PALLIATIVE NURSING PRACTITIONER
PALLIATIVE NURSING PRACTITIONER
THEORETICAL FRAMEWORK FOR A FAMILY AND PALLIATIVE NURSING PRACTITIONER
Presented by: Iriabel Nepravishta
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INTRODUCTION
Peplau’s Theory Interpersonal Relationship
Challenge Facing Palliative Care Practitioners
Impact of Society Perception of Palliative Care on Health Care Outcomes
Ways in which Peplau’s Theory can be used to address the Scope of Practice Restriction Challenge
Perspective Offered through the Application of Peplau’s Theory
Conclusion
References
A Palliative Nurse Practitioner (PNPR) is an advanced practice registered nurse (Forchuk, 2015). PNPR is trained to assess patient needs, diagnose disease, interpret diagnostic results and provide palliative medicine to treat illness with complex pain and symptoms. Additionally, PNPR will anticipate and meet the needs of the patient and family facing terminal illness and bereavement (Forchuk, 2015).
Peplau Theory is an interpersonal relation theory (Peplau, 2017). This is the theory that will be used to examine the challenge facing Challenge Facing Palliative Care Practitioners by looking at how enhancing interpersonal relationships between the nurses and the patients can help enhance health outcomes (Peplau, 2017).
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PEPLAU’S THEORY INTERPERSONAL RELATIONSHIP
Three phases: orientation, working and termination phases
Establish therapeutic relationship to provide better patient care.
A guide for resolution of the issues and concerns
Peplau’s Theory Views a Palliative Nursing Practitioner as a professional that establishes therapeutic relationship with patients. Peplau’s theory consist in 3 phases which are orientation, working and termination stages (Peplau, 2017). During the orientation phase, the patient, family and nurse work together to recognize, clarify, and define existing problem. The working phase includes deliver and application of interventions, and services of care to treat, explore and change a situation. Finally, the termination phase includes resolution and successful completion of all the other two stages on finalization of care (Townsend, 2015).
This theory is significant in palliative care because it will allow me to determine the needs of my patients and their families through the use of the orientation, working concepts. In doing so, I can serve as a resource person, a counselor and surrogate. In addition, I can provide individualized care that will meet the needs of my patients and their families. But most importantly, this theory is significant to palliative care because it will help me to transition patients and their families through end of life care by applying the concepts of the termination phase (Townsend, 2015 p. 40) , (Forchuk, 2015).
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CHALLENGE FACING PALLIATIVE CARE PRACTITIONERS
Perception of Palliative Care.
Different approaches of care among health care providers
Family conflicts.
Cultural differences
Today’s society struggles with the subject of death. We live in a decade where modern technology and treatments are prolonging life and the concept of natural death is seeming a vague illusion and almost an impossible concept to accept and face. We are dragged into the philosophy that there is nothing worse than letting our loves ones go and we hold them tight without acknowledging and respecting their wishes. Palliative Care Nurse Practitioners (PNPR) play an important role on assessing patient and family needs. They focus on providing patient-centered care to relieve symptoms and stress of a serious illness. The goal of PNPC is to improve quality of life for both the patient and the family (Townsend, 2015). Unfortunately, palliative care carries a negative stigma associated with death. Because of this there is fear and avoidance of palliative care because it is usually associated with precipitation of death (Meleis, 2014).
On the other hand, conflicting approaches to patient care can lead to conflicts among providers which can result in a decrease of the overall quality of care (Townsend, 2015). Fortunately, the application of Peplau’s theory promotes a stronger therapeutic relationship which will allow the PNPRs to be a better advocate to patients and families. Another challenge, somehow unique to PNPR, is ensuring that the family is supportive and honors the patient’s wishes during what can be a difficult time. Again, the relationship created through the use of this theory can provide the PNPR with the tools to help families transition through the grieving process (Peplau, 2017).
