End-Of-Life Care Improvements May Be Needed For Nurses To Acknowledge Patients' Dying Wishes
Nurses in the UK are often so busy that they cannot fulfil their patients' dying wishes, a new survey has found.The Royal College of Nursing (RCN) questioned 7,721 nurses about their views on the quality of the care they gave to their patients, finding that only ten per cent believed they always gave the best level of care they could.
In terms of end-of-life care, one-quarter of respondents said they had received no specific training on looking after dying patients. This is despite over 50 per cent regularly caring for such individuals.
Furthermore, nearly half of the nurses taking part in the survey reported that they did not have time to discuss patients' wishes for their final days, while just under 70 per cent said they knew of cases where seriously ill people were taken to hospital to be cared for, despite wanting to remain at home. A lack of training and appropriate resources were among the factors blamed for this.
Overall, results showed 59 per cent of patients did not have their preferences met in their final six months.
Chief executive of the RCN Dr Peter Carter commented: "Nursing the dying is an art, as well as a science. It cannot be reduced to a process of drug administration or a series of required nursing tasks, however important these things are.
"Nurses need time to listen to what the dying person wants, to recognise their fears and anxieties and to help loved ones to understand what is happening."
He added that "a 'good death' with expert care" can make a significant difference to a family's grieving process, by assuring them their loved one passed away in the place they desired.
However, for this to be possible for all patients, more resources would be needed, along with improved training relating to end-of-life care and less pressure on nurses to give them time to meet their patients' final wishes.
Expert Opinion
The details of this RCN survey are very worrying as patient care should always be a top priority, which means providing seriously ill patients with the treatment and advice they need, as well as respecting their final wishes and providing high-quality end-of-life care. <br/> <br/>“Unfortunately, in our work we have seen a number of cases where the final wishes of terminally ill patients have not been understood and taken into account, as well as errors that have resulted in patients suffering significant distress in their final days. As well as causing pain and suffering to the patient, poor end-of-life care has a significant impact on relatives and loved ones, making the grieving process even harder. <br/> <br/>“It is important training and resources are provided to staff dealing with terminally ill patients to ensure their final wishes are listened to and taken into account.” Mandy Luckman - Partner