Nurses are pivotal in ensuring that people who are approaching the end of their lives are supported to die in the place of their choice, as far is practically possible, in the way that they wish with the people they love.
No matter where this is the nurse can be the person that they see the most and have the most trust in. As nurses we must not abuse that trust and should be prepared to advocate on behalf of the dying person helping them to die well.
There appears to be a perception that providing end of lie care is the role of specialist nurses or palliative care teams – this is absolutely not the case. It is the role of every nurse, whether that is in the prison sector, with homeless people, in care homes or the acute hospital nurses must take the time to talk to dying people about their wishes and as far a possible involve the people who matter to the dying person to plan and coordinate their end of life care.
Nurses are, of course, part of a team and should not be expected to work in isolation in providing end of life care. However, they are often the people who are seen most by dying people and their families and are also perceived as being approachable and knowledgeable.
The key skills include:
- Communication skills – the ability to initiate or take part in conversations about death and dying
- Assessment – the ability to assess people’s needs, in partnership with the individual and those who are part of their lives, discuss them with everyone involved and make sure this is written down and shared
- Coordination – All the care and treatment needs and wishes of the person who is dying are shared with everyone who might have contact with them. If possible one person, who may very well be a nurse, particularly in the community, takes responsibility for this and that individual ensures that they or a nominated deputy are available for both the dying person, their family and other care professionals to ensure that the plan of care is followed and unnecessary confusion, stress and distress are avoided
- Competence – all nurses should be competent to provide compassionate and sensitive end of life care with the support of the wider multi-disciplinary team. This is a fundamental nursing skill and not one that should be avoided.