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*N126-U4-end of life
Dobrisky-End of Life Care
| Question | Answer |
|---|---|
| ***individualism outweighs | culture |
| consider the patient's view rather than | ethnicity or race in delivering care |
| be sure you know the patient's | wishes and don't assume because of their culture/race |
| it is important for a nurse to have what competence when caring for the dying patient | cultureal competence |
| what is the #1 important cultural competence? | know yourself |
| full disclosure is frowned upon in | nonwestern cultures |
| how do you handle it when a family says don't tell pappy he's dying? (considered "disclosure") | you ask the patient what he knows and what he wants to know and what he doesn't want to know |
| what would be risked if full disclosure is not given to the patient? | unable to say goodbye, unable to explore all avenues of treatment |
| medicine's focus in EOL is ________; nursing in EOL is on _________ | cure; care |
| realize that organ donation and autopsy | are not accepted in some cultures |
| if the client answers yes to do you understand how should you proceed? | ask them to explain what they understand...many cultures say yes because they don't want to cause more work for anyone |
| who should we use as an interpreter when language is a barrier? | a professional...not a family member |
| the #1 focus on EOL care? | KNOW YOURSELF |
| what is the #1 predictor of how patients feel they have been cared for? | communication |
| poor communication leads to | needless suffering |
| who wants to talk about death the most? | the dying patient |
| clear, honest, compassionate communication is essential to | quality EOL care |
| genuine listeners are | great EOL care providers |
| communication should be | honest and truthful |
| can you give too much information to patients/families? | yes |
| communication has three levels | content, emotional expression and relationship |
| why do we assess the anxiety level of a patient before sharing information? | to be sure they are ready to receive information |
| avoid too much info and making | assumptions |
| 80% of communication is | nonverbal |
| what are the three phases of communication? | introductory, working and final |
| during the final phas of communication in EOL what should you teach? | teach the family physical signs of impending death (motteling) |
| when a patient is near the end of life and speaking to someone you can't see do you reorient them? | no |
| in the working phase our goal is to | learn who the patient is by initiating life review and to determine the patient's wishes |
| avoid stating | nothing more can be done |
| trust & rapport should be built in the | introductory phase |
| what are the four E's of communication? | Engage, Empathize, Educate, Enlist |
| Engage means | have info we need and use good timing |
| empathize | Name the feeling (frightened), check the understanding, respect their decisions, support their decisions and let them know you are there for them, enlist patient's families for help |
| when families decide they don't want patient to know, it is important to | let them know that the loved one won't be able to say goodbye, that treatment options will be kept from the patient |
| when families are in conflict | don't ever take sides |
Created by:
Lori Dobrisky
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