a surgical drain through the abdominal wall). The patient had expressed a wish to die at home.
Editorial

The detrimental effect of lack of nurses on end-of-life care

Published: 2010 Vol: 4 No: 2
Author(s):
Helen Scott
End-of-life care (EoLC) is currently high on the political agenda. The government has stated that ‘better care for the dying should become a touchstone for success in the modern NHS’ (Department of Health (DH), 2008). The End of Life Care Strategy, launched in 2008, is a government-funded initiative setting out comprehensive guidance enabling the provision of dignified and respectful EoLC.
Editorial

End of Life Care Strategy: a key milestone in care of the dying

Published: 2008 Vol: 2 No: 3
Author(s):
Helen Scott, Penny Hansford, Vicky Robinson
The long-awaited, first ever End of Life Care Strategy was launched in England last month (Department of Health (DH), 2008). It is a major, government-funded initiative that sets out a comprehensive framework for caring for people, with dignity and respect, at the end of their lives. It addresses end-of-life care (EoLC) in all settings — hospitals, the community and care homes — and recognises...
Editorial

Patients' symptoms cannot be managed by medication alone

Published: 2007 Vol: 1 No: 3
Author(s):
Vicky Robinson
What does a ‘black box’ have to do with end-of-life care? The term ‘black box’ refers to a collection of different recording devices used in transportation, for example, the flight data and cockpit voice recorder in aircraft. The recovery of the black box is considered to be second only in importance to the recovery of bodies following a fatal air crash. Black box is also a term used in physics...
Editorial

Competence in end-of-life care does not need special skills

Published: 2009 Vol: 3 No: 3
Author(s):
Helen Scott
T he husband of a colleague died recently. He had been suffering from long-term chronic health problems and was physically disabled. He had been living quite happily in a care home for some months. When his condition suddenly deteriorated he was transferred to hospital where he was admitted to an acute assessment ward. He died a few days later.
Clinical skills

The dying touch: infection control at the end of life

Published: 2007 Vol: 1 No: 2
Author(s):
Lynn J Parker
Vulnerable individuals who use healthcare services are susceptible to the possibility of acquiring a healthcare-associated infection (HCAI). Government guidance has concentrated on providing strategies that assist in the reduction of such infections. All organisations that provide health and social care should have policies and procedures in place to reduce the risk of patients acquiring an...
Editorial

Issues relating to nutrition and hydration at the end of life

Published: 2010 Vol: 4 No: 3
Author(s):
Helen Scott
The personal narrative in this issue (pages 64–65) is a stark reminder of the despair relatives/ friends experience when they perceive care and communication at the end of life to be inadequate. Cessation of active management can be considered abandonment, especially when dying patients are made ‘nil by mouth’. The provision of food and fluids at the end of life requires examination in the...
Editorial

Debating issues around death and dying in general settings

Published: 2009 Vol: 3 No: 4
Author(s):
Jo Hockley
Over the last few weeks there has been a stream of letters in UK national newspapers debating different aspects of care associated with people who are dying. In particular, there has been a critique of the Liverpool Care Pathway for the Dying Patient (LCP) documentation (Ellershaw and Wilkinson, 2003), hydration at the end of life and ‘do not attempt resuscitation’ orders. For many in health care...
Clinical skills

Principles of skin and wound care: the palliative approach

Published: 2007 Vol: 1 No: 1
Author(s):
Jane McManus
The term ‘palliative care’ is used to describe care given to patients with advanced, life-limiting illness of any aetiology. It is a philosophy of care that is patient and family-centred, designed to meet the needs of the patient and family. Wound care for palliative care patients should be managed so that patient and family needs/concerns are the main focus of attention. Dressing products...
Editorial

What does 'being there' mean in the context of nursing?

Published: 2008 Vol: 2 No: 1
It is important for nurses to know themselves — their limitations, their ability to meet patients’ spiritual and psychological needs and where to turn if meeting those needs is problematic. The notion of ‘being there’ for patients is not a new concept. Palliative care literature often makes reference to this idea. The need for nurses to empathise, value, listen and build relationships with...
Editorial

'I don't care about the injection nurse - just stay with me!'

Published: 2009 Vol: 3 No: 1
Author(s):
Helen Scott
A recurrent theme throughout this issue of End of Life Care is the importance of ‘staying’ with patients. ‘Staying’ is part of the professional act of caring. It involves remaining physically and emotionally present for patients throughout their pain or emotional anguish. It does not necessarily involve trying to do something practical.
Editorial

Compassion in nursing and its importance in end-of-life care

Published: 2010 Vol: 4 No: 1
Author(s):
Vicky Robinson
Nursing is skilled compassion. Without compassion, one cannot nurse. In essence, compassion is sympathetic and empathetic pity and concern for the suffering or misfortune of others. Many people confuse sympathy and empathy, using the terms interchangeably. However, they are quite different and it is really important that the difference is understood. Sympathy, as part of compassion, means to have...
Editorial

Developing empathy: patients need and want to be heard

Published: 2009 Vol: 3 No: 2
Author(s):
Vicky Robinson
Editorial

The practice of end-of-life care is the essence of nursing

Published: 2008 Vol: 2 No: 2
Author(s):
Penny Hansford
I have just finished reading the latest report published by the Healthcare Commission (HCC) Spotlight on Complaints (HCC, 2008). It reiterates guidance issued in a previous report about the need for ‘providers to apologise to patients and their families when something has gone wrong’. Spotlight on Complaints states that, in one out of 10 cases referred to the HCC, the person making the complaint...
Editorial

The importance of therapeutic relationships at the end of life

Published: 2010 Vol: 4 No: 4
Author(s):
Helen Scott
Dame Cicely Saunders once wrote that central to end-of-life care (EoLC) is the acknowledgement of potential, continued human growth and dignity despite weakness and loss. She also asserted that no member of the multiprofessional team is more central to such human discovery than the nurse (Saunders, 2006). Therapeutic nurse/patient relationships are highly valued by patients and nurses alike.
Clinical review

Providing psychological support for adults living with cancer

Published: 2010 Vol: 4 No: 4
Author(s):
Louise Burzotta, Helen Noble
A cancer diagnosis generates fear and uncertainty for patients, families and friends. It can lead to the patient experiencing anxiety and, in some cases, depression. Nurses find caring for patients with cancer and their family/friends stressful, particularly with regard to providing psychological support. This may cause them to adopt ‘blocking’ behaviour to avoid emotional conversations with...
Clinical review

Psychological issues associated with end-stage cancer patients

Published: 2010 Vol: 4 No: 2
Author(s):
Laura Borg, Helen Noble
This article will explore the psychological issues associated with end-of-life care for patients who have cancer. Psychological distress is a term that is widely used in relation to people coming towards the end of their lives. It was therefore felt important to examine specific components of psychological distress. Three main issues facing patients with advanced cancer were identified from the...

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