TEXTBOOK:
Leadership
in Nursing Practice
(Changing the Landscape of Health Care), 3rd
edition, by Dan Weberg, Tim Porter, & Kathy Malloch
Scenario/Discussion Questions
According to the
Jefferson School of Population Health, the provision of compassionate, quality
care for individuals with chronic illness continues to be a challenge. Many
patients continue to suffer because pain is not adequately addressed during
treatment, and patient preferences are often neglected at the end of life. In
particular, hospitalized patients with lung cancer, at the end of their lives,
experience barriers to palliative care access and do so on a broad scale,
across the United States (Reville, Miller, Toner, & Reisnyder 2010).
All too often, confusion
exists about the differences between palliative care and hospice care and about
when to initiate each type of care. Both physicians and nurses have
acknowledged their lack of training in end-of-life communication and the point
at which to suggest a transition to palliative care. For hospitalized patients
with lung cancer, a delay in referral to palliative care until late in the
disease trajectory has been documented (Reville et al, 2010), and this service
is largely underutilized as a means to address symptoms and psychological
concerns. Specifically, palliative care professionals were consulted for only
8% of all hospital admissions among this patent population.
Questions
1)
As an experienced nurse, identify and
describe the specific opportunities at the institutional, organizational,
public, social, and health policy levels to improve palliative, hospice, and
end-of-life care.
2)
What are the issues at each level that
prevent adequate care?
3)
Which key stakeholders need to be involved
in addressing this issue?
4)
How will you evaluate progress at each
policy level when changes are made?
5)
Describe a plan specific to nursing
interventions at each policy level, including the facilitators of and barriers
to the policy proposal.