Improving Attitudes and Perceptions About End-of-Life Nursing on a Hospital-Based Palliative Care Unit.

Nurses play an integral role in high-quality patient care. Thus, their skills in providing end-of-life care should be assessed and continually enhanced. Education intended to improve end-of-life skills must address the affective/emotional component of nursing care. Evidence demonstrates that emotional engagement and resilience among health care providers are correlated with improved quality outcomes and, conversely, that burnout and stress negatively affect patient safety. Addressing the emotional needs of health care providers is critical to improving quality throughout the health care system. An evidence-based workshop was implemented among direct care staff on a hospital-based palliative care unit, with the goal of fostering emotional engagement to improve staff perceptions and attitudes about caring for patients at or near the end of life. Although perceptions about quality of death were not affected by this intervention, there was a significant improvement in attitudes about end-of-life nursing care. Qualitative feedback also reflected appreciation for small group discussions and opportunities to debrief with peers away from the unit. This intervention reflected the value of emotional engagement in educational efforts to improve end-of-life nursing care.

The use of metaphor in discourse about cancer: a review of the literature.

Imagery and metaphors are used throughout health communication and can be particularly powerful in discourse about cancer. Providers, patients, and the media may use descriptive language to convey the impact and experience of the disease. This article reviews the literature on metaphor in discourse about cancer and its effects. Also, the positive and negative effects of popular cancer-related imagery, such as military and journey metaphors, are explored. Metaphor can be used in nursing, through thoughtful use of imagery, to improve patient-centered care. By noting the imagery used by patients to describe their experiences with cancer, nurses can find a common language for connecting with patients and can advocate for greater awareness and more sensitive communication by other healthcare providers.