Pain Management

2. Address Mrs. Thomas’s Physical pain and decline. Explore Mrs. Thomas’s attitudes and feelings about the use of narcotics. Some patient’s choose to forgo pain medications because they fear decreased alertness and want presence with family and friends. Non-narcotic and non-sedating medication options should be explored and discussed. Help Mrs. Thomas verbalize her fears about the medications. Explain the difference between addiction and dependence. Explore Mrs. Thomas’s openness to alternative methods of pain control such as visualization, music therapy, self-hypnosis and mediation. Encourage her to listen to her body by resting when needed and participating in life when she has the energy. Mr. and Mrs. Thomas both require education about palliative care options for management of symptoms associated with her disease.

This results in the following PICO question: In terminally ill patients, does early admission into a hospice program, versus those who are admitted later, result in more effective pain control at the end of life? The focus of this question is therapy (Sackett, 1997).

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

The movie “Wit” is a great educational tool for healthcare professionals in terms of dealing with terminally ill patients. It teaches that nurses and medical professionals should always remember that their patients are not a case nor illness nor experiment but rather human beings with souls and pains. Palliative care is one of the most disputed issues of worldwide importance. While bureaucrats in different countries are making laws on the use of palliative drugs, patients with excruciating pains learn how to “take deep breaths and be strong” (Nichols & Brokaw, 2001). That is what nurse Susie Monahan from “Wit” advises her dying patient Vivian Bearing suffering from unbearable pains due to stage IV ovarian cancer after eight painful rounds

Despite significant advances in the multidisciplinary approach of palliative care and the growing body of evidence-based practice, a multitude of variables continue to interfere with excellence in end-of-life care for everyone (Anonymous, 2007). Because of this the primary nurse must be diligent in administering the proper medications to allow the patient to have minimal pain or suffering and provide emotional support and reassurance to family members, and possibly fellow staff members

Trossman (2006) states that at least 50% of patients are suffering from moderate to severe pain at their time of death, that 70 million Americans experience pain throughout their activities of daily living and that nurses hold the keys to pain management. According to Abdalrahim et al. (2010) there have been countless evidence-based studies regarding pain management; nevertheless, the inability to control the patients’ pain has increased due to nurses often devaluing the information they receive from the patients about their current pain level, these actions are directly related to a withholding of

Adequate pain and symptom management is an essential component of palliative and end-of-life care and has a direct impact on patient and caregiver experience. In September 2014, the Champlain CCAC, in collaboration with regional pharmacies, service provider organizations, the Regional Palliative Consultation Team and community palliative care physicians, introduced a Champlain Wide Pain and Symptom Management Kit (SMK). The SMK is a standard package of medications and related medical supplies placed in the home of a patient who is approaching the end-of-life for the purpose of relieving unanticipated or rapidly escalating symptoms in a timely manner.

Reducing pain among terminally ill persons is a nursing phenomenon of great importance. In this evidence based paper, terminally ill refers to patients with cancer that have six months or less to live and patients that are in hospice or undergoing palliative care. Pain, weakness, decreased intake of food and fluid, and altered breathing patterns are some physical symptoms often experienced by the terminally ill (Leow, Drury & Poon, 2010). Treating pain in the terminally ill is very important and challenging for nurses. Therefore, it is important for nurses to use both pharmacologic and nonpharmacological methods to reduce patient pain. Music therapy is one specific non pharmacological intervention nurses can use to manage pain in the terminally ill. The purpose of this paper is to write an empirically based literature review related to the effects music therapy has on reducing pain in the terminally ill.

Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80).

Pain and comfort as a rule are considered opposing in the needs of human beings. Pain is defined as an unpleasant sensory or emotional experience associated with potential tissue damage. Pain can be divided into categories of long-term pain or short-term pain and by the type of pain, level of pain, location of pain, and ease of solving the pain. Frequently, there is no way to completely manage pain, specifically in end-of-life care. Pain is at

The lack of knowledge, inappropriate assessment, and drug seeking biases of physicians has lead to chronic mismanagement of pain. Mismanagement of pain is just one facet of the current palliative health care issues we face today that has lead to patients feeling hopeless and wanting PAS. In the case of Dax, who had third degree burns on over seventy five percent of his body. He was not given the full range of care that was available to the paramedics and doctors who took care of him. This is a classic example of how unbearable “pain upsets and destroys the nature of the person who feels it.”

Pain management is the most important aspect of cancer treatment because chronic severe pain is the worst manifestation of cancer. The use of opium and its congeners, such as morphine, hydromorphone, and methadone, is relatively effective in the management of pain (Lovell et al., 2014). Cognitive behavioral therapy is critical in complementing the role of painkillers in this process. The nurse engages the patient in the therapy that will enable them to accept their problem and develop coping mechanisms. Palliative care is basically the pain management care provided to a patient to relieve the symptoms of painful sensation while managing complications due to unavailability of treatment options or the hope of recovery (Lovell et al., 2014). It

Nurses play significant roles in the clients' daily lives. They are not only the supportive advocates for the clients but also the caretakers that make the clients feel comfortable and satisfied while staying in the healthcare facilities. Compared to other healthcare team members, nurses are the ones that spend the most time with the clients. Nurses should be able to distinguish or to notice any earlier changes in signs and symptoms of the clients, especially the pain level. Pain is one of the most common clinical problems in the acute care setting. Back then in 1995, 50-75% of cancer clients passed away with the moderate or severe pain although they had already been administered with pain-reducing medications. Healthcare providers and/or

The QOL model assesses a patient’s physical, psychological, spiritual, and social well-being (ELNEC (Module 1), 2013). “In some ways, the dimensions are relatively distinct; however, there is also tremendous overlap. Physical symptoms such as pain clearly have an impact on psychological symptoms such as anxiety” (Ferrell & Coyle, 2008 pp. 45). The nursing perspective helps to identify and treat the root cause of the issue, which in this example is “pain” rather than just opting to quickly medicate for the anxiety. This is not to suggest that the anxiety will not be treated with medications, but that other nonpharmacological methods will also be considered. Both the medical model and the nursing perspective are important and when utilized together effectively by the palliative care or hospice team they can

In concurrence with the findings of past studies on this issue, the researchers found that there are inadequacies in knowledge on several aspects associated with palliative care (Valo, 2012, p.23). Some of these aspects include pain management, unfavorable drug incidents, and use of opioid.