Death, Dying, and End-Of-Life Care

A dying patient can develop cool, mottled skin, longer pauses between breaths, reduced urine output, noisy secretions, and decreasing responsiveness. These findings may be expected consequences of declining organ function; they do not, by themselves, prove that the patient is suffering or that every abnormal measurement requires correction. The nurse's first clinical questions are whether the patient appears distressed, whether a reversible cause is present, and whether an intervention fits the patient's goals of care. End-of-life care changes the target from prolonging physiological function at any cost to relieving suffering, preserving dignity, and supporting the patient's expressed wishes. That shift still requires active nursing assessment. Pain, urinary retention, fecal impaction, medication effects, delirium, and respiratory distress can be treatable even when death is near. Conversely, invasive suctioning, repeated blood tests, burdensome medications, or attempts to force food and fluids may increase discomfort without changing the course of dying. For an RPN in Canada, care is provided within provincial standards, employer policy, personal competence, and the established plan of care. The RPN observes and documents changes, assesses comfort, provides ordered and...