End of Life Care: Challenges for Nurses and Families

Physician-Assisted Dying and Its Legitimacy in the Medical Practice
August 25, 2022
Financial Management and Quality of Healthcare
August 25, 2022

End of Life Care: Challenges for Nurses and Families


Marilyn Walker, a critical care nurse at the Metropolitan Jewish Health System Hospice, began her career after losing her husband and aunt to hemorrhagic stroke and cancer of the pancreas, respectively. Her line of work demands excellent listening skills as terminally ill individuals often call the office in need of someone with whom to have a conversation. At times, Marilyn is emotionally attached to her patients hence making it difficult to come to terms with their death. Despite having to deal with multiple deaths over time, Marilyn gives her best when it comes to providing palliative care for her patients. She considers her job worthwhile as she values her practices in the medical line of duty. Facing death is a troubling experience for the patient, caregiver, and family members.

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Patients on the verge of death remain in denial and refuse to accept the possibility of sudden demise. Most of them end up suffering from depression and anxiety mainly because as the disease progresses, the hope of leading a normal life fades away since they become dependent on someone else to help them do even considerably basic tasks. At this point, a patient may need to undergo counseling to help them cope with negative feelings emanating from the consciousness of the looming death. Research reveals that 45% of cancer patients develop suicidal thoughts, which can be attributed to depression (Kyota & Kanda, 2019). Other than psychological challenges, terminally ill patients suffer physical pain as well. Some terminally ill patients desire relief from the excruciating pain even if it means dying, which at the same time feels scary.

Providing care to a patient who is on the point of death can be difficult even to the most experienced nurse. Training alone is not enough to prepare a nurse for the challenges that come with caring for dying patients. About Marilyn’s experience, nurses at times should be ready to deal with grief upon the death of a patient following attachments that developed during the time they spent together. Being around dying patients too often and interacting with them may result in anxiety disorders for health care providers (Kyota & Kanda, 2019). Upon the death of a patient, nurses have had to deal with bereaved families who usually blame them simply because they are also unable to come to terms with the loss of a loved one. Over and above an emotional burden, many grieving family members are left financially drained as most terminal diseases require a series of costly treatments.

Despite numerous challenges in providing end-of-life care, nurses play an important role in easing suffering for dying patients. They too should be allowed to grieve rather than being always expected to put on a brave face. Health facilities should ensure that nurses have a safe space to share their experiences for the sake of their mental health (Macpherson, 2018). By sharing their problems among themselves and with the nurse manager, nurses gain adequate psychological support to continue caring for patients. Additionally, nurses should comfort families and give them time to mourn to help them adapt to changes that are brought about by the death of loved ones. Anticipating variations of roles within the family, among other factors, can help avert a family crisis through prior planning.


Besides the emotional problem, many grieving families are left monetarily drained as most terminal illnesses necessitate a series of expensive treatments. Facing death is painful for the patient, health professionals, and family members. Many patients under palliative care refuse to accept that end-of-life care could be preparing them for death. By working in collaboration, patients, nurses, and family members enhance the provision of quality terminal care.