ICU: Socio-Cultural Analysis

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

For this study patient families were randomly assigned to the intervention or control group. In the control group the interactions between the family and ICU staff, including the end-of-life conference, occurred according to the usual practices and policies in the hospital; whereas in the intervention group, the research study was conducted according to specific guidelines. A bereavement information leaflet was given to each surrogate decision maker. In this research, the independent variable can be the type of family conference received by the surrogates and the dependent variables were the level of stress, anxiety, and depression levels indicated in the 90-day follow-up interview.

Very often, deliberate decisions are made which results in the end of a life. For example, a person could be kept on life support, but instead, a family member or other significant person might choose to switch off the life support machine resulting in the official death of a patient. There is also the case that resuscitation of a patient may eventually prove to be trivial and a doctor might suggest just making the patient as comfortable as possible until their eventual passing. In the above situations, a medical professional’s decisions would not be questioned or doubted. It is conventional practice (Warnock and MacDonald 2008).

The African-American cultural view of death is one of normalcy. They view death as comfortable and familiar. The sanctity of life and its preservation is extremely important within African-American culture but when death comes it is considered natural and an accepted part of life (Barrett, 2002). This differs from the traditional American cultural perspective that after the mid to late 1900’s came to view death as unnatural and something to be hidden (Corr, 2009). African-American culture may consider death to be a natural part of life but the sanctity of life is also very important to them. For this reason African-Americans are more inclined to aggressively pursue life saving treatments than those from traditional American culture (Barrett, 2005). Members of African-American culture are also less likely to want to talk about or deal with end of life decision-making (Welch, 2005).

When a person is dying, each culture has traditions and beliefs that influence end- of-life care. This paper discusses cultural beliefs and practices surrounding end of life care and death within the Latino culture, particularly focusing on people of Mexican origin. According to Spector (2013), of the over 50.5 million Hispanic individuals living in the U.S, Mexicans make up the overwhelming majority of the Hispanic community. Understanding how Mexican-Americans traditionally view end-of-life care allows a health care worker to better serve the patient as the patient transitions from acute care to palliative care or hospice care. Cultural attitudes influence the process of decision making at the end-of-life.

The good that came out of the situation was that the care plan for the last days of life had been met. The patients and the family's psychological, social and spiritual needs had been addressed, and the patient was comfortable and free from pain (Kemp 1999). The care that was carried out protected the patients' dignity and respected him as a human being, with his family being involved as much as possible with his care.

This article looks at a group of ICU nurses, and investigates their perceptions on DNR orders, and the changes implied in their nursing activities after DNR decisions are made. A ten question survey was conducted from August through September 2008, and consisted of 252 ICU nurses who had at least a year in clinical experience. This instrument was used to determine not only nurse’s attitudes in relation to DNR orders, but also their attitudes when confronted with making the decision by themselves. The findings found that many nurse’s activities did not change both passively, or actively after implementing the DNR decision. Majority of nurses in the study believed that patients’ opinions should be accepted when they reject the treatment, and

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

All of the quality indicators are important for hospital quality but the in-patient quality indicators for mortality rates are essential for better care. Research has shown that mortality indicators varying across different hospitals and suggests there could be deficiencies in quality of care that is causing this wide range. Therefore the mortality rates as quality indicators are important to provide better quality of care across our

Key people could be family, doctors, carers, religious leaders etc. Each may own distinctive role to play in order for the choices and preferences of the individual to be respected and carried out. [ Every person’s end-of-life trajectory is different and needs differ in intensity and quality over time. End-of-life care must adapt to the varying and changing needs of the individual over time and that it cannot be limited to certain settings or services. The provision of good

Caring for patients at the end of life is a challenging task that requires not only the consideration of the individual as a whole but also an understanding of the

The process of deciding when a terminally ill patient should die lies within the patient, family members, and the

The fundamental mission of the National Association of Social Workers (NASW) is to promote human well-being as well as to help meet the needs of all people, while paying special attention to the needs and empowerment of people living in poverty, oppressed and vulnerability. The social work profession focuses on human and societal well-being in a social context. The key areas of the profession are to outline the environmental forces responsible for creating and contributing to social problems. Social workers are tasked with promoting social change and social justice on behalf or with the clients. Clients in a social context include an organization, a community, a family, a group or an individual (Parker-Oliver and Demiris,

The research project will be conducted from four adult intensive care units (ICUs) at a level I trauma county hospital in Santa Clara County. The sample in this research will be registered nurses from four ICUs in the hospital. The researcher will be using a purposive sampling strategy to select the appropriate sample by recruiting ICU nurses who are qualified to provide the data needed for this study. Purposive sampling is sometimes called “judgmental sampling,” and it is based on the researcher's judgment to select the proper sample for the study (Murphy et al., 2018). The sample will consist of 8 to 10 registered nurses who are willing to share their experiences of a patient death in the ICU settings and are in the best position to provide

The article by Goodridge et al., (2009) sought to address the problem of inadequate research on the quality of end-of-life care for patients with advanced chronic obstructive pulmonary disease (COPD), who are frequently admitted and die in critical care units. The title of the article is clear and appropriate within the context of critical nursing care. In addition, the research problem has been clearly identified and the abstract precise, representative of the research topic, and in the correct form. The purpose of the article is clear both in the Abstract and Introduction sections, where the authors point out that their intentions were two-fold. One, to ascertain the perspectives of critical care providers in the quality of dying patients admitted for COPD, and two, to compare how nurses rate the quality of death and dying between patients from other critical care units and those in the COPD unit. Notably, the investigators