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The approach to end-of-life care varies widely throughout the world and is influenced by medical, cultural, social, and legal considerations. The clinician must consider these factors when managing the care of a dying patient.

Dying patients have needs that differ from those of other patients. So that their needs are met, dying patients must first be identified. Before death, patients tend to follow 1 of 3 general trajectories of functional decline:

• A limited period of steadily progressive functional decline (eg, typical of an aggressive cancer)

Physical, psychological, emotional, and spiritual distress is common among patients living with fatal illness, and patients commonly fear protracted and unrelieved suffering. Health care providers help reassure patients that distressing symptoms are regularly anticipated, prevented and, when present, treated.

We have now reached the end of the lifespan. While it is true that death occurs more commonly at the later stages of age, death can occur at any point in the life cycle. Death is a deeply personal experience evoking many different reactions, emotions, and perceptions. Children and young adults in their prime of life may perceive death differently from adults dealing with chronic illness or the increasing frequency of the death of family and friends. If asked, most people envision their death as quick and peaceful.

The Code of Ethics is widely recognized as the most comprehensive ethics guide for physicians, and is put out by the AMA. Opinions covered in Chapter 5 include: Advance Care Planning; Advanced Directives; Withholding or Withdrawing Life-Sustaining Treatment; Orders Not to Attempt Resuscitation (DNAR); Medically Infective Treatments; Sedation to Unconsciousness in End-of-Life Care; Physician Assisted Suicide; Euthanasia.

Abstract

Summary: In New Zealand, doctors work in collaborative interdisciplinary teams, particularly in the management of patients with long-term and complex conditions, and have an important role in supporting the further development of collaborative models of care. There are models of shared care between disciplines, across health sectors, including a range of health and professional groups as well as partnering with patients, family and whānau. Within teams, role clarification is necessary together with the building of professional trust in other disciplines’ specialist skills.

Summary: In New Zealand, doctors work in collaborative interdisciplinary teams, particularly in the management of patients with long-term and complex conditions, and have an important role in supporting the further development of collaborative models of care. There are models of shared care between disciplines, across health sectors, including a range of health and professional groups as well as partnering with patients, family and whānau. Within teams, role clarification is necessary together with the building of professional trust in other disciplines’ specialist skills.

Interprofessional education (IPE) and collaborative practice (IPCP) are the keys to improving health, safety, satisfaction and cost in the modern healthcare system. Interprofessional Education Toolkit: Practical Strategies for Program Design, Implementation, and Assessment provides healthcare educators, administrators, and clinicians with a practical, evidence-based manual for leading change.

This chapter conversationally explores what "leading interprofessionally" means and asserts leader attributes and essential competencies needed to model leadership for self and others to "lead interprofessionally" with purposeful intent.

Preferred Attribution:

Saewert, K. J. (2018). Leading interprofessionally. In J. M. Adams, J. Mensik, P. R. Ponte & J. Somerville (Eds.), Lead like a nurse: Leadership in every healthcare setting. Washington, DC: American Nurses Association.

Several systematic reviews have been conducted on the relationship between interprofessional collaboration and health outcomes using quantitative studies. But no systematic review had yet been conducted on this topic using qualitative studies. The following paper addresses this gap. A systematic review was conducted. From the broad search of the literature, 9 studies were ultimately selected after screening and critical appraisal, and were include in the meta-synthesis.