Palliative care nursing is a specialty where you observe your patients at their most vulnerable moments. Whether it's watching a patient struggle to hold on until the last family member arrives to say goodbye, or accompanying them as they take their last breath. It is not just about death, but rather about making the patient as comfortable and dignified as possible during the transition to their final days of life. According to WHO, “Palliative care is an approach that improves the quality of life of people and their families facing the problem associated with life-threatening diseases, through the prevention and relief of suffering through early identification, assessment and the impeccable treatment of pain”. and other physical, psychosocial, and spiritual problems.” There are many health problems that arise for patients who are facing a terminal illness or who are nearing the end of life, such as: pain management, breathing difficulties, digestive problems, fatigue, elimination difficulties, depression, etc. Although it is impossible to alleviate all of these health problems, it is vital that we, as palliative care nurses, try to alleviate as many negative symptoms as possible that may accompany our patients. Palliative care is an area of ​​nursing that will always exist, as the cycle of life will never end. For this reason it is particularly important to focus on palliative care nursing and how we can improve it from a medical and ethical point of view. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay Palliative care nursing is not a specialty for all nurses. You must be especially empathetic, compassionate, patient, and be your patients' number one advocate. You also need to have the ability to deal with the stress of being in the midst of death, grieving family members, and daily losses without it affecting your mental state. As with most areas of nursing, there are many ethical issues that accompany being a palliative care nurse. “Palliative care therefore requires many different skills, not only clinical but also relational, communicative and ethical.” You find yourself in many sensitive situations where the decisions you make may not reflect your personal values, yet you must continue to provide the best care possible regardless of your own judgment. Not only do you have to meet the demands of your patients, you are often also trying to meet the needs of their loved ones, while simultaneously dealing with the personal stress associated with them. Caring for patients near the end of their lives poses many challenges as we strive to make decisions that meet the needs of our clients while being morally justified. “Where the wishes of patients, relatives and professionals conflict and where care is limited by resource scarcity, it will often be impossible to meet all requests.” Some of the ethical issues palliative care nurses often face include: assisted dying, addressing end-of-life issues and interventions, and respecting the wishes of patients and their families. MAiD is defined in the Criminal Code of Canada as: “ (a) the administration, at the request of a person, by a doctor or professional nurse of a substance that causes death; or (b) the prescription or supply by a doctor or nurse of a substance to a person, at his request, inso that he can self-administer the substance and in doing so cause his own death." It is a medical procedure that is becoming increasingly widespread in today's society, particularly in end-of-life care. However, for a nurse who has always believed in the preservation of life, this could be particularly problematic, especially when it could potentially cross a religious or personal boundary, causing moral distress. “The intersection of personal and professional values ​​regarding life, death, suffering and nursing came to the fore when dealing with patients and families inquiring about or preparing for and expecting an assisted death.” Another topic that may pose some ethical questions is conversation about how to approach end-of-life issues and interventions. “All doctors have to make difficult decisions about withholding or withholding treatment; however, they are particularly frequent when caring for a patient entering the terminal phase, since there are no longer any reversible causes for his worsening. Symptom control and comfort are key and all interventions must support this goal." These might include: continuous intravenous hydration once end of life is deemed imminent, pain control and sedation, feeding tubes, code status, and religious/personal practices. Health care providers involved in this care must find a balance in respecting clients' wishes regarding intended care, as well as being open and honest about the realistic outcomes these interventions may or may not have, no matter how difficult they may be to address. “Instead, sensitive discussion can establish the individual patient's awareness of their terminal illness and their preferences for attention to dignity and comfort measures should irreversible deterioration occur.” There will be circumstances where your patients' wishes do not coincide with your beliefs as an individual or even as a healthcare professional. Some examples include: a patient wanting to be fed solid foods even though they are at high risk for aspiration, continuing to drink intravenously when death is rapidly approaching, refusing painkillers for fear of speeding up the dying process, or requiring insertion of a feeding tube although it will have no impact on prolonging life and may actually cause discomfort. As a nurse it is not your job to agree with your patient, but to educate them along with the rest of the healthcare team so that they understand the dying process and its importance to quality of life. When it comes to healthcare, it can sometimes be difficult to balance a patient's wishes with those of their family. Adding end-of-life care to this conversation makes this balance even more difficult to manage. This is especially true when family members' views do not match those of the dying relative, such as DNR status, requesting confidential information, or placing blame on the healthcare provider for decisions made. "Our complainants also stated that some problems may be related to the families of dying patients, for example they may have difficulty deciding on continuing treatments, or may attempt to obtain information from unauthorized persons." Although end-of-life care can be extremely stressful for family members, nurses must remember that patient care is their number one priority. During the end of their life the patient may not be able to speak for themselves, and this is where patient advocacy will have an impact.