British Journal of Community Nursing, 2013, Volume 18, Number 1, Pages 40 to 42
Summary of Article
The article entitled “A ‘good death’ at home: community nurses helping to make it possible” was written by Elizabeth Adamson and Susanne Cruickshank and published in the British Journal of Community Nursing in 2013. The authors presented relevant concerns regarding the increasing trend of addressing end-of-life choices of patients, particularly opting to die at their respective homes. This trend was allegedly supported by thrusts in government policies which acknowledge adherence to conform to patients’ preferences for addressing end-of-life situations. The authors have emphasized that the role of community nurses were seen as instrumental in attending to the needs of patients facing end-of-life concerns, especially when patients have signified their homes as the most preferred setting to transcend through natural demise. As acknowledged, the authors discussed the findings noted in a research study reportedly written by Cruickshank, et al. (2010) particularly facets which emphasized the significant role of community nurses in “in facilitating a patient’s choice to die at home; assessing, practicing and reflecting on ways to ensure the best-possible death occurs” .
Critique of Article
One strongly believe that the information contained in the article is relevant and beneficial, especially to community nurses, whose role has been specifically identified as gaining crucial importance in attending to end-of-life situations. The authors effectively provided credible and reliable sources of information which community nurses could further pursue to enhance relevant knowledge pertaining to assisting patients who opt to transcend to death at their respective home setting.
One was most appreciative that a brief review of related literature in terms of identifying research studies from previous authors who provided pertinent steps that would assist in enabling a community nurse to attend to the needs of a patient in near-death scenarios. One hereby affirms that there must be appropriate training, orientation, and immersion for community nurses to address these trends prior to being classified as highly competent and qualified to undertake these responsibilities. As one has observed and read through various articles on the concepts for palliative care, the ability of health care practitioners to address end-of-life situation necessitates, not only the theoretical framework for palliative care; but also the skills, training, and experience in attending to diverse end-of-life scenarios. Likewise, the health care practitioners should be able to accurately assess the specific needs of the patient to enable them to accord that particular health care that is most needed at that crucial time.
Finally, since proximity to the work setting of community nurses is identified as one of the factors to be considered in providing appropriate attention to patients who signified preferences to die at home, the issue of workload and availability of other community nurses who are to be retained in community health centers must be effectively anticipated so that the health requirements of other community members are not jeopardized or compromised.
Application of Article
One would definitely be able to apply the concepts and knowledge learned from the article to one’s practice as a nurse. As health care practitioners and caregivers, nurses are expected to be knowledgeable in various facets of care, including community nursing, whose roles in palliative care have been duly emphasized. The applications of theories and concepts on palliative care would always be useful in whatever setting the patient prefers or opts to die. However, in this particular scenario, since the trend and thrust appears to be focused on patients preferring to die at home, nurses who opt to be assigned in local communities should therefore be prepared to address situations which are not traditionally or commonly encountered in health care institutions. These unexpected challenges could include availability of medical supplies or medications needed, time frame for providing direct patient care within the home setting, overall condition of the patients’ residence which affect the delivery of care, presence(or absence) of other members of the family, presence (or absence) of other health care practitioners as imminently needed, and level of training, as well as experience to attend to patients whose health conditions could be complex or complicated.
Overall, one would be able to apply the principles and guidelines for addressing end-of-life situations through the information relayed in the article; as well as advancing one’s knowledge on the subject through further readings, research, and learning more about death at home and the increasing crucial role that community nurses play to attend to various patients’ end-of-life needs.
Reference
Adamson, E., & Cruickshank, S. (2013). A ‘good death’ at home: community nurses helping to make it possible. British Journal of Community Nursing, Vol. 18, No. 1, 40-42.
