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ADVANCE DIRECTIVES
ADVANCE HEALTH CARE DIRECTIVES
Websites for Providers and Patients
The following websites provide invaluable information to assist healthcare providers to understand and effectively communicate about AHCDs. Websites for patients and families also included:
* Aging With Dignity: 5 Wishes-http://www.agingwithdignity.org/five-wishes.php
* Caring Connections-http://www.caringinfo.org
* Hospice and Palliative Nurses Association-http://www.hpna.org
* National Hospice and Palliative Care Organization-http://www.nhpco.org/resources/end-life-care-resources
* National Cancer Institute-http://www.cancer.gov/cancertopics/factsheet/support/advance-directives
* National Institute on Aging-http://www.nia.nih.gov/health/publication/advance-care-planning
* Medline Plus: Advance Directives-http://www.nlm.nih.gov/medlineplus/advancedirectives.html
* U.S. Living Will Registry-http://uslivingwillregistry.com
* State Laws Governing Use of AHCDs-http://www.caringinfo.org
* American Bar Association (ABA) "My Health Care Wishes App"-http://www.americanbar.org/groups/law_aging/MyHealthCareWishesApp.html
* ABA Consumer's Toolkit for Health Care Advance Planning-http://www.americanbar.org/groups/law_aging/resources/health_care_decision_makin
PALLIATIVE AND END-OF-LIFE CARE
By the American Association of Critical Care Nurses
http://www.aacn.org/WD/Palliative/Content/PalAndEOLInfo.content?menu=
REVIEW: The American Association of Critical Care Nurses provides hands-on detailed resources for nurses involved in end-of-life care. There are multiple free resources as well as a 3.5-contact hour e-learning course ($50) "Promoting Excellence in Palliative and End-of-Life Care."
The free 72-page downloadable pdf "Acute and Critical Care Choices Guide to Advance Directives" is an outstanding resource. Although created for critical care nurses, the pdf is informative for nurses in all practice settings. The stated objectives are "to provide critical care nurses with information about the legal, ethical, and transcultural principles that guide the preparation of advance directives in the United States, and to help nurses access specific advance directive documents and materials for patient education" (p. 1). I found the Appendices particularly helpful. Appendix A, "Talking Points to Help Patients Complete Advance Directives" (p. 21) offers 10 things you can share with patients and families to help them develop an AD. For example, point 10 states, "Completing a Living Will or Medical Power of Attorney will raise your awareness of important beliefs and values that you have about your quality of life. As you review these beliefs and values, you will be better able to plan your future in satisfying ways. You and your loved ones will also become familiar with common medical procedures and treatments. It will make these treatments less overwhelming if the time ever comes to face them" (p. 22). Another Appendix offers numerous frequently asked questions and answers about ADs. Appendix C takes nurses through questions and scenarios to help discover personal beliefs about critical care and end-of-life choices. Information is offered to assist patients with choosing a "healthcare partner" (Medical Power of Attorney) as well as how to talk to physicians, nurses, lawyers, or clergy about ADs.
The AACN's resources for palliative and end-of-life care are exceptional, helpful to all nurses in every arena. Check out the free resources AACN has provided to assist nurses in meaningful discussions, advocacy, and care of patients and families for decision making at the end of life.-KSS
NURSES CHRISTIAN FELLOWSHIP
A HISTORY OF NURSES CHRISTIAN FELLOWSHIP INTERNATIONAL
The First 50 Years
By Pat M. Ashworth
240 pp., Belfast, Ireland: Blackstaff, 2012, $10, paperback.
REVIEW: This is an interesting and informative book about a 50-year period of history (1958-2008) of Nurses Christian Fellowship International (NCFI). From the first idea in 1956 to begin a worldwide organization of Christian nurses in Kenswick, England, to the birth of NCFI and moving toward increasing influence, this is a fascinating book. If you are a history buff, you will love reading about the critical thinking and action that created and developed NCFI. Color pictures bring life to the stories of NCFI, from board meetings to international conferences. Brief histories of each NCFI member country are relayed along with contacts for each member country (address, phone, email) that were current in 2008.
The vision of NCFI to connect Christian nurses around the world was wonderfully expressed by a nurse after a Pacific and East Asia (PACEA) regional NCFI conference:
"... there was a strangely warm feeling of awe, excitement, praise and growing awareness of what it means to have fellowship with one another in a cross-cultural setting. Diversity and difference were obvious in background, life-style, language, custom, food and experience Yet strong bonds of unity and similarity in Christ were evident in the reality of oneness - something so very hard to express in words" (p. 79).
Today NCFI is bringing nurses together through Regional Conferences and a World Congress, promoting friendship, communication, and collaboration among Christian nurses worldwide. NCFI encourages Christian nurses and nursing students to live out their faith in nursing and deepen their spiritual life and cultural awareness. NCFI has a vision to equip and support the development of Christian nurse leaders around the world. Discover the rich history of NCFI and how you can be a part of this worldwide fellowship.-KSS
Going Deeper
Going Deeper helps you dig deeper into JCN content, offering ideas for personal or group study with other nurses-great for NCF groups! Previous issues of Going Deeper are available free online at http://journalofchristiannursing.com under "JCN Online Extra."
* Advance Directives Education: Read Kroning, pp. 220-225.
1. What is the purpose of an advance health care directive (AHCD)?
2. How often have you discussed AHCDs with patients?
3. The author states, "When patients are provided with information, they often do not understand the purpose and implications of an AHCD." To what degree have you experienced this in your practice setting?
4. What measures do you have in place regarding advance directives? To what degree have you discussed this with your family? How confident are you that they understand your wishes?
* Adoption Education: Read Foli et al., pp. 246-251.
1. What are some of the unique needs of adopted children and their adoptive parents?
2. Discuss some of the needs of the birth parents as noted in Table 2, page 250.
3. Adopted children/adults can be unaware of their medical histories and nurses need to be educated on how to address this deficiency. What tips did you discover?
4. In a spiritual sense, Christians are adopted sons and daughters. Read Ephesians 1:3-10. Describe the adoption process as related to faith in Jesus. To what degree do you understand God's deep love for you?
* Adolescent Spiritual/Faith Assessment: Read Haley, pp. 258-262.
1. What are some of the barriers to spiritual assessments or discussions?
2. According to the author, what is the first step in addressing the holistic realm of the adolescent patient and enabling NP students to gain confidence with spiritual assessment and intervention in clinical practice?
3. Have you completed a faith assessment of an adolescent other than a standardized question related to denominational structure?
4. Read 1 Timothy 4:12. How might this verse relate to working with adolescents?
* Medical Error: Read Sredl, p. 267.
1. If you have made a medication error, did you experience the temptations the author noted?
2. How often do you see errors reported in your practice setting?
3. What issues are involved with reporting or lack of reporting errors? How does this relate to patient care?
4. See 1 Kings 9:4-5; Proverbs 10:9, 11:3; and Titus 2:7-8. What is God's perspective of integrity? How does this differ from that of current culture? What role does integrity play in today's culture or is it a thing of the past?