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Abstract: Palliative care has become an option which derives from the growing need of improving health care assistance for terminal patients' progressive, incurable illnesses, as well as for the patients' relatives. Given the complex characteristics of the procedures undertaken and their joint actions, I have chosen to refer to the four key-areas of palliative care as my main guideline, throughout this report. Communication is considered by many as one of the most important components in approaching chronic patients, who are to be found in an irreversible health condition. Communication is the basis for a therapy which provides for the creation of a relationship based on empathy and help among patients, family and the health care professionals. One of the vital aspects to bear in mind in what concerns the approach to this patient, consists of acting accordingly in the control of the multiple symptoms which are shown and which will condition entirely his/her well-being and the family's. In the cases of a severe, incurable disease, it is the nurses' job to spend most of the time with the patients and their families, deciding on their own the need to plan complete and individual care for those who are dying and give attention and make time to be with one's relatives. This implies having had formation on the professionals' behalf to successfully fulfill this mission. Palliative care is a high-complexity set of tasks. For those to be correctly performed, they demand coordinated actions, not just from one professional but from a group of professionals working together, all making an effort to maintain the best quality of life allowed to the patient. Clinical trials happened at Unité Douleur Soins Palliatifs, a hospital in Roubaix, France. The experience comprised 200 hours of labour, whose result was a significant personal gain and a priceless contribution to my professional training. In fact, it has granted me a better preparation in providing complex treatment and comfort for palliative patients and families. The intervention project I have developed in the Intensive Care Unit of Hospital de Sousa Martins Unidade Local de Saúde (Local Health Unit) in Guarda comprising 100 hours had the goal of making people aware of palliative actions inside the ICU, along with the intent to promote a change of attitudes of nurses towards terminally ill patients and assistance to their families.Thus, a training session was taught during working hours entitled "Palliative Care in Intensive Care".I acknwledge there is a sensibility for dealing with the subject within teams of professionals, but to further sensitize them, I ended up creating a set of two protocols:"How to give bad news - the Buckman protocol" and "The Family Conference". I have included both in the ICU Good Practice Handbook - with an assessment from the Chief-Nurse - to be discussed in the next service meeting and put into practice.
Dissertação de Mestrado em Cuidados Paliativos. Instituto Politécnico de Castelo Branco, 2012