Nursing Care at the End of Life: What Every Clinician Should Know
Susan Lowey, SUNY, Brockport
Pub Date: 2015
ISBN 13: 978-1-9423411-9-2
Publisher: Open SUNY
Conditions of Use
The book addresses all areas of end-of-life care, starting with history, frameworks, and models of care. The middle section sufficiently covers the read more
The book addresses all areas of end-of-life care, starting with history, frameworks, and models of care. The middle section sufficiently covers the symptoms and corresponding interventions that a hospice nurse would most commonly encounter in the illness trajectory. Although there is not an index or glossary, the table of contents is clear enough to quickly identify and find topics of particular interest.
The content is accurate and reflects current knowledge and science around end-of-life care.
The content is up-to-date and utilizes reputable sources throughout. A resource list at the end of the text gives the reader links to online sources which are not likely to change, such as the American Geriatrics Society and the American Medical Association, Institute of Medicine, etc.
The text is refreshing to read. It challenges the reader with expanding knowledge and points of critical discussion and handles a weighty topic in a way that is easy to think about and digest. The narrative is clear and easy to understand yet obviously scholarly and well supported by the current research and literature in end of life care.
The text is clear and consistent with its terminology and approach.
What really stands out is the large-font chapter titles, a poignant quote at the beginning of chapters to introduce the reader to the topic, and the learning objectives clearly indicated in a black and white box. The "What You Should Know" key points are easily identified at the end of each chapter by a green box, highlighting the most important take-aways from each chapter. References follow each chapter.
Each chapter begins with large-font chapter titles and a poignant quote at the beginning of chapters to introduce the reader to the topic. The learning objectives are clearly indicated in a black and white box. The "What You Should Know" key points are easily identified at the end of each chapter by a green box, highlighting the most important take-aways from each chapter. Each chapter is organized in the same way, so the reader knows what to expect while progressing through the text.
The interface is excellent. The no-frills approach in a PDF allows easy download and storage onto multiple device. I enjoyed reading the book on my iPhone. The reader won't find complicated graphics, images, or interactive activities in the text. Instead, Dr. Lowey opted for a simple, streamlined approach that I found aesthetically pleasing and easy to navigate between chapters. Charts and graphics are carefully selected and strategically placed wtih full explanations.
No grammatical or formatting errors were noted. The text is easy to read yet employs professional language and terminology.
The book approaches the subject of end of life care with sensitivity, knowing that many nurses are not comfortable with the topic or their ability to provice sufficient care. Dr. Lowey assures readers of all experience levels that the nursing hesitancy and limited of knowledge in end of life care is widespread. She empowers the reader that our presence and voice is our greatest and most effective intervention during end of life care. A specific chapter addresses the diversity and death practices across cultures and summarizes the religious beliefs for each of the world's major religions. No book or chapter could possibily comprehensively consider all cultural beliefs around death, dying, and funerals, but Dr. Lowey gives us a good starting point.
Nursing Care at the End of Life: What Every Clinician Should Know is a real gem for nursing students, experienced clinicians, and those new to hospice care. Having such an outstanding resource in the Open Textbook Library is a gift to the nursing profession, and to our patients. The text gives a practical, relevant, well-written, and comprehensive resource to draw upon when caring for patients in the palliation/hospice trajectory. The very best chapter is the last one in which Dr. Lowey reflects on what it's like to be a hospice nurse, how she copes with her own sadness when patients die, and other common questions that hospice nurses are often asks. If a nurse is thinking about becoming a hospice nurse and reading this book to get information, the last chapter will clearly help guide the decision. Several chapters could stand alone as reading assignments in other courses such as medical-surgical nursing or psychiatric care, or a course addressing cultural aspects of care. Whether used in its entirety, in part, as required or optional, this text is a must have in every nursing education program. I definitely plan to use this text in my classes for both required and optional reading assignments. Great job and outstanding work, Dr. Lowey!
Nursing Care at the End of Life: What Every Clinician Should Know is a comprehensive book about caring for patients and families at the end of life. read more
Nursing Care at the End of Life: What Every Clinician Should Know is a comprehensive book about caring for patients and families at the end of life. All areas and ideas related to nursing care at the end of life are included. A Table of Contents is included. An Index and Glossary are not included in this textbook.
The textbook includes accurate information about end of life care that is supported with evidence from the literature. The content is free of errors and unbiased
Nursing Care at the End of Life: What Every Clinician Should Know is relevant information as information about End-of-Life case is important for health care professionals to know and apply when caring for patients and their families at end-of-life. The content will not be quickly outdated, which is a major concern in nursing topics.
Nursing Care at the End of Life: What Every Clinician Should Know is clear and easy to read. The book includes professional vocabulary, but defines the terms used.
Consistent terms and frameworks are used throughout the book.
Nursing Care at the End of Life: What Every Clinician Should Know is presented in smaller reading sections with headings and subheadings to divide up the chunks of content. The book is not overly self-referential. Dr. Lowey cites her work in this area, but it is not overdone.
Nursing Care at the End of Life: What Every Clinician Should Know is well organized and flows well. There are 12 chapters in the text. Each chapter includes learning objectives, content, a “What You Should Know” section, and references. The major sub-topics for end of life care are included. And Afterword and End of Life Care Resources section is included. The tables and figures are helpful and point out the key ideas.
When I read the book in the online format, the font changed to difficult to read fonts and also changed to italic for some chapters. I found this difficult to read. The figures and tables were not impacted. I recommend using the PDF format of the book for this reason as it was consistent and easier to read. This may have been some odd technical aberration, but did happen to me at several different checks on different days. However, I mention in case you have similar issues so you can try the PDF as another option. Being able to download the PDF is an awesome plus!
The book is free of grammar and spelling errors.
This book includes a chapter about Diversity in Dying. The chapter outlines various religious beliefs and practices related to death and dying. Nurses are told to become familiar with the death and dying practices of the family. This is appropriate because families will have their own cultural practices that may or may not be used by everyone of their culture or religious affiliation.
Nursing Care at the End of Life: What Every Clinician Should Know is a well written book with outstanding content and organization. Thanks to Dr. Lowey for this open educational resource!
This book is very comprehensive and the author's scaffolding of foundational to more complex concepts yields a very thorough and yet concise read more
This book is very comprehensive and the author's scaffolding of foundational to more complex concepts yields a very thorough and yet concise understanding of the content.
This book contains very well researched, current, and unbiased information, allowing the reader to glean an understanding of the various theories of death and dying and the myriad of approaches to the care of the dying patient.
The content of this text is current, relevant, and most essential in the training of nursing students and is written in such a manner as to not require frequent updates. The content is applicable to all facets of nursing as death and dying are encountered in any given specialty within the nursing profession. This text serves to fill in the gaps of coverage of death and dying in many nursing programs and would also be of benefit to the practicing nurse who desires to pursue additional independent learning opportunities.
The text is written in a manner consistent with educational resources aimed at the target population of nursing students, however, even one not familiar with nursing jargon/technical terminology would benefit from reading and be able to understand the overall intent of the text.
This text is divided into very concise chapters and utilizes a consistent framework throughout, which allows the reader to quickly identify the author's given style of writing, yielding an ease of comprehension and expeditious sense of familiarity and understanding.
This text is written in a format of very concise, modular sections which could easily be dissected and read in part, but also as a whole. The text references multiple sources of a wide range of expertise, offering the reader many opportunities to explore a particular topic of interest in greater depth.
The topics are presented in a clear, logical, and systematic manner, allowing the reader to either review or learn afresh the foundational principles and then move deeper into the more complex and finely tuned content.
This text is free of any significant interface issues, and no distortions of content, images, or charts is noted. The text was downloaded without difficulty and the formatting is clear, consistent, and reader-friendly.
The text contains no grammatical errors.
This text is culturally sensitive and addresses the unique differences in terms of cultural or religious views of death and dying while avoiding generalizations. The text seeks to educate the reader on the wide range of patient, family, and health care professional responses to death and dying while also avoiding generalization. This facet allows the reader to glean insights without forming potentially inappropriate or inaccurate presuppositions when faced with other cultures or religions in practice.
This book is an invaluable resource to all nursing students and practicing nurses as it very concisely articulates the unique complexities encountered in the care of the dying patient and the dying patient's family. This book accurately asserts that the content explored in this text is often covered minimally in the traditional nursing curriculum, leaving many nurses feeling inadequate, unprepared, and less than confident when caring for the dying patient in practice. This book more than adequately fills the void and I will be utilizing this resource in the future. Thank you for compiling and sharing this information.
This book is very comprehensive in its coverage of the topics of nursing at the end of life. And although the book does not include a separate index read more
This book is very comprehensive in its coverage of the topics of nursing at the end of life. And although the book does not include a separate index or glossary, it does provide plenty of terms and definitions within the text in a thoughtful and organized manner. The website resources at the end is comprehensive.
I found the accuracy of this book to be excellent. With the exception of one small error of two words joined together, I found no other errors. And the inclusion of various perspectives provides an unbiased view of nursing in this context.
The relevance to today's nursing field and hospice care is extremely up-to-date. Having experienced my mother's and father's hospice care at different times within the last six years, I found the advice and information affirming and relevent. Obsolescence is easily avoided with supplementing information when it is necessary. The personal experiences and examples are timeless.
The terms were clearly defined and the examples provided the helpful context. The prose was very accessible and easy to follow and enjoyable to read without being too wordy or technical. For example, p. 60 clearly gives a thorough description of the classifications of pain and differentiating between the mechanisms and temporal patterns.
Each chapter is nicely framed, beginning with the objectives and moving to an introduction and the main ideas, then finishing with "what you should know." This framework provided an easy-to-follow pattern.
The book's modularity is wonderful. The three main parts I. Anticipation II. In The Moment and III. Afterwards provides structure of the individual chapters and their focus. This allows instructors to easily assign readings in individual sections. And the subheadings within the chapters are very useful.
The organization of the book showed topics divided into a simple sequence related to the care of the patient. The three major sections clearly follow the sequence related to the care of the patient. The chapters within the sections are logically divided and clearly presented. The subheadings within the chapters also makes it easy to find individual topics. And even though this book may target nurses, it is organized in a useful fashion for the patient and family member as well.
The figures and tables are nicely formatted and easy-to-read. The Models of Care (p. 39) figures were a bit confusing at first but the explanation in the text following the figures was provided and made it more clear. The tables provided easy-to-reference guides for such areas of questions to ask the patient as well as religious beliefs about death and dying.
I found no grammar errors and the language used corresponded to the nursing field but also provided concrete examples for the lay person.
The book mentioned consideration of different groups of people with its definition of 'diversity' on p. 109. It also provided different religious perspectives of death and dying in the chapter on Diversity and Dying. But more importantly the language and style of the book continually used phrasing of 'inclusiveness' and repeatedly cautioned the nurse to be aware of the care and communication with the patient and family so as not to offend or exclude anyone based on different cultural or ethnic backgrounds.
This book is a valuable resource for anyone, not just a nurse or caregiver, patient or family member of a patient. Its comprehensiveness and validity can be summed up with Susan Lowey's reminder about the importance of care a dying patient receives and how it may not be remembered by the nurse, but it will surely be remembered by the patient's family (p.94).
Health Care is - by definition - a profession that is focused on preventing the end of life. This text aims to guide health care providers through read more
Health Care is - by definition - a profession that is focused on preventing the end of life. This text aims to guide health care providers through the inevitable process that all patients will experience, divided into stages of care: Anticipation, In The Moment, Afterwards.
Content is presented in as unbiased a manner as is possible with such a high-emotion subject.
Content is very timely and up to date. There are some references that are older (greater than 10 years), but they are included in such a way that the age of the study does not detract from the predominant thesis in each chapter. Updating the work to include the latest trends in best clinical practices should not be difficult, as the compartmentalization of the information - while building on previous learning - is not so interwoven as to substantially detract from the flow of the narrative.
Written in such a way as to be accessible to a layperson not clinically trained, but also not too basic for the healthcare provider, the text is clear, concise, and accessible to the reader. When complex clinical information is presented, it is not dumped on the reader; rather there is a "ramp up" feel to the content.
There is good consistency in the book, as well as mercifully few "callback" references to earlier chapters.
The three main content areas (Units?) work well to guide the clinician through the process of learning about the end of life process. Within each of these units, however, the individual chapters - upon first reading - seem to require the healthcare provider to take each chapter in order. Once read and when the content is familiar, however, the chapters are useful as stand-alone references.
Highest marks for the organization and flow of the book. Leading the clinician through the death and dying process in a chronological "presentation of symptoms" order makes the text exceptionally well suited for this subject. Again, once the healthcare provider is familiar with the text, then accessing specific information in non-sequential chapters is not only possible, but easy.
This reviewer experienced no problems with the format of the text.
No errors in grammar, punctuation, or sentence structure/mechanics.
No text can be all things to all people. This text manages to hit the "middle of the bell-shaped curve" in that it is applicable to most people under most circumstances, most of the time. The Ethics chapter will be the most "controversial," as Ethics is - by definition - a morality based, Right-And-Wrong subject. Further, there is no overtly judgmental language when dealing with controversial topics (withdrawing/withholding care, assisted dying, etc.). Being from Oregon, I would have personally liked to see more than one paragraph on assisted suicide, but the author's treatment of the subject is satsifactory.
The layout of each chapter is especially useful. Starting with learning objectives bullet points, the author guides the reader through the content, then wraps up each chapter with three main bullet point "Things You Should Know." The text lends itself to note taking and information retention. Overall, a good text that will be useful to clinicians working with end of life patients, as well as a helpful adjunct for those in the healthcare realm (long term care, acute care, ethics committee, etc.) to supplement their understanding of the issues.
The text is comprehensive and appropriately provides a basic understanding of terms of a difficult topic for care givers. read more
The text is comprehensive and appropriately provides a basic understanding of terms of a difficult topic for care givers.
The book's content is accurate and supported appropriately with relevant references.
Even though some of the material seemed old, it is the gold standard. The content is up to date, and somewhat ageless. Medications for pain may change, however, learning how to manage palliative care clients remains difficult for many.
There text is not written with techinical terminology such as medical procedures, however, to a nonmedical person, there might be some terminology they are unfamiliar with.
The text is consistent in terminology and framework throughout the text. For example each chapter begins with learning objectives.
The text is easily divided into smaller section that are managable for assignments.
The text is organized and presented in a logical and clear fashion.
The text is free of significant interface issues. There were not any navigation or chart distortion issues on computer or phone display access.
The text was written without any noticeable grammatical errors. It was written at a level that a nurse could share the text with a family member and they could understand the information.
The text touches on a cultural diversity and end-of-life care in a very non-offensive way.
This text is a great addition to any course that discusses end of life. It touches on hospice and palliative care, as well as pain control when dying, all in one text. Many texts are lacking this combination.
Table of Contents
Part I. Anticipation
1. A Historical Overview of End-of-Life Care
2. Types and Variability within Illness Trajectories
3. Conceptual Frameworks Guiding Death & Dying
4. Models of Organized End-of-Life Care: Palliative Care vs. Hospice
5. Initiating Conversations about Goals of Care
Part II. In the Moment
6. Management of Pain and Physical Symptoms
7. Management of Emotional and Spiritual Distress
8. Ethical Concerns in End-of-Life Care
9. Care at the Time of Death
10. Nurse–Patient–Family Communication
Part III. Afterwards
11. Diversity in Dying: Death across Cultures
12. Grief and Bereavement
Afterword Evaluation of Self: Lessons Learned
Online End-of-Life Care Resources
About the Book
Nursing Care at the End of Life: What Every Clinician Should Know should be an essential component of basic educational preparation for the professional registered nurse student. Recent studies show that only one in four nurses feel confident in caring for dying patients and their families and less than 2% of overall content in nursing textbooks is related to end-of-life care, despite the tremendous growth in palliative and end-of-life care programs across the country. The purpose of this textbook is to provide an indepth look at death and dying in this country, including the vital role of the nurse in assisting patients and families along the journey towards the end of life. There is an emphasis throughout the book on the simple, yet understated value of effective interpersonal communication between the patient and clinician. The text provides a basic foundation of understanding death and dying, including a brief historical examination of some main conceptual models associated with how patients cope with impending loss. An overview of illness trajectories and models of care, such as hospice and palliative care are discussed. Lastly, the latest evidence-based approaches for pain and symptom management, ethical concerns, cultural considerations, care at the time of death, and grief/bereavement are examined. The goal of this text is to foster the necessary skills for nurses to provide compassionate care to individuals who are nearing the end of life and their families. Every chapter contains a “What You Should Know” section which highlights and reinforces foundational concepts.
About the Contributors
Dr. Susan Lowey works with both juniors and seniors in the traditional Nursing program, teaching Community Health Nursing and Nursing Research at SUNY, Brockport. She earned her PhD in Health Practice Research from the University of Rochester and was awarded a Claire M. Fagin Fellowship from the Building Academic Geriatric Nursing Capacity Program for her post-doctoral work. Improving care at the end of life, with a particular focus on symptom management, is the focus of Dr. Lowey’s research. The majority of her clinical practice has been as a community health hospice nurse providing care for dying patients and their loved ones.
Dr. Lowey holds national certification as a board certified hospice and palliative care nurse (CHPN) through the National Board for Certification of Hospice and Palliative Nurses. In addition, she is a certified ELNEC (End-of-Life Nursing Education Consortium) trainer (Core and Geriatric). She is also an appointed member of the National Board for Certification of Hospice and Palliative Nurses Registered Nurse Examination Development Committee and holds another appointment as the ESPO Representative on the Membership Executive Committee through the Gerontological Society of America. Dr. Lowey also serves as one of the faculty representatives for Omicron Beta, Brockport’s Chapter of Sigma Theta Tau International Honor Society.