The term public health nurse, as was originally intended was to treat social, and economic challenges, not just taking care of the sick individuals. It started in the mid-18th century in England, where Florence Nightingale gave knowledge to the first nurses in the district nursing model. Together with her classmate, Henry Street Settlement House was developed, New York City. Regardless of the social assertions that the poor were responsible for their social status, Wald often emphasized the dignity of a person of even the poorest in the society. Also, it is through her that in 1895, she and her colleagues enrolled more nurses, and various activists, lawyers, union organizers, and social reformers t help in developing the health care in the society(Meier, 2009, p. 292).
Home health, hospice, and palliative nurses are different from the other nurses in the nursing sector by the unwavering end-of-life healthcare they provide. Their obligations include around the clock (24-hours) nursing availability, management of pain and other health signs, and family assistance. These community healthcare requirements which are to work inconsistency with the personal, academic preparation, experience, and obligations, and as a result enhance the highest level healthcare are met through the roles of these nurses. Despite the setting, the hospice and palliative nurses attempt to attain a comprehension of the precise health issues from the perception of every patient and the respective family.
Patients served include, the children and grown-ups with hereditary injuries, individuals of any age with acute, severe, and life-threatening diseases, people suffering from continual chronic situations, and severely and critically ill patients. According to Arnold (2004), “Palliative, and hospice care is a general method to caring for the ill, and the interventions they use is through the integration of the disease-modifying therapies. Through the growing practice of expertise for the properly trained healthcare experts in this sector, they are required to improve health for the patients with life-threatening or incapacitating chronic diseases (p. 472).”The skills in the palliative and hospice care alike to the other medical professionals demands specific areas of proficiency, abilities, and self-regulation.
Converse to hospice care palliative care involves either of the primary, secondary, or tertiary levels of practice. Brody (2010) notes, “Primary level of palliative care is and should be relevant to what the treating practitioners offer their patients (namely pain, and symptom control, conversations regarding advance care planning). On the other hand, a secondary level of palliative care is provided when the practitioner refers to an expertise level palliative care specialist for anomaly complex or problematic situations. Tertiary level, on the other hand, constitutes study and teaching in addition to expertise-level palliative care skills” ( p. 546)
Nurses in this line of duty (palliative, and hospice) come across several ethical dilemmas in their tasks. The predicaments have emerged to be usual in the light of the advances in the medical field. The various nurses who are in the limelight of offering proper and affectionate and professional EOL (end-of-life) care, feel inadequate to handle and publicize these unethical challenges when they take place (Brumley, 2007, p. 998). The unethical practices revealed in the hospice, and palliative care is the same as to those shown in the literature. This includes inadequate communication, unregulated pain control provisions of healthcare which is not beneficial, patient autonomy threatened, matters associated with the ending of life-prolonging treatments. Brumley (2007) accords, “The key ethical act revealed in the literature is the medical futility. These practice results into severe pain, loss of self-esteem, and the reduction in the quality of life (p. 999).”
References
Arnold RM, W. D. (2004). Broaching the Topic of a Palliative Care Consultation with Patients and Families no. 42. Journal of Palliative Medicine., 472-473.
Brody A, C. E. (2010). he Effects of an Inpatient Palliative Care Team on Discharge Disposition. Journal of Palliative Medicine, 541-548.
Brumley R, E. S. (2007). ncreased Satisfaction with Care and Lower Costs: Results of a Randomized Trial of In-Home Palliative Care. Journal of the American Geriatrics Society, 993-1000.
Gelfman LP, M. R. (2008). Research Funding for Palliative Medicine. Journal of Palliative Medicine., 36-43.
Meier DE, B. L. (2009). OLST Offers Next Stage in Honoring Patient Preferences. . Journal of Palliative Medicine., 291-295.
