Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) Palliative Care by Critical Care Nurses

Thursday, July 14, 2011

Jami A. Smith, DHEd, RN
Department of Nursing, West Texas A&M University, Canyon, TX

Learning Objective 1: The learner will be able to describe the standards and competencies required for palliative care and the interdisciplinary approach of HIV/AIDS palliative care.

Learning Objective 2: The learner will be able to describe the elements of grief reactions through caring for the patient and the bereaved family.

Palliative care is important in Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) care, both at the end-of-life and throughout the course of illness. Palliative care interventions remain important in the routine care of patients with HIV/AIDS across the continuum of care, not only in order to improve quality of life and address the wide range of medical and psychosocial issues related to chronic, progressive illness, but also in order to help enhance adherence with HIV-specific therapies. Despite all nurses being involved in the delivery of care to dying people although to a greater or lesser degree, there remains marked variability of knowledge and skill surrounding both the care provided and outcomes achieved. Palliative care skills should be incorporated in training for all clinical staff, and palliative care domains addressed in standard assessment procedures. Critical care nurses must be able to use critical thinking and problem-solving skills, and communicate effectively with multidisciplinary team members. They must also possess key critical care skills and competencies that will equip them when faced with a patient with critical care needs and must be competent in palliative care. In order to determine the competence of critical care nurses to deliver the level of care expected of specialists, nursing requires a clear description of the attributes and standards expected of nurses. It is imperative that each critical care nurse is assessed and evaluated on his/her knowledge of palliative care, exposure to critical care, and ability to care and provide palliative care. Palliative care research needs to be enhanced and access to palliative care expertise needs to be improved. Therefore, a HIV/AIDS palliative care course is designed, implemented, and evaluated to prepare nurses to assume the role of a critical care nurse in the healthcare setting.