Approaching the attention to the wish to hustle death. Team reflections

Leiva-Santos, Juan Pablo; Rodriguez-Calero, Miguel Ángel; Julià-Mora, Joana María

doi:10.1016/j.enfcle.2024.09.005

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Later becomes ‘practice of loving-kindness, compassion and equanimity in the context of conscious care’. CF2. ‘Installation of faith – hope’. Later becomes ‘Being authentically present and allowing and maintaining the individual’s deep and subjective belief system, compatible with his or her freedom. This free individual, with his or her own beliefs, is a being for care’. CF3. ‘Cultivation of sensitivity towards oneself and others’. Later becomes ‘being sensitive and compassionate to self and others by cultivating own spiritual practices, beyond ego-self to transpersonal presence’. CF4. ‘Development of a trusting relationship’. Later becomes ‘Developing and sustaining an authentic relationship of care, through a relationship of trust’. (Involves coherence, empathy, non-possessive acceptance and effective communication). CF5. ‘Promotion and acceptance of the expression of positive and negative feelings’.Later becomes ‘being present and becoming a supporter of the expression of positive and negative feelings in a connection with the deepest spirituality of the person being cared for’. CF6. ‘Systematic use of creative problem-solving in the care process’.Later becomes ‘the creative use of oneself as a participant in the art of caring and of all ways of knowing as part of the care process’. (Use of the Nursing Process as a Scientific Method in Nursing). CF7. ‘Promotion of interpersonal teaching-learning’. Later becomes ‘Engaging in transpersonal teaching-learning that addresses the unity of the being and its meaning and that tries to remain within the other’s frame of reference’. CF8. ‘Provision of the environment of support, protection and mental, physical, socio-cultural and spiritual healing’. Later becomes ‘creating a healing environment at all levels (physical, non-physical, environmental, energy and consciousness) whether it be the whole, beauty, comfort, dignity and peace’. FC9. ‘Assistance in satisfying human needs’which is later called ‘assistance in basic needs, with conscious and intentional care that touches and envelops the spirit of individuals, honouring the unity of Being, and allowing spirituality to emerge’. CF10. ‘Recognition of existential, phenomenological and spiritual forces’.Caring for one’s own soul and the soul of those who must receive care." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sara Furtado-Eraso, Blanca Marín-Fernández, Paula Escalada-Hernández" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Sara" "apellidos" => "Furtado-Eraso" ] 1 => array:2 [ "nombre" => "Blanca" "apellidos" => "Marín-Fernández" ] 2 => array:2 [ "nombre" => "Paula" "apellidos" => "Escalada-Hernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1130862124000688" "doi" => "10.1016/j.enfcli.2024.06.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862124000688?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2445147924000821?idApp=UINPBA00004N" "url" => "/24451479/0000003400000005/v1_202410311036/S2445147924000821/v1_202410311036/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Approaching the attention to the wish to hustle death. Team reflections" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "424" "paginaFinal" => "425" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Juan Pablo Leiva-Santos, Miguel Ángel Rodriguez-Calero, Joana María Julià-Mora" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Juan Pablo" "apellidos" => "Leiva-Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Miguel Ángel" "apellidos" => "Rodriguez-Calero" "email" => array:1 [ 0 => "miguel.rodriguez.calero.sspa@juntadeandalucia.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Joana María" "apellidos" => "Julià-Mora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Soporte Hospitalario de Cuidados Paliativos, Hospital Manacor, Mallorca, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Calidad, Hospital Universitario Torrecárdenas, Almería, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Una aproximación a cómo atender los deseos de adelantar la muerte. Reflexiones en equipo" ] ] "textoCompleto" => "Life and death throw goals, challenges, and indignities at us all, even at those of us involved in researching palliative care. This letter forms part of the life and death cycle of one of the authors and the grieving of the other two.The initial draft of this text was drawn up by Dr. Leiva-Santos. In his memory and in the memory of the many professionals who have dedicated their lives to the solace of other peoples’ suffering, we decided to complete it, after a team reflexion on the desire to hasten death, expressed by many patients. We live in times of vertiginous change, driven by technological developments that determine our lifestyle and communication. Areas such as artificial intelligence and robotics have evolved exponentially. At the same time, health sciences demand more humanised processes. The last four years have marked and accelerated this pace even more. The SARS-Covid pandemic led to both human and material losses whilst simultaneously highlighting the intrinsic dynamic social complexity of what it means to be human. Anthropologically, whether we are aware of it or not, we are living through historic times playing leading roles. 2020 marked the beginning of this pandemic but at the same time, it was also the year of commemoration and exoneration for the nursing community. The NursingNow movement emphasised the role of the nurse as a leader, researcher and tireless caregiver of patients and their families, and especially of those who are suffering.Against this backdrop in Spain, in 2021, we witnessed the passing of a law that decriminalises and regulates euthanasia, and that demands from health professionals the skills of deliberation, reflection and ethical solidity. This law, however, missed the opportunity to place care as the backbone of end-of-life care, and perhaps move towards the development of a “comprehensive law on end-of-life care” that would incorporate access to euthanasia, the conceptualisation of which should be based on the relief of suffering rather than on the legal construction of “a right to death”.The desire to hasten death (DHD) can be defined as a phenomenon of one’s reaction to suffering, in relation to an illness that may be life-threatening, and which places the person in a situation of hopelessness to which they can find no other way out.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> This desire may be expressed spontaneously, or explicitly investigated by the professional, but it must be differentiated from the process of accepting one's own death. In their bedside work, health professionals must be prepared to actively listen, respond to and/or accompany the DHD,<a class="elsevierStyleCrossRef" href="#bib0010">2</a> a fluctuating phenomenon that can emerge with some frequency in patients with advanced disease or at certain critical moments, and which has been related to factors of physical, emotional, spiritual and social origin. This desire is not always an expression of a genuine desire to die, but rather a means to end suffering.The concept of dignity also appears here, as a term that is associated with a fundamental human right, and with a process of death without symptoms of distress or pain, with autonomy, respect for ideas and beliefs, and with the minimum possible invasive procedures.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>For health professionals knowledge of the explanatory DHD model is essential. It contains six themes<a class="elsevierStyleCrossRef" href="#bib0020">4</a>: (1) Physical, psychological, spiritual and social suffering; (2) The “loss of self” understood as the set of losses: physical functionality, the meaning of life, perceived dignity, control, etc.; and (3) Fear, both of death itself and of the process of dying. In this situation, the patient shows hopelessness and great emotional distress; the DHD can emerge as (4) A desire to live, but "not like this”; (5) as a means to end suffering and, finally, (6) As a mechanism of control over life, that is, as having an ace up one's sleeve. Suffering is the common denominator in all patients.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>How can health professionals be with the people who suffer and avoid compassion fatigue and burnout? Cultivating compassion is a necessary tool.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> The role of the nurse is vital in the assessment; identification of needs; participation in the advance care planning during the dying process and/or referring to palliative care professionals those patients who suffer from a progressive, active, advanced, complex disease with no chance of curative treatment. This practice guarantees the person's control over their own experience of illness, allows them to manage uncertainty and offers support to their loved ones.Teamwork is essential for the timely channelling of these resources. Compassion must be up to the new challenges implied by advanced technology in health systems. The vocation to accompany and alleviate suffering must be protected and enhanced. The resources for this must be sought in science and wisdom through the ages led by the compassionate spirit of our species.FundingThis work has not received funding." 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"fecha" => "2011" "volumen" => "20" "paginaInicial" => "795" "paginaFinal" => "804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20821377" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An integrative review of dignity in end-of-life care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Q. Guo" 1 => "C.S. Jacelon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0269216314528399" "Revista" => array:7 [ "tituloSerie" => "Palliat Med." 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ISSN: 2445-1479

Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nurses from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. Its objectives are to promote the dissemination of knowledge, promote the development of evidence in care and contribute to the integration of research in clinical practice. These objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Reviews, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes two kinds of articles: comments about original articles of special interest written by experts, and evidence synthesis articles based on bibliographic reviews.

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Impact factor 2023

0.7

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SJR 2023

0.214

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0.319

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Vol. 34. Issue 5.