Position Statements 2006 [Nurses' Role n Providing Care to Dying Patients and their Families]

Nurses’ Role in Providing Care to Dying Patients and their Families

ICN Position:

Nurses are uniquely prepared to offer compassionate and skilled care for dying patients and their families.The International Council of Nurses (ICN) views the nurse’s role as fundamental to a palliative approach that aims to reduce suffering and improve the quality of life for dying patients and their families through early assessment, identification and management of pain and physical, social, psychological, spiritual and cultural needs.

ICN supports national nurses associations in their endeavours to:

Support nurses dealing with complex palliative care issues related to death and dying, including compassionate and skilled care during the end stage of life, respecting the patient’s will and ethical standards and cultural norms in death and mourning, and addressing the support and bereavement needs of family members in homes, hospital settings, hospices, nursing homes and other places where terminal care is provided.
Advocate for nurse participation in multidisciplinary approaches to care for dying patients and their families.
Promote nursing care that respects ethical and cultural principles and national nursing legislation.
Enhance involvement of nurses in discussions, policy and legislation related to issues of death and dying including care of dying patients and their families.
Promote integration of the following into basic and post-basic nursing curriculum: understanding a palliative approach, skills in pain assessment and management, respect for cultural values, the right of dying patients to make informed decisions, including the right to choose or to refuse treatment, and the right to a dignified death.

Background:

Increasingly people are living longer and have a range of chronic and complex illnesses that are life limiting. A palliative approach has much to offer to them and their families. Nurses have a responsibility to be knowledgeable and skilled in providing care to dying patients and their families.

Dying persons and their families have individual cultural beliefs and values. Nurses must provide culturally sensitive and holistic care that respects spiritual and religious beliefs. A caring and supportive environment that acknowledges the inevitability of death helps family members to accept and deal with loss and grieving.

Advances in life-sustaining procedures and changes in societal values about quality of life have raised ethical dilemmas in nursing. The current debate mainly focuses on euthanasia. However other issues, such as withholding or withdrawing treatment, patient directives and choices or “living wills” and concerns for quality of life are equally important.

The role of nurses and other health care professionals in caring for dying patients continues to be debated and nurses must be knowledgeable about the current issues and legislation about end stage of life issues.

The alleviation of pain and suffering is a fundamental nursing responsibility and nurses are expertly trained in pain management, palliative care and in helping people in dealing with grief, death and dying. The quality of care during the end stage of life greatly contributes to peaceful and dignified death and provides support to family members in dealing with their loss and grieving process.