Article in Critical Care Nurse discusses how
nurses at critical access hospitals can use palliative approach to care for
rural residents and families
The United States has 1,332 critical access hospitals located
in rural communities, providing mostly acute inpatient services, ambulatory
care, labor and delivery services, and general surgery.
With fewer than 25 beds each and a mean daily census of 4.2
patients, these hospitals may frequently have a single registered nurse as the
only healthcare professional on duty.
The article “Palliative
Care in Critical Access Hospitals” uses a case report to illustrate the
role that critical access hospitals play in meeting the need for high-quality
palliative care in rural settings.
Palliative care provides psychological, spiritual,
goal-setting and decision-making support not only to patients with
life-threatening illnesses but to their families as well.
The benefits of such care include early initiation of
comfort-focused treatment goals, decreased length of stay, continuity of care
and reduced cost of care without an increase in mortality.
Unlike hospice care, palliative care is appropriate early in
the course of illness, and patients can be simultaneously treated for their
condition, including therapies intended to prolong life.
Millions of patients are living with serious, complex and
potentially life-threatening conditions, increasing the need for palliative and
end-of-life care.
Co-authors Dorothy “Dale” M. Mayer, RN, PhD, and Charlene A.
Winters, PhD, APRN, ACNS-BC, are on the faculty of the College of Nursing,
Montana State University, Missoula.
“As expert generalists, rural nurses are well positioned to
provide support and promote quality of life close to home for patients of all
ages and their families,” Mayer said.
“In sparsely populated areas, nurses are not strangers to
their patients, often providing care to their neighbors, friends and
relatives.”
The healthcare system is increasingly moving away from the
consultative model of palliative care, in which clinicians bring in specialists
to advise on individual cases.
The authors advocate for a different model, in which frontline
staff, including physicians, nurses, social workers and chaplains, incorporate
a palliative approach into patient care, especially with patients who have
complex health conditions.
This approach is especially suited for rural area and critical
access hospitals, in part because of an inherent sense of community between
friends and neighbors.
“With limited personnel and resources, healthcare providers
can no longer rely on specialized palliative care teams as the only clinicians
to provide palliative care,” Winters said.
“Working together,
rural nurses and their urban nursing colleagues can provide palliative care
across all healthcare settings to meet the needs of rural residents and their
families.”
The American
Association of Critical-Care Nurses, which publishes CCN, offers
resources and tools to help nurses care for patients and their families at the
most difficult times of their lives, including an e-learning course and a free,
online self-assessment tool.
For more information on palliative and end-of-life care,
please visit www.aacn.org/palliativeedu.
As AACN’s bimonthly clinical practice journal for high acuity,
progressive and critical care nurses, CCN is a trusted source for
information related to the bedside care of critically and acutely ill patients.
Access the article abstract and full-text PDF by visiting the CCN
website at http://ccn.aacnjournals.org/.
About Critical Care Nurse: Critical
Care Nurse (CCN), a bimonthly clinical practice journal published by
the American Association of Critical-Care Nurses, provides current, relevant
and useful information about the bedside care of critically and acutely ill
patients.
The journal also offers columns on traditional and emerging
issues across the spectrum of critical care, keeping critical care nurses
informed on topics that affect their practice in high acuity, progressive and
critical care settings. CCN enjoys a circulation of more than 106,000
and can be accessed at http://ccn.aacnjournals.org/.
About the American Association of Critical-Care
Nurses: Founded in 1969 and based in Aliso Viejo, California, the
American Association of Critical-Care Nurses (AACN) is the largest specialty
nursing organization in the world. AACN represents the interests of more than
500,000 acute and critical care nurses and includes more than 225 chapters
worldwide.
The organization’s vision is to create a healthcare system
driven by the needs of patients and their families in which acute and critical
care nurses make their optimal contribution. www.aacn.org; www.facebook.com/aacnface; www.twitter.com/aacnme
