PracticeEffective pain and symptom management is an important part of patients with life-threatening diseases and their families. Reducing pain and other symptoms does not only provide relief to suffering patients but will also eases the grief that families will face after the patient’s death (Sun et al., 2015). Nurses play a huge role in reversing the treatment of pain and other associated symptoms and should therefore possess basic competencies in the management of symptoms. To achieve quality outcomes, nurses need to use patients and family fears together with the knowledge and skills regarding symptom management using pharmacological, nonpharmacological, and integrative therapies (Paice et al., 2018).EducationNurses need to learn about the seriously ill , other vulnerable populations and the required prioritization. According to the American Nurses Association (2017), Content about palliative care should be included in any curricula including the academic and development settings. Nurses also need to utilize palliative care learning materials as provided by nursing organizations and agencies.ResearchGiven that healthcare resources are limited, it is important that end of life care is evidence-based rather than solemnly based on the provider’s intuition. Chronically ill patients deserve quality, person-centered and evidenced-based care whether they are at the home, hospital, or any other facility. Evidence-based interventions help guide nurses in their choices of the most appropriate treatment plan (Black et al., 2015). Research also helps nurses highlight and be aware of the potential benefits and harms and make informed decisions based on the expected outcomes (Black et al., 2015).AdministrationAn unhealthy work environment can lead to medical errors, conflicts and stress among healthcare teams, and ineffective care delivery (AACN, 2016). Due to these reasons, healthcare providers need to promote a healthcare environment that will benefit both the patient and the family. The goal is to provide quality care and leave the patient and family members fully satisfied.peer 2 linEnd of life care constitutes several aspects, including pain and symptoms management, ethical decision-making, and cultural sensitivity. Advanced practice registered nurses as the superiors in clinical practice and care delivery at the system level. Nevertheless, challenges are emerging in palliative care clinicians’ current surroundings necessitating the advanced training of registered nurses to provide care for every patient and their families.Practice- Identity, assess, and treat psychosocial and spiritual issues conceded with palliative care.APRN nurses strive to improve their primary standards of palliative care. Thus, compelling them to seek palliative care knowledge for an overall improvement in providing care for a patient and people close to them (Hoerger et al., 2018). In their practices, especially among dying patients, they designate specific care and preferences. Such consideration would improve their technique and recognition of conditional changes and compassion and support to the patients and those important to them.Education- Advances knowledge about palliative care.Availability of End-of-Life Nursing Education Consortium (ELNEC) improves palliative care by offering new directions and improving the preceding techniques. According to Dahlin and Coyne (2018), ELNEC advances knowledge about end of life care among nurses through various projects, including train-the-trainer course, professional development seminars and conferences, and hosting a regional training session to help nurses from both rural and underserved communities to improve their innovative ways in caring for dying patients.Research- Asses the bonding of patient, family satisfaction, and their utility of health care resources for palliative care choices.According to Weave et al. (2019), improving nursing care for dying patients extend to research constituting investigation and evidence-based recommendations. Therefore, the research assesses and reassesses challenges conceded with palliative choices, the objectives, and disseminating standards for palliative care (Ferrell et al., 2018). Hence, it offers credible information for improving comfort and quality of life among palliative patients.Administration- Support palliative care.Precisely, the administration supports the development and incorporation of palliative care for patients and families by coordinating tools, equipment, and medical staff to ensure smooth running during palliative care. Tertiary-level healthcare providers are obliged to provide inpatient services, including radiotherapy and other treatment care, for people with intractable complications and suffering. However, the role of the family is critical in palliative care. Medical staff aceturate that the patient and their families understand the essence and prognosis and the medication prescribed. The support of health workers and the family member contribute the effective collective decision-making (Ferrell et al., 2018)THE ORIGINAL ASSIGMENT WAS THE FOLLOWING:End of LifeEnd-of-Life Care (including advanced directives, palliation) Topics to review: Article: Nurses roles and responsibilities Providing care and support at end of life.https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdfChoose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life managementUsing the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.Practice1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.Education1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.Research1. Increase the integration of evidence-based care across the dimensions of end-of-life care.2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.Administration1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.4. Support the development and integration of palliative care services for all in- and outpatients and their families. for more information on Nursing Organizations and Agencies check on this:https://en.wikipedia.org/wiki/American_Nurses_Association
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