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Our shared collection with BCcampus breaks down resources by subject area. You can also filter by ancillaries, accessibility criteria, review or adoption status, as you search for the best fit in your courses. We’re always here to help if you’re not sure where to start.
You can also browse a growing collection of Made-in-Manitoba resources by visiting our PressbooksEDU catalogue.
Nursing Care at the End of Life: What Every Clinician Should Know by Susan E. Lowey, The College at Brockport, SUNY is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
Nursing Care at the End of Life: What Every Clinician Should Know
Description: Nursing Care at the End of Life: What Every Clinician Should Know should be an essential component of basic educational preparation for the professional registered nurse student. Recent studies show that only one in four nurses feel confident in caring for dying patients and their families and less than 2% of overall content in nursing textbooks is related to end-of-life care, despite the tremendous growth in palliative and end-of-life care programs across the country. The purpose of this textbook is to provide an indepth look at death and dying in this country, including the vital role of the nurse in assisting patients and families along the journey towards the end of life. There is an emphasis throughout the book on the simple, yet understated value of effective interpersonal communication between the patient and clinician. The text provides a basic foundation of understanding death and dying, including a brief historical examination of some main conceptual models associated with how patients cope with impending loss. An overview of illness trajectories and models of care, such as hospice and palliative care are discussed. Lastly, the latest evidence-based approaches for pain and symptom management, ethical concerns, cultural considerations, care at the time of death, and grief/bereavement are examined. The goal of this text is to foster the necessary skills for nurses to provide compassionate care to individuals who are nearing the end of life and their families. Every chapter contains a “What You Should Know” section which highlights and reinforces foundational concepts.
Posted: April 15, 2016 | Updated: January 14, 2022
Author: Susan E. Lowey, The College at Brockport, SUNY
Subject Areas
Health and Medical, Nursing
Original source
milneopentextbooks.org
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Reviews (4)
Avg:
Institution:PCTIA accredited career training institutionTitle/Position: Instructor
Q: The text covers all areas and ideas of the subject appropriately and provides an effective index and/or glossary
It would be good to see a list of words appropriate for entry level students studying the topic.
this will help them increase their understanding what common terminations means.
Comprehensiveness Rating: 4 out of 5
Q: Content is accurate, error-free and unbiased
Content is well supported with research.
It would be good to see more of Health Canada stats than CDC stats.
Content Accuracy Rating: 3 out of 5
Q: Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement
Content is up-to-date with the regards to review of context and concepts about hospice palliative care.
Relevance Rating: 4 out of 5
Q: The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used
It will be good to see some tables or infographic to be able to see what statistical numbers means of a clearer picture.
Clarity Rating: 3 out of 5
Q: The text is internally consistent in terms of terminology and framework
The use of hospice palliative care is conistently to its meaning as written in the book.
Consistency Rating: 3 out of 5
Q: The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course (i.e., enormous blocks of text without subheadings should be avoided). The text should not be overly self-referential, and should be easily reorganized and realigned with various subunits of a course without presenting much disruption to the reader.
Good to see the contents divided accordingly realistic expectations in facing death and dying.
Modularity Rating: 4 out of 5
Q: The topics in the text are presented in a logical, clear fashion
The timeline is very logical and it clearly show the process.
Organization Rating: 4 out of 5
Q: The text is free of significant interface issues, including navigation problems, distortion of images/charts, and any other display features that may distract or confuse the reader
It will be easier to read with more space between texts.
It will be nice to see images and charts.
Interface Rating: 3 out of 5
Q: The text contains no grammatical errors
Texts are free from grammatical errors.
Grammar Rating: 3 out of 5
Q: The text is not culturally insensitive or offensive in any way. It should make use of examples that are inclusive of a variety of races, ethnicities, and backgrounds
The words are inclusive.
It includes the holistic approach.
Cultural Relevance Rating: 4 out of 5
Q: Are there any other comments you would like to make about this book, for example, its appropriateness in a Canadian context or specific updates you think need to be made?
I recommend to do some book content matching with the standardized provincial curriculum for HCA and get connected with the BC Care Aide registry for consideration of having the open textbook be used to supplement the added hospice palliative care content for HCAs and 1st year Practical Nursing students.
Institution:Brandon UniversityTitle/Position: Assistant Professor
Q: The text covers all areas and ideas of the subject appropriately and provides an effective index and/or glossary
All areas are covered appropriately, the index and chapter outlines are clear. Although there is no specific glossary all terms are clearly defined in the text. The book is a U. S. text so I found the Historical Overview lacking in the areas where other countries have provided leadership in the development of end-of-life and palliative care. Canada, Britain and Australia are significant contributors. The author speaks a lot about the United States health care system and structure which is quite different from the Canadian context. This is an area where I would have to add content to my course. I already add it any way because I currently use a British text. End-of-life care is a world issue and the author does add material from the World Health Organization which is good. Content that is missing is how children face the end of their own lives or how they deal with the death of loved ones close to them. I would have liked to see a case example in each session to encourage students to discuss and apply what they have learned.
Comprehensiveness Rating: 4 out of 5
Q: Content is accurate, error-free and unbiased
Content is accurate, up-to-date, error-free and unbiased.
Content Accuracy Rating: 5 out of 5
Q: Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement
This book will not quickly become outdated or obsolete. As legislation changes in the United States and Canada and other countries I would see the need for some sections to be expanded upon i.e. in Canada we are currently in the process of managing and continuing to develop the Medical Assistance in Dying legislation which can make the ethical issues surrounding end-of-life care more complex.
Relevance Rating: 4 out of 5
Q: The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used
The text is clear and easy to read. It is definitely written at an undergraduate level. Definitions and terms are clearly explained.
Clarity Rating: 5 out of 5
Q: The text is internally consistent in terms of terminology and framework
The text is internally consistent in terms of terminology used and the framework. I like the framework of Anticipation; In the Moment and Afterwards.
Consistency Rating: 5 out of 5
Q: The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course (i.e., enormous blocks of text without subheadings should be avoided). The text should not be overly self-referential, and should be easily reorganized and realigned with various subunits of a course without presenting much disruption to the reader.
Modularity - The text is divided into manageable subsections. It is great that it has twelve sections as this fits nicely with a twelve week semester course. The reading is light enough that Canadian context readings and assignments could be provided to students without overloading them with reading requirements. I could possibly see myself using some of the sections in a different order. Because I teach psychiatric nursing students there is higher expectations for interpersonal communication skills, counselling skills, personal self-awareness and self-care, critical thinking and an understanding of individual, group and family dynamics. Relationship and the therapeutic use of self is central to the practice of psychiatric nursing therefore students are required to develop affect tolerance and the ability to be present with individuals who are distressed and suffering. Our students would be expected to differentiate between depression associated with a terminal diagnosis and depression that may need to be treated to improve quality of life. mental status examinations and spiritual assessments are part of their core competencies. Psychiatric students need to learn more about pain management and the management of physical symptoms so this text is helpful in these areas. I would be able to drop some of the materials i use in this area because this text covers these areas well.
Modularity Rating: 4 out of 5
Q: The topics in the text are presented in a logical, clear fashion
The topics in the text are presented in a logical clear fashion.
Organization Rating: 5 out of 5
Q: The text is free of significant interface issues, including navigation problems, distortion of images/charts, and any other display features that may distract or confuse the reader
The text is simple to navigate and the charts are clear and easy to read. I would have like some case study materials or examples to use.
Interface Rating: 5 out of 5
Q: The text contains no grammatical errors
I did not notice grammatical errors.
Grammar Rating: 5 out of 5
Q: The text is not culturally insensitive or offensive in any way. It should make use of examples that are inclusive of a variety of races, ethnicities, and backgrounds
The text is culturally sensitive and non-offensive. different races, ethnicities, and backgrounds were included although i think these areas could have been expanded upon. Children and adolescents were not addressed in any specific ways. Not every person in an identified group will adhere to the same religious or spiritual beliefs, however, the book does emphasize individual preferences and the need for nurses to have a non-biased approach. there needs to be a distinction between collectivist cultures and non-collectivist cultures as this impacts communication and how advanced care planning is done. the cultural mix in Canada is different and this is where i would add specific Canadian data. In Canada we emphasize cultural safety and humility more so than cultural competence. We would ask individuals and family members about the cultural practices that are important to them. Our Aboriginal, Inuit and Metis people come from different tribes and have differing belief systems. There is often a mix of traditional and non-traditional beliefs. In Canada we are in the process of reconciliation with our indigenous population so this would be contextual information that would be provided. I have lots of Canadian cultural materials to use. The LGBTQ community and other vulnerable populations are not specifically addressed, i.e. the homeless, the mentally ill, the incarcerated, developmentally challenged individuals and those with other disabilities or challenging life circumstances are not specifically identified. All of these people are under-served in palliative and hospice care.
Cultural Relevance Rating: 4 out of 5
Q: Are there any other comments you would like to make about this book, for example, its appropriateness in a Canadian context or specific updates you think need to be made?
This book could be used in Canada, however there are specific segments where Canadian legislation and the structure of the Canadian health care system along with the Canadian cultural experience would need to be expanded upon. As noted above I have already had to do this with the current text i am using. This text would be an improvement over the one I am currently using. The segments I really liked include: Types and Variability within Illness Trajectories; Models of Organized End-of-Life Care; Palliative vs. Hospice; Initiating Conversations about Goals of Care; Management of Pain and Physical Symptoms; Care at the Time of Death; Nurse-Patient-Family Communication; Grief and Bereavement and the Afterward. The areas that are good include: Management of Emotional and Spiritual Distress; Ethical Concerns in End-of-Life Care and Diversity in Dying: Death Across Cultures. the Historical overview needs to be inclusive of the work done outside of the United States.
I would definitely consider adopting this text for my course 69:272 Introduction to Palliative Care. I already have the additional Canadian content that i would use and I can create my own case examples. (Some of these materials are already created). I also use films and film assignments as part of my course.
Thank you for permitting me the option of reviewing this text.
Institution:University of Alberta (Edmonton)Title/Position: Clinician Scientist
Q: The text covers all areas and ideas of the subject appropriately and provides an effective index and/or glossary
• Excellent in that many texts or chapters on EOL care focus on cancer patients, this text encompasses and acknowledges EOL with chronic illness (e.g., persons with Alzheimer’s) and acute injury EOL (e.g., trauma)
Comprehensiveness Rating: 3 out of 5
Q: Content is accurate, error-free and unbiased
• Few diagrams, which are used with permission
• Personal description at end is appropriate
Content Accuracy Rating: 4 out of 5
Q: Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement
• Focus on philosophical perspective and broad scope is beneficial, e.g., communication, compassion, competence, comfort
• Excellent chapter on initiating conversations about goals of care, e.g., in terms of scope, depth, perspective, applicability
Relevance Rating: 4 out of 5
Q: The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used
• Clear, definitions given, new terms described
Clarity Rating: 4 out of 5
Q: The text is internally consistent in terms of terminology and framework
• Yes, introduction indicates that it is about compassion, comfort and conversation, and focus of chapters encompasses these
Consistency Rating: 4 out of 5
Q: The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course (i.e., enormous blocks of text without subheadings should be avoided). The text should not be overly self-referential, and should be easily reorganized and realigned with various subunits of a course without presenting much disruption to the reader.
• Yes – For example, could use the chapter on symptoms as stand alone for a seminar or lecture, or clinical support
Modularity Rating: 5 out of 5
Q: The topics in the text are presented in a logical, clear fashion
• Organization by “Anticipation, In the Moment, Afterwards” nicely links patient/client/family phases but also demedicalizes and humanizes the experience
Organization Rating: 5 out of 5
Q: The text is free of significant interface issues, including navigation problems, distortion of images/charts, and any other display features that may distract or confuse the reader
• Yes - however there are few images which is negative for visual learners, nor are there references to websites. However, the “ Learning Objectives” and “What you Should Know” boxes are helpful to anticipate chapter and then summarize for learners. And there are good connections between chapters.
Interface Rating: 4 out of 5
Q: The text contains no grammatical errors
• Well written and easily readable for year 1 or 2 students
Grammar Rating: 5 out of 5
Q: The text is not culturally insensitive or offensive in any way. It should make use of examples that are inclusive of a variety of races, ethnicities, and backgrounds
• Does provide a few examples, perhaps more pertinent to US population, e.g., cultural perspectives at end of life, but majority of content is inclusive and none is insensitive or offensive
Cultural Relevance Rating: 4 out of 5
Q: Are there any other comments you would like to make about this book, for example, its appropriateness in a Canadian context or specific updates you think need to be made?
• Flexibility – It suggests that there is ability to which would be beneficial to build upon the material for Canadian context or updates, E.g. CASN outcomes for undergraduate students, Canadian statistics, advance care planning within provincial context,
• Hospice, funding differ from US as well as terminology update for chapter on models of organized EOL care – this is very specific to US
• Although Kubler-Ross’ research is debated, it is handled well in terms of the possibilities and understanding that it is not linear. It is balanced with other research and theories. Would like to see other components such as caring, distress and suffering by key researchers , e.g, Betty Ferrell (used textbook but only cited one research article), Janice Morse (suffering, enduring, discomfort), Judith Hupcey (family support)
Institution:College of New CaledoniaTitle/Position: Instructor - Northern Collaborative Baccalaureate Nursing Program 
Q: The text covers all areas and ideas of the subject appropriately and provides an effective index and/or glossary
The topic of nursing care at the end of life was covered extensively, from the history of end-of-life care, through nursing care in anticipation, in the moment and afterwards. The chapters covered each topic in detail, with recent references to support. However, much of the data was American resources and applicable primarily to the United States of America. For example, many studies were directly applicable to an American demographic and resources are American based. As this text is being reviewed for adoption to a British Columbia educational program, some chapters are not relevant in their entirety. However, that does not detract from the content when applied to an American context. I feel that this text would benefit from a global perspective, utilizing information and resources from the WHO as well as other leaders in palliative and nursing care such as Canada and the UK.
The text covers a wide aspect of nursing care in end-of-life including background information such as illness trajectories and the prominent frameworks and models applicable to this specialty area. This information is useful to nursing students, novice nurses and experienced nurses new to this specialty area. As a nurse experienced in palliative and end of life care in the community and acute care setting, I found the text contained both relevant review information as well as more recent studies and evidence to support different concepts in end of life care. As an educator, I found several chapters of particular interest to use in teaching family nursing care.
The index is well organized and effective.
Comprehensiveness Rating: 4 out of 5
Q: Content is accurate, error-free and unbiased
The content in the text appears to be error free and accurate. The content was unbiased as far as I can see, however a more in depth focus on cultural diversity, cultural competency and cultural safety would be beneficial. The text is geared towards an American readership. As previously mentioned, a global perspective would increase the applicability of the text to a larger population. Some of the content is biased towards the American style of healthcare and therefore not general for use by educators in other countries.
Content Accuracy Rating: 4 out of 5
Q: Content is up-to-date, but not in a way that will quickly make the text obsolete within a short period of time. The text is written and/or arranged in such a way that necessary updates will be relatively easy and straightforward to implement
The text includes references both classic and from the last 10 years. Most of the references seem to be from 2000-2010, making them 10+ years old already. As each chapter is so specific, I think it would be easy to update the chapters that focus heavily on evidence based practice, such as management of pain and physical symptoms. The chapters that focus on history, frameworks and models could remain as is for a longer period of time. An updated version would be relatively easy to achieve as well as integrating new chapters, if desired.
Relevance Rating: 4 out of 5
Q: The text is written in lucid, accessible prose, and provides adequate context for any jargon/technical terminology used
This text is an excellent level for novice nurses and students to read. The language is accessible, yet at an appropriate level for nursing professionals. The content is well worded, with supporting evidence introduced in a natural and flawless manner. The text does not rely extensively on citing literature but uses it effectively to support the content. The sections about management of emotional and spiritual distress and care at the time of death carry a conversational tone that makes the content easy to follow and comprehend, especially for novice nurses and students.
Clarity Rating: 5 out of 5
Q: The text is internally consistent in terms of terminology and framework
The text follows a consistent framework, style of writing and terminology. Differences in the terminology used are discussed in chapters 1, 3 and 4. The terms end-of-life, palliative care and hospice are well defined and used consistently throughout the text.
Consistency Rating: 5 out of 5
Q: The text is easily and readily divisible into smaller reading sections that can be assigned at different points within the course (i.e., enormous blocks of text without subheadings should be avoided). The text should not be overly self-referential, and should be easily reorganized and realigned with various subunits of a course without presenting much disruption to the reader.
The chapters are well defined and specific to each content. As an educator, I can easily demarcate which chapters I want the students to read. These chapters are self-contained and do not require the student to read the text in its entirety. The chapters are divided into smaller sections with subheadings that makes content easy to follow. Learning objectives and what you should know sections at the conclusion of each chapter help to focus the reader on the important content.
Modularity Rating: 5 out of 5
Q: The topics in the text are presented in a logical, clear fashion
The topics follow a clear chronological order of progression. The text starts with an overview of the history of the topic and then progresses to content in a linear fashion from diagnosis through to death and aftercare.
The topics are clear and succinct.
Organization Rating: 5 out of 5
Q: The text is free of significant interface issues, including navigation problems, distortion of images/charts, and any other display features that may distract or confuse the reader
No concerns at all. I printed this text from the pdf in order to read and review and there were no issues with the print version or the online view version.
Interface Rating: 5 out of 5
Q: The text contains no grammatical errors
I did not find any errors.
Grammar Rating: 5 out of 5
Q: The text is not culturally insensitive or offensive in any way. It should make use of examples that are inclusive of a variety of races, ethnicities, and backgrounds
The text includes a short section on after care in terms of different cultures and religions common in the USA, but could be more detailed. A global perspective could be implemented. Cultural competence and safety could be elaborated on. Sexual orientation is not mentioned but the topic of transgender and LGBTQ2 nursing care could be included. The Social Determinants of Health also play a large role in any nursing care aspect and could be included in terms of end of life care.
Cultural Relevance Rating: 4 out of 5
Q: Are there any other comments you would like to make about this book, for example, its appropriateness in a Canadian context or specific updates you think need to be made?
Yes. This text is great for novice and students nurses as well as nurses transitioning to this area of nursing care.
