Role In Facilitating End Of Life Care ✓ Solved

Q 1agacnps Role In Facilitating End Of Life Care Would Be The Same As

Q 1agacnps Role In Facilitating End Of Life Care Would Be The Same As

Role of Advanced Practice Registered Nurses, specifically AGACNPs, in facilitating end-of-life care aligns with the responsibilities of all healthcare professionals to prioritize patient interests and honor their wishes (Walker & Serviduduio, 2015). Initiating early, honest conversations with patients about their end-of-life preferences, ideally involving close family members, is fundamental in building mutual understanding and guiding care decisions (Walker & Serviduduio, 2015).

A significant challenge in end-of-life care involves establishing legally binding directives like living wills and advanced directives (Cogo & Lunardi, 2015). A living will is a specific document that dictates a patient’s healthcare preferences when terminally ill, and it remains unchanged unless the patient explicitly amends it; in contrast, an advanced directive encompasses a broader set of instructions that can be dynamically modified by the patient or appointed decision-maker (Cogo & Lunardi, 2015). Physicians and healthcare teams often encounter situations where incapacitated patients have directives, but next of kin or decision-makers choose to override or disregard them, which can pose ethical dilemmas and legal challenges, especially in jurisdictions such as Florida where family decisions may override directives (Cogo & Lunardi, 2015).

In clinical practice, healthcare providers strive to honor patient wishes by reviewing directives with decision-makers, emphasizing the importance of aligning care with the patient’s values. When conflicts arise, ethics consultations aid in resolving disagreements by evaluating patient autonomy and legal statutes (Walker & Serviduduio, 2015). Case studies involving chronic diseases like COPD and CKD highlight the importance of early conversations on end-of-life preferences, which can ease decision-making in critical moments and ensure care aligns with the patient’s desires (Cogo & Lunardi, 2015; Walker & Serviduduio, 2015).

The legal weight of advanced directives varies by state; in Florida, directives serve as guides rather than absolute authorities, with family decisions often taking precedence (Ouimet Perrin & Kazanowski, 2015). This practice underscores the ethical obligation for healthcare providers to advocate for patient-centered care, explaining disease trajectories and involving patients in decision-making processes whenever possible, even when they are minors or have progressive illnesses like Duchenne muscular dystrophy (Ouimet Perrin & Kazanowski, 2015). Respecting patient autonomy—particularly in chronic, progressive illnesses—is ethically imperative to promote wellness, independence, and dignity at end of life (Ouimet Perrin & Kazanowski, 2015).

Sample Paper For Above instruction

The role of Advanced Practice Registered Nurses, including Adult-Gerontology Acute Care Nurse Practitioners (AGACNPs), in facilitating end-of-life care is integral to ensuring that patient wishes are prioritized and upheld throughout the healthcare continuum. These responsibilities encompass initiating early, meaningful conversations about end-of-life preferences, guiding patients and families through complex decisions, and navigating legal and ethical challenges associated with advance directives.

Communication and early planning are foundational elements of end-of-life care. AGACNPs are uniquely positioned to initiate discussions about prognosis, treatment options, and patients’ values, thereby fostering mutual understanding and empowering patients to have control over their care trajectory (Walker & Serviduduio, 2015). These conversations are more effective when they occur early, allowing adequate time for patients and families to process information, express concerns, and make informed choices aligned with the patient's wishes (Walker & Serviduduio, 2015). The presence of loved ones during these discussions is essential for emotional support and for consensus-building, particularly when navigating potentially conflicting decisions later in the illness course.

Legal documents such as living wills and advanced directives serve as critical tools in end-of-life planning. A living will explicitly states the patient’s preferences regarding life-sustaining treatments when they are unable to communicate, while an advance directive can include broader decisions and designate decision-makers (Cogo & Lunardi, 2015). These documents provide clear guidance to healthcare providers and family members, reducing ambiguity and ensuring the patient's wishes are respected. However, complexities arise when these directives conflict with family members’ wishes or legal statutes, especially in certain states where family decisions may take precedence over the directives (Cogo & Lunardi, 2015).

In practice, healthcare professionals work diligently to honor patient autonomy by thoroughly reviewing directives with decision-makers, explaining the significance of the documents, and clarifying the patient’s values and goals of care. When disagreements occur, ethics consultations serve as valuable resources to reconcile conflicts by evaluating ethical principles such as autonomy, beneficence, non-maleficence, and justice (Walker & Serviduduio, 2015). For example, in intensive care units managing chronic illnesses like COPD and CKD, early discussions about prognosis and patient preferences can significantly influence end-of-life care, leading to more aligned and respectful decision-making (Cogo & Lunardi, 2015).

Legal considerations vary across jurisdictions. In Florida, advanced directives act as guides rather than binding documents, with family preferences often taking precedence (Ouimet Perrin & Kazanowski, 2015). This underscores the importance of effective communication and documentation, as well as the need for ethical advocacy by healthcare providers who must explain disease progression and treatment options clearly to align care with the patient's values. For example, patients with Duchenne muscular dystrophy, who often face progressive muscular weakness affecting respiratory and cardiac functions, benefit from early and honest discussions about their disease trajectory and end-of-life preferences (Ouimet Perrin & Kazanowski, 2015). Ethical practice insists on respecting the autonomy of these patients, including involving them in decision-making when they are capable, regardless of age, and ensuring their wishes are prioritized whenever feasible.

In conclusion, AGACNPs play a vital role in facilitating end-of-life care by leading conversations early in the disease process, navigating complex legal and ethical landscapes, and advocating for patient-centered decision-making. Respect for autonomy, clear communication, and adherence to legal frameworks are key in ensuring that patients' wishes are honored and that end-of-life care is delivered with dignity, compassion, and respect for individual values.

References

• Cogo, S. B., & Lunardi, V. L. (2015). Anticipated directives and living will for terminal patients: an integrative review. Revista Brasileira de Enfermagem, 68(3), 464.
• Ouimet Perrin, K., & Kazanowski, M. (2015). End-of-Life Care. Overcoming Barriers to Palliative Care Consultation. Critical Care Nurse, 35(5), 44–52.
• Walker, S., & Serviduduio, C. (2015). How Can Palliative Care Discussions Occur Earlier in Patients’ Diagnoses? ONS Connect, 30(2), 21–26.
• Miller, B. (2017). Nurse in the know: The history and future of advance directives. Online Journal of Issues in Nursing, 22(3), 1-13.
• National Institute on Aging. (2018). Advance care planning: Healthcare directives. Retrieved from https://www.nia.nih.gov/health/advance-care-planning
• Wheeler, M. S. (2016). Primary palliative care for every nurse practitioner. Journal for Nurse Practitioners, 12(10), 650–651.
• Walker, S., & Serviduduio, C. (2015). How Can Palliative Care Discussions Occur Earlier in Patients’ Diagnoses? ONS Connect, 30(2), 21–26.
• Johnson, S., & Witter, P. (2019). Legal and Ethical Aspects of Advance Directives in End-of-Life Care. Journal of Palliative Medicine, 22(4), 423–429.
• Smith, R., & Williams, M. (2020). Ethical Challenges in End-of-Life Decision-Making. Annals of Palliative Medicine, 9(11), Ⅰ2047–Ⅰ2052.
• Evans, L., & Adams, S. (2021). Promoting Patient Autonomy in Palliative Care Settings. Nursing Ethics, 28(2), 265–276.