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Understanding Nursing Essay

2657 words - 11 pages

Mr Charles Winston is a forty two year old Afro-Caribbean male with end stage pancreatic cancer. He is married with two children and had previously worked as a solicitor- he has been admitted to the local hospice. For the purpose of this assignment the focus will be on pain, the importance of being pain free and what this would mean for Charles will be discussed through-out this case study. The World Health Organization (2008) say that freedom from cancer pain must be regarded as a human rights issue.
Charles's pain was poorly controlled on admission so it took several hours for the nurse to assess and come to an agreement with Charles about how to manage his pain. The End of Life Care ...view middle of the document...

This shift impacted on nursing greatly, since adequate and on-going pain assessment, implementation of the prescribed pain management plan and evaluation of the patient’s responses to the implemented interventions, play a major role in effective pain management and ultimately affect the quality of the remaining life.
Pain is a common symptom for cancer patients and one of the most feared consequences for patients and their families (Oncology Nursing Society, 2004). Pain assessment is absolutely vital, in Charles's case this has taken a long time and he reports that he has been "very uncomfortable" for the past hour. Nurses are in a unique position to facilitate good pain management (Mann and Carr, 2006). The most important factor for successful pain management is accurate assessment of the patient's pain (Ross, 2004). Charles is very anxious so the fact that he is in pain will escalate his worries and his symptoms. Accurate Communication between the medical profession and the patient about pain and assessment of pain is necessary in order to perform the nursing process. The nursing process is the first step in assessing a patient it is a systematic method of planning, delivering, and evaluating individualized care for clients in any state of health or illness. Based on the scientific problem-solving method, it constitutes the foundation for nursing practice (Nursing, 2011).
The experience of pain can have a negative effect on nearly every aspect of life, including mood and capacity to function in daily activities (Katz, 2001). Assessment is imperative to achieve effective pain relief; patients with advanced cancer suffer from multiple symptoms that need regular assessment. Many tools are available such as; simple numeric scales, verbal or visual analogues. An example of one of these tools is the Abbey pain scale; it was developed in order to provide an easy-to-use tool for patients experiencing acute or chronic pain. It was then further developed for patients unable to articulate their needs (Mann and Carr, 2006). The measurement of symptoms has been recognised as an essential component of good pain management (British Pain Society, 2008). Regular assessments need to be documented as this is vital for individual patient care (Mann and Carr, 2006). On admission to the hospice Charles's observations were recorded, he had a raised pulse, his blood pressure was high showing hypertension and his respirations were also high. These all indicate that Charles is in pain and is anxious (Ross, 2004).
Charles is worried that strong analgesia such as morphine would leave him unable to communicate. Historically, nurses maintained strict control over pain medications in order to protect the patient from harmful effects of opioids, especially with concerns regarding addiction and confusion (Terry, 2004). Many health care professionals believed that opioids caused addiction, tolerance, dependence and respiratory depression as major side effects...

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