Select a current health care or nursing issue in your work environment ( Topic chosen: NURSING STAFFING)
Write a 5 page paper, excluding cover sheet and references that covers the following:
. Description of the nature and extent of the issue or problem.
. Description of who the issue or problem affects (including both the target population and health care professionals).
. Description of the short- and long-term effects of the problem on the target population and the health care system.
. Discussion points on the theoretical frameworks for understanding the existence of the issue or problem.
. Discussion points on the ethical issues this problem raises in the delivery of health care.
· Include a reference list that is appropriate to the body of literature available on this topic that has been published in the past five years.
· Cite and include a five sources, with the majority being from peer-reviewed sources.
· Adhere to APA style and formatting throughout your paper and when citing your sources.
Here are some links that might be helpful.
http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios
http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios/Optimal-Nurse-Staffing-ES-Sep15.pdf
http://www.nursingworld.org/nursestaffing
http://www.americannursetoday.com/what-every-nurse-should-know-about-staffing/
http://www.americannursetoday.com/ethics-case-study-poor-staffing-results-in-brain-damaged-patient-2/
PAIN CONTROL IN 3
Pain Control in the Cancer Patient
Students Name
Capella University
BSN 4006 Policy, Law, Ethics, and Regulations
Date
· Description of the nature and extent of the issue or problem.
· Description of who the issue or problem affects (including both the target population and health care professionals).
· Description of the short- and long-term effects of the problem on the target population and the health care system.
· Discussion points on the theoretical frameworks for understanding the existence of the issue or problem.
· Discussion points on the ethical issues this problem raises in the delivery of health care.
Running head: PAIN CONTROL IN 1
Pain Control in the Cancer Patient
The treatment of pain is so important that the Joint Commission deemed it the fifth vital sign in the year 2000. There have been many issues regarding addiction and pain management once physicians started to treat pain aggressively. However, patients still need to have their pain, treated and the Joint Commission continues to have standards on the treatment of pain. One of the standards is patients have the right to have their pain assessed and managed ("Facts about pain," 2015).
Nature and Extent of Treating Cancer Pain
In the field of cancer care treating cancer pain is as important as treating the cancer itself. Not all patients deal.
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
Select a current health care or nursing issue in your work environ.docx
1. Select a current health care or nursing issue in your work
environment ( Topic chosen: NURSING STAFFING)
Write a 5 page paper, excluding cover sheet and references that
covers the following:
. Description of the nature and extent of the issue or problem.
. Description of who the issue or problem affects (including
both the target population and health care professionals).
. Description of the short- and long-term effects of the problem
on the target population and the health care system.
. Discussion points on the theoretical frameworks for
understanding the existence of the issue or problem.
. Discussion points on the ethical issues this problem raises in
the delivery of health care.
· Include a reference list that is appropriate to the body of
literature available on this topic that has been published in the
past five years.
· Cite and include a five sources, with the majority being from
peer-reviewed sources.
· Adhere to APA style and formatting throughout your paper
and when citing your sources.
Here are some links that might be helpful.
http://www.nursingworld.org/MainMenuCategories/Policy-
Advocacy/State/Legislative-Agenda-Reports/State-
StaffingPlansRatios
http://www.nursingworld.org/MainMenuCategories/Policy-
Advocacy/State/Legislative-Agenda-Reports/State-
StaffingPlansRatios/Optimal-Nurse-Staffing-ES-Sep15.pdf
http://www.nursingworld.org/nursestaffing
2. http://www.americannursetoday.com/what-every-nurse-should-
know-about-staffing/
http://www.americannursetoday.com/ethics-case-study-poor-
staffing-results-in-brain-damaged-patient-2/
PAIN CONTROL IN 3
Pain Control in the Cancer Patient
Students Name
Capella University
BSN 4006 Policy, Law, Ethics, and Regulations
Date
· Description of the nature and extent of the issue or problem.
· Description of who the issue or problem affects (including
both the target population and health care professionals).
· Description of the short- and long-term effects of the problem
on the target population and the health care system.
· Discussion points on the theoretical frameworks for
understanding the existence of the issue or problem.
· Discussion points on the ethical issues this problem raises in
the delivery of health care.
Running head: PAIN CONTROL IN 1
3. Pain Control in the Cancer Patient
The treatment of pain is so important that the Joint Commission
deemed it the fifth vital sign in the year 2000. There have been
many issues regarding addiction and pain management once
physicians started to treat pain aggressively. However, patients
still need to have their pain, treated and the Joint Commission
continues to have standards on the treatment of pain. One of the
standards is patients have the right to have their pain assessed
and managed ("Facts about pain," 2015).
Nature and Extent of Treating Cancer Pain
In the field of cancer care treating cancer pain is as important as
treating the cancer itself. Not all patients dealing with cancer
have the need for pain medicine, but when cancer pain occurs it
needs to be frequently treated with narcotics in ever increasing
amounts. There are many issues when treating patients with pain
medications. Patients may be reluctant to take the pain
medication in case they will need it later, and it will not be
effective. They also fear they will become addicted even when
the patient has been told that the cancer is incurable. A difficult
issue facing the oncology community is the cancer patient
whom is a known addict. The ethical duty of the health care
provider is to treat adequately the cancer pain. The nurse is
required to assess the patient’s pain level. The nurse may have
unresolved feelings regarding the addict’s honesty in rating
their pain. The nurse may feel that they are contributing to the
patient’s addiction or fear the patient is diverting their pain
medications. To provide the patient with adequate pain control,
the nurse must put aside their reluctance to provide the patient
with narcotics.
Who I is Affected by Cancer Pain
The nurse must be aware of the issues of how undertreated
cancer pain can affect the quality of the patients’ remaining
life. This issue is so important that the World Health
Organization (WHO) created standards and guidelines for the
treatment of pain. The WHO recommends a three-step approach
4. to the treatment of pain. There are multiple guidelines for the
treatment of cancer pain, but most suggest the non-opioid
treatments as the first step. Medications such as Advil, and
Tylenol are the most common first step in pain treatment. Steps
two and three include the use of opioid medications. The goal
according to the WHO is the patient to be free of cancer pain
(Chapman, 2011). The reality of cancer pain, is that it can be
controlled, but not eliminated. An example of this; a patient at
Holzer was in the office to see a palliative care physician. The
patient was in extreme pain, so bad he was unable to sit or
stand, he would cry out in pain. The physician ordered 4
milligrams of Dilaudid with no relief of pain. He was then given
4 more milligrams and still was still suffering. He was going to
be admitted to the hospice room for pain control. He was given
ever increasing amounts of pain medication. He finally could sit
still, but rated his pain at a 10, and the nurses were concerned
that he was not accurately rating his pain. The palliative care
physician who spent a considerable amount of time with the
patient asked him what his pain was when he was first given the
Dilaudid, his reply was a 20. The nurses, while well trained,
failed to assess his pain adequately. After the patient got his
pain under control he went home on a pain pump. His pain was
under control but not gone.
Short and Long Term Effects of Cancer Treatment
The WHO noted with the improvements in cancer treatment,
that patients will be living longer with their disease. As a
consequence of longer life and effective treatments, including
surgery, radiation and chemotherapy, pain is a more common
side effect of these treatments (Feilding, Sanford, & Davis,
2015).
Cancer-associated pain takes many forms. Pain can be acute
because of a biopsy or surgery. Treatments such as
chemotherapy can have pain as a side effect. Neuropathic pain
is a common side effect of certain chemotherapy medications.
Acute pain from a pathological fracture can also occur
(Chapman, 2011). Cancer that metastasizes to the bone or spinal
5. cord can cause extreme pain that is difficult to control.
To perform a complete assessment, the nurse must have a
thorough knowledge of cancer and the associated pain. At each
office visit, the patient’s pain must be assessed as well as how
their pain is affecting their quality of life. It is not enough for
the nurse to use the standard pain scale. Asking a patient to rate
their current pain on a scale from 1-10 does not allow the nurse
or physician to see the full range of the depth and breadth of
cancer pain.
Poor pain assessment is not the only barrier to poor cancer pain
control. Poor pain control of cancer pain is not just a local issue
or even a national issue, but it is an international issue. A
Korean study that involved 201 cancer patients examined
patient reported pain barriers. One of the most frequently
reported barrier was the patient’s attitude toward taking pain
medications. The patients surveyed were concerned about
addiction, tolerance, side effects, and harmful effects of taking
opioids. The study noted that patients with depression are more
likely to report pain control barriers than those without
depression. Patients with depression were also 25% more likely
to report severe pain (Kwon et al., 2012). The study evaluated
patients’ attitudes towards the treatment of cancer pain. One
interesting point was the patients’ view of the inevitability of
pain from cancer or fatalism. This same fatalism is also
common in the Appalachian area of the country as described in
a study through the University of Kentucky (Royse & Dignan,
2011). This shows how universal attitudes towards cancer and
pain are.
Theorectical Frameworks for Understanding Cancer Pain
Nurses are often not adequately trained to assess and document
pain other than rating pain from the one to ten scale. A study
was completed in which two different methods were employed
in educating nurses on pain assessment management techniques.
The study focused on content delivery (Phillips, Helenika,
Hickman, Lam, & Shaw, 2014). The study involved scenarios
6. that evolved from chart reviews. The study had noted that data
was gathered in an ethical manner. The study indicated that
online learning has the potential to improve the nurses’ ability
to assess the patient’s pain. The program that was used in
teaching was not as important as was the frequency of the
education. The more frequent the education, the better the nurse
did in assessing and reporting the patient’s pain. Nurses who
worked in the field less than five years did better with the
education than nurses who were working in palliative care for
more than five years. In general, after the educational program,
the nurses’ knowledge of pain assessment improved, as did their
confidence in assessing pain. The nurses’ documentation that
would allow for clinicians to make better decisions did not
improve.
The study concluded that online learning interventions can and
do improve the ability of nurses to improve pain assessment
skills. This had a positive impact on the patients’ reporting of
pain. It noted that the nurse is an important part of the process
to assist the patient with receiving adequate pain control. They
also discussed a blended learning approach for nurses who are
challenged by online learning formats (Phillips et al., 2014).
ethical issues this problem raises in the delivery of health care.
Ethical Issues that can Come up from Cancer Pain Control
Nurses are on the frontline of cancer pain control. They must be
able to put their own prejudice and biases aside to allow the
patient to have the best quality of life for however the long
patient has. This can be months to years with modern medical
and radiological treatment. Nurses all too often ask a patient to
rate their pain from one to ten, and if the number is low, the
nurse may not go any further in a pain assessment. When the
number is high, around nine or ten, the nurse may not believe
the patient, but must question the patient further. Just as in the
case of the hospice patient who felt his pain before the large
doses of Dilaudid was a 20, because 10 did not describe his pain
level. Even if the adequate control of pain was not mandated by
the Joint Commission, the nurse has a duty to prevent needless
7. suffering of the patients in their care. A well-trained nurse
working with cancer patients needs to understand and come to
terms that adequate control of the patients’ pain may cut their
life short, but will improve the quality of the life they have
remaining.
Patients’ worldwide are reluctant to take large amounts of pain
medication that may be needed to provide comfort. However,
nurses worldwide need to help the patient understand the
importance of adequate pain control.
References
Reference style for a book:
Carlyle, T., & Niemeyer, C. (1996). On heroes, hero-worship,
and the heroic in
history. Lincoln, NE: University of Nebraska Press.
Reference style for a print journal:
Ellinger, A. D., & Bostrom, R. P. (1999). Managerial coaching
behaviors in
learning organizations. Journal of Management
Development, 19(9), 752
770.
Here are some examples of Electronic references
Bartlett, S. (2010, March 3). Schools helpless against nursing
shortage. Press-
Republican.Retrievedfromhttp://pressrepublican.com/0100_new
s/x1726192928.
com
8. Kuehn, B. M. (2008). Groups target nursing school bottleneck
to address medical workforce deficit. JAMA: The Journal of
the American Medical Association, 300, 887-888.
doi:10.1001/jama.300.8.887
TO CHANGE THE HEADER ON THE SECOND PAGE CLICK
“Different First Page”
AFTER YOU CLICK INSIDE THE HEADER.
Bartlett, S. (2010, March 3). Schools helpless against nursing
shortage. Press-Republican. format of
all Retrieved from
http://pressrepublican.com/0100_news/x1726192928.com
references.
Huston, C. J. (2010). Professional issues in nursing: Challenges
and opportunities. Philadelphia, PA: Wolters Kluwer/Lippincott
Williams and Wilkins. indent for
each Kuehn, B. M. (2007). No end in sight to nursing
shortage: Bottleneck at nursing schools a key reference.
factor. JAMA: The Journal of the American Medical
Association, 298, 1623-1625.
doi:10.1001/jama.298.14.1623
Kuehn, B. M. (2008). Groups target nursing school bottleneck
to address medical workforce and DVD deficit. JAMA: The
Journal of the American Medical Association, 300, 887-888.