In many areas of Ireland, children dying at home still have inadequate access to specialist palliative care. This causes unnecessary emotional and physical distress to the child, family, caregivers and healthcare professionals. Irish health policies aimed at improving the situation need to be fully resourced, structured, implemented, supported and evaluated. Timely referral of the child, advance care planning, patient advocacy and, finally, management of symptoms at the end of life by palliative care children's nurse specialists can transform the experience of all involved. The author reflects on caring for a child with a life-limiting condition using the McNeilly (2006) reflection model.
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