BNUR1900: Nursing Fundamentals Quiz

BNUR1900: Nursing Fundamentals

• Focuses on the concept of family, end-of-life care, and medical assistance in dying (MAID).
• Presented by Peter Kennedy RN, BScN, MBA on November 21, 2024.

Learning Objectives

• Discuss the concept of family.
• Develop an understanding of end-of-life care.
• Develop an understanding of Medical Assistance in Dying (MAID).
• Develop insight into the impact of MAID for the person and the family.
• Discuss the provision of care for the person who has requested MAID.
• Discuss the provision of support to the family of the person who requested MAID.

Entry to Practice Competencies

• Clinician 1.15: Incorporates knowledge about ethical, legal, and regulatory implications of MAID when providing nursing care.

Family

• Purpose: Protect, teach, and nurture members.
• Functions: Survival, security, healthy emotional/social development, relationship maintenance, instruction about society and the world, and assistance with learning roles and behaviours.
• Influences: Values, beliefs, customs, interaction/communication patterns.
• Definition: Individuals related (biologically, emotionally, legally), or with close bonds to the person receiving health care, including close bonds, romantic attachments, shared households, and child-rearing responsibilities, and people the person identifies as significant (e.g. parents, caregivers, friends, substitute decision-makers).

Family and Health Promotion

• Provides initial perceptions of health and health promotion activities.
• Helps define health, establish beliefs and values about health, and supports guidance for health and illness behaviours.
• Effective families integrate stability with growth and change, and have a flexible structure to accept help from outside the family system.

Family and Nursing

• Family units experience changes throughout the life cycle.
• Nurses play a vital role in providing care to families, which requires developing skills to assess families.
• Important to consider individuals within the context of their larger family structures, recognizing family structure, assessing family function and understanding the current developmental stage of the family.
• Developing interviewing skills and communication skills is crucial.

Families and Older Persons

• Familial relationships become important as persons age.
• Older persons are often more dependent on family members for care and support.

Aging and Relationships

• Includes: Marriage/partnerships, divorce, LGBTQ2 relationships, changing relationships with adult children, grandparenting, and sibling relationships.

Family Caregiving

• Includes: spousal caregiving, aging parents caring for adult children, adult children caring for aging parents, grandparents raising grandchildren, and long-distance caregiving.

Dying

• Death is not the problem, but dying is the work.
• Dying impacts the person who is dying, their loved ones, and those caring for them.
• A challenging and private life experience.
• Rationalization of death differs among people.

End-of-Life Care

• Should be available to all, regardless of setting, provided by appropriate care providers.
• Many people prefer home death, though this varies among people.
• Nurses must be knowledgeable about end-of-life care options and resources for patients.

Hospice and Palliative Care (HPC)

• Improves quality of life for patients and families facing life-threatening illnesses.
• Prevents and relieves suffering through early ID and impeccable assessment/treatment of pain.
• Comprises comfort care (physical, psychosocial, and spiritual).
• Often provided at home.
• Focuses on supportive comfort care.

Guiding Principles of Framework on Palliative Care in Canada

• Person- and family-centered care.
• Death, dying, grief, and bereavement as part of life.
• Caregivers as both providers and recipients of care.
• Integrated, holistic, equitable access.
• Recognition and valuing of Canada's diversity.
• Valued, understood, adequately resourced palliative care services.
• High-quality, evidence-based palliative care that improves quality of life is a shared responsibility.

Death, Dying, and Nursing

• Nurses are exposed to dying and death across healthcare settings, with varied experiences and coping methods.
• Grief is common in nurses, emphasizing the importance of developing coping skills.
• Debriefing and support from colleagues are essential.

Medical Assistance in Dying (MAID)

• Legalized in 2016 in Canada.
• Allows certain adults to request a physician's help in ending their life.
• In 2021, a joint parliamentary committee reviewed Canada's MAID legislation.
• Nursing goal: Support the patient who requests MAiD and support their family.
• Includes practitioner-assisted MAID and patient self-administered MAID, defined by administering a medication at a patient's request.

Bill C-7 (MAID Legislation)

• Removed requirements for a person's natural death to be reasonably foreseeable.
• Removed the 10-day reflection period.
• Removed the consent requirement for the procedure for those whose natural death is reasonably foreseeable.
• Requires only one independent witness for consent verification.
• Introduces new safeguards for those without foreseeable natural death (90-day gap requirement).

MAID Nursing Role

• RNs and RPNs participate by providing nursing care and supporting the NP/physician.
• Provide information without coercion or encouragement.
• May perform tasks like educating patients, comfort/support, inserting IV lines (with orders) for medications causing death, acting as an independent witness.

Conscientious Objection

• The law permits nurses to decline participation in MAID based on personal beliefs.
• Nurses must continue to provide care until a replacement caregiver is found.
• No moral judgments should be expressed to patients or family members regarding MAID.

CNA Code of Ethics

• Nurses understand the laws surrounding MAID and their beliefs/values about MAID.
• Nurses discuss any conscientious objections to providing care for MAID patients with supervisors in advance.

Perpetual Case Study: Reflection Questions

• How would a future healthcare provider feel if assigned to care for a patient who has requested MAID?
• How would one respond if asked about requesting MAID?
• How can one manage own emotions and thoughts about MAID to support patients and families in a caring/supportive manner?

This quiz covers essential concepts in Nursing Fundamentals, focusing on family dynamics, end-of-life care, and Medical Assistance in Dying (MAID). You will explore the ethical, legal, and regulatory implications of MAID as well as the role of the family in providing support during such critical times.