A Prospective Study with Patients and Families on the Usefulness of Accurate Prognosis for Palliative Care Patients.

Prediction of life expectancy in terminally ill patients is an important end-of-life care issue for patients, families and mental health workers during the last days of life. This study was conducted to examine the importance/usefulness for patients/families to have an accurate prognosis and its impact on planning their activities prior to death. All patients admitted during a period of one year were included. Patients' and families' viewpoints on the usefulness of an accurate prognosis was documented at admission. There were 285 patients in the cohort. The median time to death was 8 days. Most families (83%) rated the importance of an accurate prognosis as moderately (13%) to very much useful (70%). A total of 42% of patients were able to complete e the questionnaire. Among these, 58% found it moderately to very much useful. For families, having an accurate prognosis influenced the planning of visits (69%), communication/closure (42%) and spiritual needs/funeral arrangements (31%). Patients identified planning of visits (10%), communication/closure (12%), and goals/accomplishments (9%) as very important. Discussing the prognosis and its impact is very helpful for the mental health professionals to have open and honest conversations with patients/families to identify, prioritize and adapt treatment to achieve goals prior to death.

Nursing and Maslow's Hierarchy: A Health Care Pyramid Approach to Safety and Security During a Global Pandemic.

The COVID-19 pandemic of 2020 tested health care organizations in ways many had never experienced. In response to new problems, nurses and other staff needed creative solutions that would allow them to quickly and safely provide care. Nurses concurrently experienced stressors to their personal needs. The authors collected examples of creative problem-solving through staff interviews and reflected on Maslow's hierarchy of needs to consider how nurse's needs were being met throughout the pandemic. Recognizing that basic needs must be addressed before an individual can ascend the levels to eventual self-realization, the authors share how one health care organization quickly and successfully met the patient care requirements while supporting nurses basic needs like safety and trust.