Nursing and End of Life Care

Case Study Submitted by: Beke Jacobs
Country: Germany

Nursing is a uniquely placed profession, with nurses having the incredible responsibility of providing care and alleviating suffering, even in life’s most vulnerable moments, including during the process of dying.

Life expectancy of people across the globe is increasing and options for medical treatment, particularly in Western countries are increasing. Often this raises questions about the feasibility of treatment in light of the wishes of the individual patient.

Consequently, there is a need to reflect on to what extend the individual wants to be medically treated, given their illness, fragility or the approach of the end of life. This is especially important because therapeutic teams are frequently confronted with life-critical decisions in situations in which the patient can no longer express his or her will.

 Beke Jacobs, a Registered Nurse and Head of the Patient Information Centre of the University Medical Centre of Schleswig Holstein, Germany, provides a counselling service to support patients in the process of understanding end of life decisions and mandates.

There are many challenges that nurses face when managing patients who have moved into palliative treatment. Not only are there complicated legal requirements, patients’ may have made advance directives that need to be followed, and nurses have to also meet the needs of the patient and their family members.

With a written advance directive, patients can determine that certain medical measures are to be carried out or omitted, if they are no longer able to decide for themselves. This ensures that the patient’s will is implemented, even if it can no longer be expressed autonomously in the current situation.

Beke’s work informs, advises and supports patients and their relatives in acute care situations in the hospital, and also provides counselling on demand and during informative events, free of charge.

Experienced nurses have the training, skills and experience to empathise with patients, take into account medical interventions and their impact, enabling them to provide care and support during the discussion of end of life care. Nurses provide a vital service in ensuring dignity and respect at this most difficult time.

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