Table Of ContentP Palliative Care
Palliative Care Nursing
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A Guide to Practice
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Second Edition A
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Written by experienced authorities from around the world giving a wider international u
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perspective on palliative nursing, this substantially expanded new edition has been i
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specifically adapted to reflect working practices within the NHS. eC
All nurses, especially those that are new to palliative care, and those working in other ta
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areas of health where palliative skills are required, will find this essential reading. r
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‘Palliative Care Nursing addresses palliative care from a nursing perspective, and will assist nurses r
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in a variety of settings to care for people and their families with confidence and competence. It offers c
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all nurses an evidence-based approach to handling the many difficult scenarios faced by nurses who iu
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care for dying people and their families. It is an authoritative text on palliative care nursing and will e
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provide up-to-date knowledge and ideas for enhancing the care that nurses provide in assisting people s
achieve a peaceful dignified death.’ i
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Susie Wilkinson, in the Foreword
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Other books of related interest
ES
Helping the Patient with Advanced Disease: a workbook
de
Edited by Claud Regnard
c
i
to
Introducing Palliative Care, Fourth Edition i
on
Robert Twycross
nd
A Long Walk Home
Rachel Clark
a M E
The Cytotoxics Handbook, Fourth Edition n d
Edited by Michael Allwood, Andrew Stanley and Patricia Wright d a i
S rg te
Palliative Care Formulary, Second Edition a d
a
Robert Twycross, Andrew Wilcock, Sarah Charlesworth and Andrew Dickman n re b
c t y
Stepping into Palliative Care: a handbook for community professionals h
O
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Edited by Jo Cooper a ’
C
A
Communicating with Dying People and their Relatives o
Jean Lugton ra n
n n
K28536 d o
6000 Broken Sound Parkway, NW ISBN: 978-1-85775-839-9 a r
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Foreword by Susie Wilkinson
Palliative Care
Nursing
A Guide to Practice
Second Edition
Edited by Margaret O’Connor and Sanchia Aranda
Foreword by Susie Wilkinson
CRC Press
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Contents
Foreword
Preface
Acknowledgements
Chapter 1 Framing Palliative Care 3
Sanchia Aranda
Chapter 2 Evidence-Based Practice in Palliative Care 7
Alan Pearson
Chapter 3 Communication Skills in Palliative Care 23
Annabel Pollard and Kathleen Swift
Chapter 4 Occupational Stress in Palliative Care 41
Mary Vachon
Chapter 5 Ethical Decision-making 53
Margaret O’Connor and Sanchia Aranda
Chapter 6 Spiritual Care 69
Rosalie Hudson and Bruce Rumbold
Chapter 7 A Framework for Symptom Assessment 89
Sanchia Aranda
Chapter 8 Pain Management 101
Jeannine Brant
iv Contents
PALLIATIVE CARE NURSING
Chapter 9 Breathlessness 117
Mary Bredin
Chapter 10 Fatigue 137
Davina Porock
Chapter 11 Constipation 155
Beth Bailey
Chapter 12 Nausea and Vomiting 173
Robyn Millership
Chapter 13 Nutrition and Hydration 187
Margaret O’Connor
Chapter 14 Malignant Wounds 199
Wayne Naylor
Chapter 15 Confusion and Terminal Restlessness 215
Eleanor Flynn and Karen Quinn
Chapter 16 Psychological and Existential Distress 229
David Kissane and Patsy Yates
Chapter 17 Sexuality and Body Image 245
Kate White
Chapter 18 Complementary Therapies 259
Pauline McCabe and Amanda Kenny
Chapter 19 Working with Families 271
Linda Kristjanson, Peter Hudson, Lynn Oldham
Chapter 20 Bereavement 285
Donna Milne and Regina Millard
Chapter 21 Palliative Care in Chronic Illness 303
Julie Skilbeck and Sheila Payne
Chapter 22 Ageing, Dementia, and Palliative Care 313
Jenny Abbey
Chapter 23 Caring for Dying People in Critical Care 329
Jane Seymour
Chapter 24 Paediatric Palliative Care 341
Leanne Monterosso and Sharon De Graves
References 355
Foreword
Palliative Care Nursing: A Guide to Practice addresses palliative care from a
nursing perspective, and will assist nurses in a variety of settings to care for
people and their families with confidence and competence. Written in the main
by nurses, the book presents the expertise that the contributing authors have
gathered over many years of practical experience in clinical practice, backed by
extensive research and an awareness of the relevant nursing and medical
literature. The book is a tribute to all the contributing authors.
This book offers all nurses an evidence-based approach to handling the many
difficult scenarios faced by nurses who care for dying people and their families.
The World Health Organization definition of palliative care (WHO 2002)
emphasises, for the first time, the importance of ‘impeccable assessment’ in the
provision of high-quality palliative care. Each chapter of Palliative Care Nursing
gives nurses detailed guidelines for making in-depth assessments to elicit the
patients’ problems, followed by relevant advice to enable them to plan effective
care.
Palliative care is now accepted as an important aspect of health care by an
increasing number of government health departments and by health
professionals all over the world. For nurses worldwide who are contributing to
new palliative-care services, as well as for those working in established service
settings, this book is a must. It is an authoritative text on palliative-care nursing,
and will provide up-to-date knowledge and ideas for enhancing the care that
nurses provide in assisting people achieve a peaceful dignified death, and in
caring for their families and loved ones.
I have great pleasure in commending this excellent book.
Dr Susie Wilkinson
Head of Palliative Care Research and Senior Lecturer in Palliative Care
Marie Curie Palliative Care Research & Development Unit, London, UK
Preface
Palliative care has been traditionally defined as ‘ . . . specialised health care of
dying people, aiming to maximise quality of life and assist families and carers
during and after death’ (PCA 1999). The long tradition of the hospice
movement attests to a commitment to care for people who are dying. More
recently, palliative care has developed into an active practice-based discipline
aimed at improving the care of those who are facing the end of their lives.
Palliative care now begins before the traditionally understood dying phase of
care, and has become a multidisciplinary practice involving interactions with
other relevant parts of the health-care system.
Wherever palliative care is practised, it is founded on the following values
and principles (PCA 1999):
◗ the dignity of the patient and family;
◗ compassionate care of the patient and family;
◗ equity in access to palliative-care services;
◗ respect for the patient, family, and carers;
◗ advocacy on behalf of the expressed wishes of patients, families, and
communities;
◗ pursuit of excellence in the provision of care and support; and
◗ accountability to patients, families, and the wider community.
The success of the first edition of Palliative Care Nursing suggests that the
original goal of developing a book that would make palliative care accessible to
nurses in all health settings has been realised. This second edition has been
totally revised, rewritten, and redesigned to ensure that the book remains a
reliable and useful practice guide for nurses, especially for those who are new to
palliative care and those who work in other areas of health in which palliative-
care skills are required.
Preface vii
Palliative Care Nursing
This complete revision and rewriting required a comprehensive re-evaluation
of the first edition. Feedback from nurses revealed that the clinically focused
chapters of the earlier edition were especially useful in guiding practice, and this
has resulted in an increased focus on clinical issues in this second edition. The
content of the new book has therefore been refocused to incorporate a wider
range of clinical problems faced by nurses in their care of dying people. Each of
these new chapters has been written by a nurse with recognised expertise in the
topic area and a commitment to providing recommendations that are firmly
evidence-based. Many of these authors are from countries other than Australia,
and this reflects a widening of content and readership from a predominantly
Australian focus to a wider international scope.
This book will empower nurses through the development of their clinical
knowledge, and will contribute to enhanced care for people who are dying.
Acknowledgements
Radcliffe Medical Press has received much help and advice from the UK
contributors to this book, and from Susie Wilkinson, who wrote the foreword.
It was on Susie’s advice that we asked the following experts to review certain
chapters to ensure they reflected current practice in the NHS.
Margaret Goodman, Marie Curie Palliative Care Research and Development
Unit, Royal Free Hospital, London
Kath Jenkins, Marie Curie Centre, Caterham, Surrey
Carole Mula MA, Macmillan Nurse Consultant in Adult Palliative Care,
Christie Hospital NHS Trust, Manchester and North Manchester Primary
Care Trust
