Archive for the ‘Human Rights’ Category

Effective Measures Toward Pain Management, comment

July 12, 2010

Nursing assessment plays a significant role in the management of pain in caring for a patient.  Pain being a very subjective area to measure you can not only take the subjective level of pain you must also take into account the objective level of pain observed.  The level of pain is a grey area; it is not as simple as being in pain or not being in pain.  There are different levels to the pain and this varies from patient to patient.  Each patient has their own level of pain tolerance.  For example; in the practice I work in now we use a NIBP to measure the patients’ blood pressure in which most patients are not affected by this instrument.  However there are some patients that cannot tolerate the NIBP, it is too painful for them to use to measure their blood pressure; these patients have a lower threshold for pain.  They experience pain in a different way, however their pain is real.  As a nurse you need to be alert and conscious of each patient’s pain threshold.

An accurate pain assessment holds such an imperative function of a nurses advanced health assessment when caring for their patients.  When a nurse is functioning in the role of some area of forensic nursing their experience and knowledge of pain assessment may be called upon to use in their responsibility as a forensic nurse.  For example; if a forensic nurse is being called upon in the court of law to provide testimony in a legal matter they may have to incorporate this experience and knowledge of assessing pain to give an honest and accurate testimony.  Another example of pain assessment being incorporated into forensic nursing would be when a forensic nurse is assessing a possible victim of abuse; the victim may downplay their pain.  As a victim they may try to hide their pain and the forensic nurse will be required to be able to observe accurately any objective signs of pain to give the victim the care they need.

Original Post

September 2, 2009

Title: Effective Measures Toward Pain Management

Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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Effective measures toward pain management, comment

April 6, 2010

Yes pain control is a very large part of our care in the ER. It is very frustrating for a busy ER nurse when you have a chronic pain patient on the call bell before the med is due and you are trying to run a code or even prevent one. Unfortunately there is no education for the chronic pain patients but we are suppose to stop what we are doing to wait on them. I think it needs to be understood by all the definition of triage!

Original Post
September 8, 2009
Title: Effective measures toward pain management
This post reminds us that the measurement of pain is primarily subjective. As providers, we must always remember that people respond to and express pain very differently. We must be culturally sensitive when assessing and treating pain. Pain is the 5th vital sign. Pain affects the physical and psychological well-being of our patients. It is our responsibility to ensure that our patients’ pain is being well managed. We must know our own biases and misconceptions and leave them at the door.

Original Post
September 2, 2009
Title: Effective measures toward Pain Management
Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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Effective Measures Towards Pain Management, comment

March 24, 2010

According to JCAHO guidelines, accountability for pain management is shifted from the individual practitioner to the organization. Nurses are called to examine their own views and cultural beliefs regarding pain management and to rethink them if they are in conflict with their employer’s standard. Often patients complain of having to call frequently for medicine, having to wait unrealistic time frames for medicine and of receiving too little pain medicine or none at all. If pain assessment is truly "the fifth vital sign," then we must assess pain just as we would assess other vital signs – every few hours and prn. If the patient’s blood pressure were elevated, we would act on it. The same holds true for the pain assessment – we must act on it. When the patient becomes anxious and fearful that the pain will return, it complicates pain relief because of that anxiety and fear; therefore, at least initially, it is often necessary to give pain medication on a fixed schedule. Usually by the time the patient calls, they are already hurting and pain is more difficult to control. Two areas of self-assessment are important for the nurse to examine. The first is pain management in the drug addicted individual. Often nurses refer to individuals requiring frequent pain relief as "drug seeking." The patient who has a history of drug use will often require greater amounts of pain medicine. Drug abusers still have the intrinsic right to adequate pain management and the nurse must advocate for the patient, suppressing any personal feelings about drug abuse and knowing that drug abusers feel pain the same as (or sometimes more intensely than) any patient. While we must use discretion in our pain assessments, giving narcotics only when indicated, we are also morally obligated to do no harm, which includes withholding needed medicines. We must believe the subjective report of our patient and not withhold medications because we fear enabling the abuser. The other area needing self-awareness is in the care of the dying patient. Caregivers sometimes withhold opiods near the end of life because they do not want to give "the fatal dose." In the patient whose death is imminent it is inhumane to allow them to end their life in suffering when the nurse has the tools to provide the relaxation and peace experienced through the relief of pain. Death is something we all will face one day, and most of us fear dying. Hospice nurses assess the patient’s expectations of the dying experience upon admission, and most patients desire to be pain free when death occurs. When death is near, many patients cannot communicate the need for pain relief, so the nurse must be especially vigilant in attending to the patient’s needs.

Original Post
November 9, 2009
Title: Effective Measures Towards Pain Management, comment
Being culturally sensitive is paramount in the assessment and treatment of pain. It begins before any contact with the patient. It begins with self awareness of how the nurse views pain and the understanding that the nurse’s beliefs are formed by his/her own culture. By self actualization, a nurse is better prepared to interact more therapeutically in the patient’s behalf. The Joint Commission requires that a patient be assessed and reassessed ongoing to pain relief, taking into account the patient’s cultural, spiritual and ethnic beliefs. According to McCaffery (1999), pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does. It is a combined phenomenon with sensory, emotional, cognitive and physical parameters. Pain assessment and pain relief however, may be different for every patient. Nurses should educate their patients and families to report the pain, and to expect relief. It is far more likely that a patient’s pain will be under treated due to withholding or inappropriate prescribing of opioids. The nurse should very familiar with the pain tools and use them consistently, taking into account cultural differences. The signs and systems of pain should be assessed carefully. The nurse should not second guess the patient or family and should not dismiss what is being said. They should also listen carefully to their patients and look for contributing factors. The nurse will want to ask the patient regarding their belief about pain and satisfaction with the current pain level. This information will direct the actions that the nurse will take, both pharmacologically and in providing comfort measures.

Original Post
September 8, 2009
Title: Effective measures toward pain management, comment
This post reminds us that the measurement of pain is primarily subjective. As providers, we must always remember that people respond to and express pain very differently. We must be culturally sensitive when assessing and treating pain. Pain is the 5th vital sign. Pain affects the physical and psychological well-being of our patients. It is our responsibility to ensure that our patients’ pain is being well managed. We must know our own biases and misconceptions and leave them at the door.

Original Post
September 2, 2009
Title: Effective measures toward Pain Management
Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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Effective Measures Towards Pain Management, comment

November 9, 2009

Being culturally sensitive is paramount in the assessment and treatment of pain. It begins before any contact with the patient. It begins with self awareness of how the nurse views pain and the understanding that the nurse’s beliefs are formed by his/her own culture. By self actualization, a nurse is better prepared to interact more therapeutically in the patient’s behalf. The Joint Commission requires that a patient be assessed and reassessed ongoing to pain relief, taking into account the patient’s cultural, spiritual and ethnic beliefs. According to McCaffery (1999), pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does. It is a combined phenomenon with sensory, emotional, cognitive and physical parameters. Pain assessment and pain relief however, may be different for every patient. Nurses should educate their patients and families to report the pain, and to expect relief. It is far more likely that a patient’s pain will be under treated due to withholding or inappropriate prescribing of opioids. The nurse should very familiar with the pain tools and use them consistently, taking into account cultural differences. The signs and systems of pain should be assessed carefully. The nurse should not second guess the patient or family and should not dismiss what is being said. They should also listen carefully to their patients and look for contributing factors. The nurse will want to ask the patient regarding their belief about pain and satisfaction with the current pain level. This information will direct the actions that the nurse will take, both pharmacologically and in providing comfort measures.

Original Post
September 8, 2009
Title: Effective measures toward pain management, comment
This post reminds us that the measurement of pain is primarily subjective. As providers, we must always remember that people respond to and express pain very differently. We must be culturally sensitive when assessing and treating pain. Pain is the 5th vital sign. Pain affects the physical and psychological well-being of our patients. It is our responsibility to ensure that our patients’ pain is being well managed. We must know our own biases and misconceptions and leave them at the door.

Original Post
September 2, 2009
Title: Effective measures toward Pain Management
Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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Effective measures toward pain management, comment

September 8, 2009

This post reminds us that the measurement of pain is primarily subjective. As providers, we must always remember that people respond to and express pain very differently. We must be culturally sensitive when assessing and treating pain. Pain is the 5th vital sign. Pain affects the physical and psychological well-being of our patients. It is our responsibility to ensure that our patients’ pain is being well managed. We must know our own biases and misconceptions and leave them at the door.

Original Post
September 2, 2009
Title: Effective measures toward Pain Management
Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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FGM Practices

September 2, 2009

Cultural practices that violate human rights and the health status of the individual create ethical dilemmas for nurses. Protecting human rights/ well-beings and respecting/honoring cultural valves is the foundation for nursing. Before reading the chapter on female genital mutilation (FGM) I must admit I knew very little about this practice, how wild spread it is and the physical and psychological scarring it leaves on the individual. After educating myself by researching this topic, I concluded that due to its long term physiological and psychological health consequences that FGM is very similar to forms of torture, in that it seeks to control the mind, body and sexuality, which is a direct infringement on human rights. Those that accept this practice believe that the benefits (enhancing fertility or a religious requirement) out weight the risks (maternal infant morbidity and mortality). For most, customs and beliefs are deeply ingrained and passed on to the next generation. Healthcare conflict arises when cultural value imposes on human rights, for example, the patient who had just given birth to a baby girl confides in the nurse about the need to have daughter secretly circumcised. The right to privacy and confidentiality will be violated to protect the health and well-being of the baby because FGM is considered a form of abuse in the United Stated and nurses are mandated by law to report suspected or actual cases. The health consequences of those that undergo the FGM procedure varies according to the type of procedure performed, ranging from STDs’ to sterility. Nurses are in a position to changing harmful traditional practices by raising awareness/educating communities about the impact that this practice has on the health status and human right issues.

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Effective measures toward Pain Management

September 2, 2009

Pain is an alteration in ones comfort level, which can significantly impact the physical, emotional, and psychological well-being. Pain is a subjective experience that can only be explained by the patient. Cultural and ethnicity are a few factors that influences patients response to pain, to improve outcomes nurses must be able to understand pain from a cultural perceptive. People respond to and view pain differently. Among various groups for various reasons emotions may or may not accompany pain it is viewed by some as an act of punishment or as a spiritual test. Having knowledge of patient’s views and how they define pain is very valuable in that it can assist the nurse in achieving positive outcomes by incorporating this information in the plan of care. Nurses who ignore or refuse to develop cultural sensitivity not only do they violate patients’ rights but also a chance of having a trustful relationship and without this you can expect poor outcomes. Pain is often poorly assessed and poorly managed due to reasons like misconceptions and nurses lack knowledge. This usually leads to under medications and poor outcomes, such as the post-op abdominal surgery patient that develop pneumonia because is unable to perform cough and deep breath exercises every 2hrs secondary to pain because of the nurses’ misconceptions about administering pain medication to a patient with history substance abuse. To achieve goals of effective pain management nurses must first be aware of their values and personal beliefs concerning pain and the behaviors associated with it, this will assist in developing an awareness and sensitivity to the patient’s need. Nurses must be knowledgeable and skilled in collection of both subjective and objective data (by accepting the patients’ assessment of pain by using pain assessment tools and observation of emotional behaviors such as crying or moaning), which will assist in identifying the intensity of patients’ pain and promote better outcomes. Misconceptions must be explored and addressed because these also impact outcomes, such as administering pain med on regular basis will lead to addiction or those who abuse drugs usually over exaggerate their pain, by acknowledging these misconceptions nurses will be able address patients’ pain related issues more professionally and improve steps toward effective pain management.

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Care of torture victims

August 20, 2009

Torture is a dehumanizing experience that violates human rights. Victims are subjected to a variety of mental and physical suffering such as solitary confinement, witnessing torture to others and beatings. This act is usually performed for the purpose of intimidation, a means of extracting information and as a form of punishment. The effects have created many negative consequences on nearly all aspects of the victim’s life, such as the effects of disfigurement and chronic pain from repeated beating has a negative impact on the mental and physical well-being, also directly influence the socioeconomic status by impairing the ability to emotionally and financially care for self and family. The psychological affects of torture can be pretty devastating for the victims, and the rate of post traumatic stress disorders are significant. The minds and souls of these individuals are constantly haunted by the past events so they sleeping disorders and nightmares are serious concern of theirs. If treatment is not received, and there are many who are reluctant in seeking treatment due to sense of betrayal and distrust toward society in the aftermath, their problems can result into more serious conditions such as depressive and sociopathic disorders. Forensic nurses/multidisciplinary team are well equipped to address issues of torture and abuse. By acknowledging the declaration of human rights and the concept of justice as being an integral part of the victims healing process, the forensic nurse/team can assist victims in restoring trustful relationships and re-establishing a sense of safety. Compassionate care is also helpful in achieving these goals. In performing forensic examination, a thorough assessment is done of the victims physical/psychological problems, these problems are addressed and treated, accurate documentation of findings and proper collections of evidence are all a step toward justice for the victims.

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Would Forensic Nurses make a difference?

June 15, 2009

If I wanted to create terrorists, what would be the best way to go about it? Possibly torturing and trying to justify that behavior when we criticized other countries for the same behaviors….maybe invading a country that did not provoke attack and torturing their countrymen. Maybe another means might be involving ourselves in a social fabric that has existed for thousands of years and hoping to politically change them through torture, coercion and unfair detention with no legal representation or repercussions. While being detained at Gitmo, who cared for the detainees? Were there nurses present, or even available? If so, are they subject to the same code of behavior as their civilian cohorts? Or were the detainees attended by corpsmen? Does the same code of ethics rule military nurses as civilian nurses or like all things military, does the military law and code of ethics take precedent? If there were nurses there, were they so frightened by the events of 9/11 that they approved of interrogation methods that were obviously inhuman? Does the military utilize nurses trained in forensics? Does that not sound like a great idea if they don’t? If they are not utilized with the medical services, are they involved with the military police or intelligence? An unfortunate chapter that mars the greatness of the US could have greatly been improved by forensic nurses with enough rank to influence the treatment of the prisoners of war.

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Human Rights

May 18, 2009

Human rights advocates for health care organizations and forensic scientists to work together to have an impact on the world’s moral code of ethics. So these disciplines are able to address violence and human rights violations. Genocide is distinguishable from other crimes by the motivation hehind it. It is any act that has the intent to destroy, in whole or in part a national ethnic, racial or religious group. Where as torture is more aimed at an individual to obtain informatiion by inflecting pain and or suffering. Torture is not sanctioned by the goverment of the United states but in other countries such as, China and India these countries are still known as human rights abusers. Due to torture and having survivors which need rehabilitation, nursing played a role in establishing gloval rehabilitation centers. The Rocky Mountain Survivors Center (RMSC) for victims of torture, was organized in Denever, Colorado. Human rights classification have been addressed through the center, by raising the awareness of the forensic nurse role in documentation of torture and evaluation of the injury related to torture. The center provides information, conseling and supportive services for survivors of torture and their families. The center provides training and education to health care providers who deal with survivors and their families. In light of a need for these services the health and justice communities are recruiting and training nurses to education and care for countries world wide.

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