End of Life Care – Fundamentals of nursing care at the end of life
This resource has been developed for you by the Royal College of Nursing (RCN) and is designed to offer you support in your delivery of appropriate end of life care alongside your existing training.
It has been developed in line with the Getting it right every time: nutrition and hydration at the end of life online resource which can be used for more in depth learning around delivery of nutrition and hydration care at the end of life.
Who is it for?
This resource is for you if you are a registered nurse, student nurse, health care assistant (HCA) or assistant practitioner working in any setting or specialism. The aim is to give you an understanding of your role when it comes to meeting the needs of people with life limiting illnesses. You can work through this resource at your own pace either all at once, or by one of the “bite sized” pieces of learning whenever it is convenient for you.
It might also be useful for others in health and social care. Members of the public may also find the content of this resource valuable.
Why was the resource developed?
This resource has been developed using information from the 2014 RCN End of Life care survey which showed that staff wanted more education and information around caring for people at the end of life. In addition the report More Care, Less Pathway (Neuberger 2013) highlighted the need for education in end of life care. This demonstrates the commitments made by the RCN to improve end of life care following this report. The same issues relating to poor care at the end of life were also identified in the recent Ombudsman Report Dying without Dignity (2015).
This resource goes some way to address some of the issues raised in these reports.
The content within this resource reflects guidance recommended in the key priorities and principles from the four countries and is therefore applicable and beneficial to nurses across the UK. It also reflects compliance with the RCN Nursing Principles. The resource is not fully comprehensive but provides a broad overview of many topics and is intended to stimulate you into seeking further information in areas of particular interest or pertinence to your area of practice.
What is end of life care?
Every year more than half a million people die in the United Kingdom, and most of these deaths occur in hospitals. Whilst some deaths occur suddenly, the majority of deaths occur after a period of chronic illness, with three quarters of all deaths being expected. During this time people often require ongoing care which may include end of life care. It helps them to live as well as possible until they die, and to die with dignity. It also includes support for their family or carers. A person is ‘approaching the end of life’ when they are likely to die within the next 12 months.
Within end of life care there are few areas that are as complex as providing nutrition and hydration to a patient.
After completing all the sections in this learning resource, you should:
- have improved confidence in providing end of life care to an individual with a life limiting illness according to the principles of nursing practice
- have improved knowledge of how to recognise the changing needs of the person at the end of their life (and those close to them) and know how to respond to these
- have improved understanding of the need for effective communication in discussing end of life care with individuals reaching the end of life and those close to them
- have raised awareness of any ethical questions that might arise when providing support and how to address these
- have improved understanding of the benefits of providing good, clear and straightforward information to patients and their families in regard to their end of life care
- be aware of and recognise the barriers or fear the person (and those close to them) may feel about discussing the dying process
- have improved understanding of the need to keep accurate records and document summaries of conversations
- have improved understanding of how to communicate and have open discussions with the person reaching the end of their life (and those close to them) around their needs and any decisions relating to the changes in their condition
- have an improved understanding of the importance of listening to the patient and family’s point of view and experience of end of life care
- have improved understanding of the need to respect each individual’s cultural and spiritual beliefs in the care you deliver
We hope you find this resource useful and enjoy using it. Do show it to your friends and colleagues, and let your employers know about it too. We welcome your feedback about this online induction resource and invite you to share your views about your learning experience. Please get in contact with us at firstname.lastname@example.org
We invite you to complete our reflective learning diary which will comply with the NMC revalidation process.