- Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.
- All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.
- Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.
- Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.
- Those who practice in secondary or tertiary palliative care will have specialist education and certification.
- Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.
- Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.
- Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.
- Increase the integration of evidence-based care across the dimensions of end-of-life care.
- Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.
- Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.
- Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.
- Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.
- Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.
- Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.
- Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.
- Support the development and integration of palliative care services for all in- and outpatients and their families.
ests, appraisals of situations and events. These situations and events can be things such as memories, understanding of emotions, goals, conceptions, precognitive associations and interoception (a sense and awareness of the internal bodily state). Appraisals are constructed and conceptual, whereas precognitive associations are reactive and stimulated . They aim to twist and manipulate stimuli, cognitively reconstructing it so that the desired response is produced. A real-life example of this has been conducted in an experiment. Researchers explored the amount of empathy and consideration conveyed in a general practitioner’s check-up for the common cold in a patient and found that “the interaction between patient and health care practitioner can have significant healing influences” (Rakel, D., et al. 2011). From the 200 patients who partook in this experiment, 64% of those who had positive interaction reported recovery or an accelerated recovery rate, whereas only 39% of those who had a negative interaction or a normal interaction experienced faster recovery . From this, it can be deduced that patient appraisal, particularly the aspect that understands emotions, has a monumental impact on health and immune function. It is the relationship between precognitive associations and appraisals that produces the placebo effect. Appraisals rely on the stimuli of the external environment to trigger the formation of neural pathways in precognitive association and morph what is learned into what ‘should’ be learnt, so that the required response can be developed and expressed. The biggest and most effective placebo effects are induced when there is repeated, successful cognitive experience and reinforcement of pathways. Essentially, the more the pathway is recalled and used, the stronger it is, so the induced effect is more powerful and easier to summon. The Mechanism of the Confirmation Bias The confirmation bias is one of the oldest and most ordinary psychological phenomena. I say ordinary because, as Nickerson (1998) put it: “If one were to attempt to identify a single problematic aspect of human reasoning that deserves attention above all others, the confirmation bias wou>GET ANSWER