Title: End of Life Nursing Care: a guide for best practice
Authors: De Souza J & Pettifer A
Publisher: Sage Publications
Reviewer: Robert Becker, independent lecturer in Palliative Care
What was it like?
This jointly authored book is aimed squarely at undergraduate nurses in the UK and is a welcome addition to the small number of books targeted at this audience. The authors are experienced educators and clinicians in palliative care and understand well the learning needs of student nurses in today’s complex clinical environment. The writing style is clear, logical and fluent using well thought out case studies, reflective questions, action points and summary facts in each of the 12 compact chapters. It’s not a long book at 200 pages and it’s a “how to do it” text rather than an in depth treatise of end of life care issues. That said the analysis provided is perceptive and insightful.
What were the highlights?
Its strengths lie in its readability, unpretentious language and its correlation to everyday nursing practice. The evidence base is strong, bang up to date and used wisely to support the pragmatic advice offered rather than being an exercise in academic analysis. The reflective questions are challenging and useful for portfolio development and I particularly liked the multiple references to a number of contemporary films that deal with end of life issues in sensitive ways. Students can and do learn a lot from multimedia examples such as these.
Strengths & weaknesses:
Invariably there will be compromises in such a short book, which deals with a large and complex area and this book does fall short in a few areas of note. There is little reference to the many challenges faced when dealing with different cultures and religions. For example, concerns surrounding disclosure of information, the use of opiates in pain management and gender issues for carers; all highly relevant to nursing care across the UK.
Also I find it odd that of the three major advance care planning tools supported by the End of Life Care Strategy (2008), which underpin this text in many areas, the two medically led ones i.e. the Gold Standards Framework and the Liverpool Pathway, are rightly discussed and put into context. Yet the Preferred Priorities in Care document, which is the sole nurse led and developed tool fails to receive even a mention. It is wide use and advocates real partnership and empowerment for patients through patient held documentation; ideals that are at the core of undergraduate nurse education.
The authors further assert that the four NMC Generic Standards for Competence (2010) are addressed within the text and while there is a brief reference to this in the introduction, they are not cross referenced at any point in the book. An opportunity lost I think, particularly as these competencies underpin the undergraduate curriculum across the UK.
Who should read it?
This is a book worthy of success despite its limitations and student nurses will find it useful as both a reference text to support their academic work and as a book, which offers some pragmatic strategies for use at the bedside.