The Ruland-Moore theory serves as a good guide for establishment of standards of care appropriate for the terminally ill and significant others. Education should be rendered toward the limitations and scope of care for patients and their significant others. This theory should give us light as to the importance of nurse educators, patient coordinators, pain managers and support groups. It is a nurse's responsibility to be well-informed of an effective healthcare team. To what extent does our responsibility as nurse advocates to this group cover? With regards to nursing education, wherein one of the outcome criteria calls for a patient to be without pain, standard of care should be aimed toward finding specific means to know when a patient, whether responsive or unresponsive or paediatric, is in pain to meet this goal. The numeric pain scale (0-10 scoring of pain) has been created to assess a patient's tolerance to and severity of pain. In cases of unresponsive and/or paediatric clients, the FLACC scoring and the Wong-Baker's scale has been created to have a more objective way of assessment. Furthermore, a terminally ill patient should not be limited to his/her use of analgesics, for as long as analgesic dosages are appropriate for his/her age, weight and condition. The nurse should also be knowledgeable enough of the patient's and his/her family's religious beliefs and cultural practices. In the Middle East, it is considered unethical to commence or suggest a Do Not Resuscitate order. This is why a great number of ICU patients remain hospitalized long-term and are often "brain-dead" and on the ventilator. Even when sufficient information has been given by the medical physician regarding a patient's poor prognosis, the Do Not Resuscitate principle does not apply and is unlawful. (Roland, 1998)
This knowledge would allow for spreading expert nursing practices to all nurses in a systematic fashion, helping family members make decisions that are consistent with their values and goals for end-of-life care and reducing the amount of psychological distress of family members who make end-of-life decisions. It is also recommended that end-of-life education be broadened in nursing schools to give both undergraduate students and new nurses a better understanding about the concepts around end-of-life care and the dying process. (McMillen, 2008)
References:
Roland, C.M. & Moore, S. (1998). Theory Construction Based on Standards of Care: A Proposed Theory of the Peaceful End of Life. Nursing Outlook 1998 (46)4: 169-175.
R. E. McMillen, “End of life decisions: nurses perceptions, feelings and experiences,” Intensive and Critical Care Nursing, vol. 24, no. 4, 2008.
0 comments:
Post a Comment