PEOL THEORY IN NURSING PRACTICE

Nurses should be able to inform and encourage of the existence of options that patients and families can take such as the Sacrament of Annointment in the Philippines. Such rituals are not only done on the hour of death, but can also be encouraged earlier as this is believed to be part of a patient's process for healing, which now meets one of the outcome criteria of the standard for Peaceful End-of-Life -- "The patient is at peace" (Ruland and Moore, 1998)

Shimane, K. (2011, August). Image of the End-of-life Stage. Creating a Peaceful and Reliable End-of-life Stage. Retrieved from Ministry of Economy, Trade and Industry

In Nursing Practice, the Theory of Ruland and Moore has been laid down with great emphasis. Especially those working in established institutions, the set policies or guidelines that healthcare workers follow in dealing with near dying patients are connected to the said theory. However, these are not absolute and palliative care for the dying can be done with special considerations. (Thelen, 2005)

End-of-life care at home 007. (2012, January 18). People deserve to have their end-of-life care wishes met. Retreived from theguardian website http://www.theguardian.com/society/2012/jan/18/end-of-life-care-policy

As the patient’s disease worsen and the end is very near, healthcare providers should be dedicated in creating a peaceful end of life care to them. Together with the patient’s family, palliative care will be decided in which its goal is no longer for curative treatment. Rather, it will be focused on pain and symptoms management while giving attention to provision of comfort and dignity as he die, surrounded by people close to his heart. As the patient advocate, the nurse needs to cooperate and collaborate more between the interdisciplinary team and the patients’ family. Those who care for the dying patients need to be honest and straightforward in discussing death among the family members. They should be sensitive enough in delivering this unfortunate event and be able to empathize with them as they express their grief. In Middle Eastern countries, it is important for the family to be present with such situation. Nurses must allow opportunity for this and provide privacy as they recite the holy Qur’an precided by their Motawa (prayer leader for Muslims). One of their beliefs is to offer a prayer to Allah (their God) in behalf of their family member. For them, the patient will be at peace once they pray altogether. Muslims also believe that no matter what the effect of analgesia is, either worsening the patient’s condition or not, it is important to lessen the pain he is experiencing. They do not consider the “Do Not Resuscitate” order too as they count this as an immoral act. For them, it is necessary for a person to die whenever Allah will allow. Nurses should be aware of this and respect this decision. Another way of giving a sense of accomplishment for the dying Muslim patient is through contributing to a charity before he dies. In behalf of him, family members will donate money to any charity chosen by the patient. With this, he feels his life becomes more meaningful and he shows an act of being noble before his life will be taken.

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.

M. Thelen, “End-of-life decision making in intensive care,” Critical Care Nurse, vol. 25, no. 6, 2005.