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1.
Journal of Pain and Symptom Management ; 65(3):e265-e266, 2023.
Article in English | ScienceDirect | ID: covidwho-2229076

ABSTRACT

Outcomes: 1. Using a case-based approach for this presentation, learners will self-report the ability to prognosticate patients with kidney disease and integrate basic tenets of palliative nephrology into their practice 2. Using a case-based approach and legal case examples, learners will self-report the ability to analyze ethical issues commonly encountered caring for patients with kidney disease and employ best practice recommendations The option to forego dialytic therapy is an important life event—but studies have shown that up to 95% of patients with advanced chronic kidney disease (CKD) have not had the opportunity to discuss conservative management with their providers. This is reflected in the very low rate of patients enrolled in hospice care with end stage kidney disease (ESKD) as their primary diagnosis. Throughout years of research, multiple barriers have been found, rooted in current kidney care practice, that preclude the delivery of palliative care to this vulnerable population. This talk is designed to provide learners of all levels the tools to address these barriers to end-of-life care for patients with CKD, while providing empiric evidence on how to overcome them. Furthermore, the talk elevates the topic by navigating through the challenges and questions raised by modern medical ethics in this setting of rapidly evolving norms and values. The subject is organized into: • Identifying "who” among patients with CKD are most at-risk for poor outcomes and who may benefit from Palliative Care • Reviewing "what” to discuss with patients and loved ones, using effective communication skills, when broaching conservative management of ESKD • Outlining "how” to care for patients with ESKD opting for non-dialytic management with appropriate pharmacologic and non-pharmacologic interventions to alleviate their symptom burden • Recognizing "why” foregoing dialysis raises difficult ethical questions that often cause distress and conflict among providers, patients, and even loved ones There is a growing need for incorporating palliative care in the practice of nephrology. While dialysis has been the mainstay of advanced CKD management, with what we have learned especially these past years during the COVID pandemic, it is time we all step up to provide palliative care for this truly underserved and vulnerable population.

2.
Nurs Educ Perspect ; 43(5): 335-336, 2022.
Article in English | MEDLINE | ID: covidwho-1985130

ABSTRACT

ABSTRACT: The disruption of classroom and clinical education caused by the COVID-19 pandemic resulted in student distress and worry regarding the future of their education. Faculty trained in palliative care adapted the SPIKES mnemonic and applied it to real-time interactions with students in an effort to decrease distress and enable continued learning. Palliative care concepts, approaches, and techniques can be used to successfully facilitate faculty-student interactions during times of crisis and rapidly changing educational environments.


Subject(s)
COVID-19 , Palliative Care , Faculty , Humans , Learning , Pandemics , Teaching
3.
J Hosp Palliat Nurs ; 24(2): 132-139, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1642435

ABSTRACT

The COVID-19 pandemic has created a global health crisis. Novel and intolerable pressures have been placed upon nurses affecting their capacity to provide care. The aim of this exploratory study was to determine the impact of the COVID-19 pandemic on nursing care delivery, the empathetic response of nurses to their patients and family members, and the emotional and physical well-being of the nurses. Four frontline nurses were interviewed while in the midst of the pandemic. Common themes emerged from analysis of the nurses' narratives and included changes in role, increased workload, depersonalized and mechanical care delivery, communication challenges with patient and family members, deficits in palliative care education, perceived poor administrative support, and physical/emotional exhaustion. Clinical leaders and nursing staff have opportunities to engage in supportive endeavors, which can restore focus and regain positive perceptions, strengthen coping skills, and deliver palliative care education in response to the ongoing challenges and stressors created by the COVID-19 pandemic. Together, they can build resilience in frontline nurses and ultimately impact delivery of compassionate and empathetic care to patients.


Subject(s)
COVID-19 , Nursing Staff , Humans , Pandemics , SARS-CoV-2 , Workload
4.
J Hosp Palliat Nurs ; 22(6): 435-441, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-760058

ABSTRACT

In the midst of COVID-19, the nation has become increasingly aware of the impact of social isolation on physical, social, spiritual, and psychological health. Older adults, especially those who are nearing the end of life, are already at higher risk of the detrimental effects of social isolation and loneliness. Novel social distancing rules imposed by governments and agencies during the COVID-19 pandemic have caused older adults to experience a degree of social isolation and loneliness that is unprecedented. This article highlights aspects of the social isolation and loneliness literature. Three cases of elderly patients who required medical care during the COVID-19 pandemic are presented. Common themes of factors contributing to social isolation in each of the health care delivery settings are described, and opportunities for creative interventions by health care providers are identified. As the pandemic continues to unfold and evolve, providers should aim to regularly assess patient risk of isolation and be proactive in preventing negative effects. Additionally, what is learned from health care providers' experiences delivering palliative care during a pandemic can be incorporated into daily practice as social isolation and loneliness are long-standing challenges for the elderly population.


Subject(s)
Aged/psychology , Coronavirus Infections/psychology , Palliative Care , Pneumonia, Viral/psychology , Social Isolation/psychology , Aged, 80 and over , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Female , Humans , Lymphoma/nursing , Male , Pandemics , Pneumonia, Viral/epidemiology , Risk Assessment , SARS-CoV-2 , Telemedicine
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