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QUESTION 1 

Hi, my name is Katarina, and I will discuss how palliative care providers adapted during the COVID-19 pandemic to ensure safe and effective care delivery. 

The COVID-19 pandemic has caused significant obstacles and challenges for palliative care providers. As a result, palliative care providers have had to modify and adapt to new practices to continue safe and efficient care during the pandemic. To continue providing high-quality care while reducing the risk of COVID-19 transmission, palliative care providers have had to implement several strategies. During the pandemic, palliative care providers utilised Telehealth and virtual communication methods. This meant that providers maintained contact regularly with the patients through phone consultations, video calls and virtual meetings. This was done to ensure that the patients were still receiving ongoing care while keeping them safe and minimising the risk of viral transmission.

An important aspect is the safety of the patients/residents, staff, and families. Personal protective equipment (PPE) is another tactic that palliative care professionals employ during the pandemic. To protect staff from COVID-19, personal protective equipment (PPE) such as masks, gloves, face shields and gowns have been crucial. To protect themselves and their patients from the spread of COVID-19, palliative care providers must ensure that they have a sufficient supply of personal protective equipment (PPE). Also, to reduce the likelihood of COVID-19 transmission, palliative care providers have been required to implement infection control measures. Contamination control measures, like hand hygiene, social distancing, and isolating patients with Coronavirus, have been fundamental in limiting the spread of Coronavirus transmission in palliative consideration settings and creating a safer environment to protect every individual. 

Palliative care providers recognise the importance of addressing the requirements and concerns of the patient's family and carers. Even though visitation restrictions were put into place, alternative virtual methods of communication were established. Patients' families could stay informed and involved in decision-making, care planning and stay in touch through video conferencing and other apps. This allowed them to be a part of the patient's care even though they could not be physically present. The patients and families being unable to see each other physically had a negative effect on their mental health. In saying this, emotional support and counselling services were provided, recognising the emotional toll that everyone faced during this challenging time. Interdisciplinary collaboration played a vital role in adapting palliative care delivery. Palliative care providers worked closely with doctors, nurses, social workers, and mental health professionals. This collaborative approach ensured that the patients, emotional, physical, ­­and psychosocial well-being were cared for. By integrating the skills and expertise of different healthcare professionals, palliative care providers provide adequate support to patients and their families. 

QUESTION 2

During the pandemic, palliative nurses faced one ethical issue: how to allocate limited resources. Critical care items like ICU beds, ventilators, medications, and personal protective equipment (PPE) are in short supply due to the surge in COVID-19 cases during the pandemic. As a result, concerns about ethics have been raised because palliative nurses have had to make difficult decisions about allocating and prioritising these limited resources fairly.

Palliative nurses have had to use a team approach to allocating resources to solve this ethical problem. Guidelines and procedures for allocating limited resources have been developed by palliative nurses in collaboration with other healthcare professionals through consultations and discussions. Ethical principles such as equity, fairness, and transparency are the foundation for these guidelines and procedures. However, the difficult task of allocating limited resources to needy patients, such as ICU beds, ventilators, and medications, affected palliative nurses. In addition, healthcare systems were overwhelmed by the unprecedented rise in COVID-19 cases, resulting in a lack of essential resources. Consequently, palliative nurses faced the moral dilemma of properly prioritising and allocating these resources."

Palliative nurses had to balance various ethical principles to address this challenge. They had to uphold the beneficence principle and work to provide each patient with the best possible care. On the other hand, following the fundamental principles of palliative care, they looked to reduce suffering and encourage comfort. However, they were forced to confront the distributive justice principle, which ensures that limited resources are distributed equally among all patients. Palliative nurses approached this ethical challenge by making decisions together and systematically. With multidisciplinary teams of doctors, nurses, and hospital administrators, they discussed the ethical issues. They discussed making fair decisions considering factors like clinical need, visualisation, and potential for benefit."

QUESTION 3 

Effective communication has always been an essential aspect of palliative care, but during COVID-19, it has become even more pronounced. 

Communication in palliative care is essential because it builds understanding, trust and shared decision-making between the healthcare providers, the patients, and their families. In saying this, during the COVID-19 pandemic, communication became even more critical as it was the only way to connect the patients and their families with healthcare professionals, as being physically present was very restricted. 

Effective communication ensures that palliative care remains patient-centred. This means respecting individual preferences, goals, and values. It became vital to have honest and open conversations about the various treatment options, mentioning the risks and benefits and the impact on the quality of life. This allowed the patients and families to make crucial decisions that resonated better with their wishes and values. 

In the context of the COVID-19 pandemic, advanced care planning also requires effective communication. The process of discussing, understanding, and writing down a patient's wishes for their care in the event of a severe illness is known as advanced care planning. Effective communication showing empathy, compassion and sensitivity is essential to ensure that patients and their families comprehend the advanced care planning process and make informed decisions regarding their care.

Palliative care providers have had to adopt a person-centred approach to guarantee effective communication during advanced care planning. As a result, communication is tailored to each patient's preferences and needs, and patients and their families are involved in the decision-making process.