Pain Management with Patient with Substance Abuse History - Research Paper Example

?PAIN MANAGEMENT WITH PATIENT WITH SUBSTANCE ABUSE HISTORY INSERT INSERT INSERT GRADE INTRODUCTION Pain is the feelingthat a human being, an animal or an insect has when it gets hurt. Often, in biology, only living organisms undergo pain. The pain is unpleasant and is often caused by damaging a stimulus. There are several ways of damaging a stimulus which include getting a cut from a sharp object e.g. a knife, pricking from a needle or burning from hot water or fire and a hard hit by an object such as a heavy stone. Pain often causes the rapid reactions or responses that make an individual move away from the substance causing the pain. In several parts of the world, pain from diseases is the reason for patients visiting hospitals in order for the pain to be resolved. Pain often resolves instantly once the stimulus that causes the pain is removed by the doctor while in other cases, the pain might persist for a long duration even after the withdrawal of the pain causing stimulus. Pain is often resolved through the introduction of painkilling drugs or antibiotics that totally help to withdraw the pain from the body of an individual. On the other hand, pain management is the removal of pain or the reduction of suffering from those individuals living with pain. This is done by specialists who include physicians, physiotherapists and even nursing practitioners discussed at length in this paper. These specialists employ the introduction of medicine into the body of the individual living with the pain. The task of medicine in the individuals’ body is to reduce or relieve the pain totally. In the present world, substance abuse is a major problem particularly among the youths. However, there are several measures being put in place in order to curb this menace. In this research, pain management in patients with substance abuse history is going to be discussed at length. The research will also examine the various problems that nurses and other medical practitioners face when handling patients with substance abuse history. STATEMENT OF PURPOSE In this research on pain management in patients with substance abuse history, it will be realized that nurses always have problems in managing pain in the patients. This is because getting information from the patients always proves to be an uphill task. Substance abuse patients will be discovered to be very secretive. As a result, the nurses will not have the ability to know the previous illnesses nor the drugs that were abused by the patients. Many youths feel that nobody should know what, when and where they take the drugs. In addition, it will be realized that the patients feel alienated from the rest of the world. This is because they are discriminated and given special treatment that other patients do not receive. This proves to be a challenge to the nurses since the alienation will be a barrier to obtaining information from the patients. The research will find out that the nursing practitioners have harsh treatment towards patients with substance abuse history. The harsh treatment makes patients to withdraw themselves making them not to give out important information needed by the nursing practitioners. This makes the management of pain in the patients very difficult. During the research, it will be identified that several hospitals lack the necessary technology and expertise needed to deal with the management of pain in patients with substance abuse history. Lack of technology and expertise often seems to discourage the substance abuse patients and as a result, they do not give necessary information to the nurses. This leads to the challenge of pain management in the patients. It will also be realized that the nurses do not have proper guidance and counseling skills necessary to convince the substance abuse patients to stop the substance abuse behavior. With all these problems experienced by the nurses while dealing with the patients, it will be identified that pain management in patients with substance abuse history is a big challenge. Thus, more measures and more nursing practices should be put in place to curb or reduce the problems faced when dealing with patients with substance abuse history in hospitals. It will also be realized that patients experiencing pain as a result of substance abuse are often undertreated. This leads to pain management in patients with substance abuse history becoming a big task. The patients with substance abuse history experience pain just like the other patients yet there is very little attention paid to them [Dix, Sandhar, Murdoch & MacIntyre, 2004]. PROBLEM STATEMENT In this research, it will be realized that pain management in patients with substance abuse history is a big problem in all health institutions worldwide. Normally, physicians and nurses are the people who face this problem while dealing with their patients. This problem of managing pain in patients with substance abuse history is persistent because the patients continue to be secretive and do not disclose their problems freely to the physicians and nurses. It will be identified that without obtaining information from the patients, curbing pain that they undergo is a big challenge. The other reason for difficulty in pain management in the patients will be identified as discrimination or alienation from other patients and the rest of the world. This makes the patients to develop a formed opinion about their health and hence they are discouraged and do not cooperate with the medical practitioners. Therefore, the doctors and the nurses will have a big problem in managing pain that the patients undergo. The other reason for the persistence of the problem of managing pain in the patients that will be identified is harsh treatment by the medics towards the patients. Harsh treatment is a negative approach used by most doctors and nurses when dealing with patients with substance abuse history in hospitals [Dix, Sandhar, Murdoch & MacIntyre, 2004]. It will be realized that this usually acts as a discouragement to the patients causing them not to cooperate with the medics during their treatment. The uncooperative behavior due to the harsh treatment therefore makes pain management in the patients very difficult. It will also be realized that most hospitals lack proper technology and expertise necessary for pain management in patients with substance abuse history. Without technology and experienced nurses and medics, definitely pain management in the patients will remain to be an uphill task. That is to say, with the persistence of the problem of pain management in patients with substance abuse history, the objective of this research is to address and overcome the barriers to effective pain management in patients with substance abuse history. These barriers include: secretiveness of the patients with substance abuse history, alienation and discrimination of the patients by the medics, harsh treatment towards the patients by the medics and lack of technology and expertise in hospitals. It is expected that if all the listed barriers are addressed, there will be cooperation among patients, nurses, doctors and other medical practitioners and this will solve the problem of pain management and under treatment of pain in medical wards in hospitals which are as a result of substance abuse. Addition of technology and other experienced personnel will also help solve the problem of pain management in hospitals. It is evident that substance abuse has caused several disorders and diseases among the youth. Despite the struggle to improve this situation, many diagnoses provided for in hospitals often favor patients with pain related to other types of diseases than those related to substance abuse. NURSING THEORY There are several nursing theories that serve as frameworks when dealing with various patients in hospitals. However, this nursing research proposal is focused on addressing the issue of pain management in patients with substance abuse history. Important issues when dealing with patients with substance abuse history is their comfort, happiness and cooperation with the medics. If all these are addressed, effective pain management in the patients will be achieved. Therefore, one of the nursing theories that serves as a framework for pain management in patients with substance abuse history is the comfort theory. The theorist behind the comfort theory is Sandra Merkel, a clinical nurse specialist. According to the comfort theory, patients who are really stressed up and have depressions are introduced to comfort by the attending nurse or physician [Morgan, 2006]. Substance abuse includes consumption of hard drugs such as cocaine and heroin to mention but a few. Substance abuse can also be in the form of consumption of alcohol in large amounts. Consumption of alcohol in large amounts usually leads to diseases such as liver cirrhosis. Consumption of tobacco in large amounts can also lead to lung cancer. With all diseases resulting from continuous substance abuse, the patients undergo a lot of pain. This pain should be managed when the patient visits a health institution and this is the responsibility of the medics. Once a patient suffering from pain resulting from substance abuse is admitted to hospital, the patient is able to meet some needs such physical needs. However, there are some needs that the patient is unable to meet with the condition of his or her sickness. The nurse therefore has the duty of identifying the needs that the patient is unable to meet and then implements comfort measures that will help the patient meet the needs [Kolcaba and DiMarco, 2005]. The comfort measures implemented by the nurse aim at providing relief to the patient and supporting the patient undergo the painful experience. REVIEW OF LITERATURE The overall purpose of this research is to address the issue of pain management in patients with substance abuse history. This will be addressed by identifying and overcoming the barriers to effective pain management in a patient with substance abuse history as discussed above. There are other researchers who previously, have done research on pain management in patients with substance abuse history. One of them is Rubria Marine de Price.According to her research; problems similar to the ones that will be realized in this research paper are identified. The problems facing pain management according to Rubria include harsh treatment by nurses and doctors towards patients with substance abuse disorders [Grant, Cordts & Doberman, 2007]. Harsh treatment of patients always leads to lack of cooperation between the nurses and the patients. Uncooperative patients pose a big challenge to pain management since no important information can be obtained from them. Another problem according to Rubria Marines de Price though dissimilar to the problems that will be identified in this research paper is the lack of knowledge and misconception of treatments among the nursing practitioners. Most medical practitioners exhibit the lack of knowledge through administering the wrong drugs to certain diseases. This may result to serious repercussions to the patients. It might even result to death. The lack of knowledge and misconception of treatments is a great barrier to pain management. The patients develop mistrust and tend to evade treatments and this is a great problem facing pain management of patients. Rubria Marines de Price also examines at length the problem of fear of side effects by the medical practitioners while dealing with the pain in patients with substance abuse history. Medical practitioners have fear that once they administer opioids to patients, the patients may undergo sedation and respiratory depression [Grant, Cordts & Doberman, 2007]. Once patients and the medical practitioners develop fear of side effects, managing pain that the patients are going through becomes a major challenge. Opioids are often best for treating pains that result from substance abuse disorders and diseases. Rubria Marines de Price’s research on pain management in patients with substance abuse history is very extensive. She discusses at length the various barriers to pain management which include negative attitudes by medical practitioners towards patients with substance use disorders. She also discusses another problem facing pain management which is system barriers. Rubria also talks of lack of knowledge and misconceptions of opioid treatment and fear of side effects by both patients and medical practitioners. The overall purpose of Rubria’s research is to investigate the appropriate pain management strategy in health care settings, to identify the gaps in knowledge on the topic of pain management in the acute care setting in patients with substance use disorders and finally to identify the significance for the acute care nurse practitioner in addressing the problem of pain management. In her research, Rubria comes out with the possible measures that can be put in place by medical practitioners to make sure this problem of pain management in health care institutions is dealt with. As compared to other types of previous researches done by other nurse researchers, there exist similarities and differences between Rubria’s research and other nurse practitioners researches. Among the similarities is that just like other types of researches done on pain management in patients with substance abuse history, she has listed the problems that face pain management in health care centers. According to her, the barriers include negative attitudes by nurse practitioners towards patients with substance use disorders, system barriers, lack of knowledge and misconceptions of opioid treatment and fear of side effects. Just like in other previous researches done on pain management, Rubria has literature search methods that were used during the research. However, the differences evident in her research and other researchers are that unlike other researchers, she does not provide the possible solutions that need to be put in place in order to deal with substance abuse among youths in the world. Rubria does not include other forms of treatment to patients with substance abuse disorders apart from the administration of opioid treatment to the patients. EXPECTED OUTCOMES In this research paper, the research that will be done on pain management in patients with substance abuse history has certain expected outcomes. The objective of this research is to overcome barriers to effective pain management in a patient with substance abuse history. Therefore, it is expected that the patients will abandon their secretiveness and this will enhance the cooperation between the patients and the medical practitioners. If this takes place, pain management in patients with substance abuse history will no longer be a big challenge. It is also expected that medical practitioners in health institutions will bring to an end the discrimination and alienation of patients with substance abuse history from the other patients. If this happens, pain management in patients with substance abuse history will be enhanced. The other expected outcome is the abolition of harsh treatment by nurses and doctors towards patients with substance abuse history. Harsh treatment of patients with substance abuse history often acts as a barrier to effective pain management in the patients [Waldman & Steven, 2006]. If this is stopped, effective pain management will be achieved. This research also expects that technology will be enhanced in hospitals and more experienced medics will be involved in ensuring effective pain management in patients with substance abuse history. Inexperienced doctors and nurses may lack the necessary knowledge or have misconception of treatments. These tend to be some of the reasons behind this great menace of pain management [Waldman & Steven, 2006]. Medical practitioners should therefore strive towards fighting the lack of knowledge, misconceptions and ignorance. If this is done, it will be one of the greatest steps taken towards dealing with pain management. RESEARCH DESIGN In conducting this research, youths having substance disorders will be studied at length. Several hospitals will be visited to compare and contrast their conditions and how pain management is done in various hospitals. Since they will be alert and not unconscious, interviews with them will be done to know how and whether effective pain management is ensured in their various hospitals. Due to the large number of patients with substance abuse history, random sampling will be done to get information at random from various patients. In conducting the research in hospitals, various apparatus will be used to collect data. For example, a stethoscope will be very important in determining the heartbeats of the patients and the necessary steps to be taken. An x-ray machine will also be important in viewing any internal damages in internal organs that may have resulted as a result of substance abuse. Psychological tests will also be important in determining any mental disorders among the patients that may have resulted from substance abuse. Important data on the causes of the disorders and diseases will be recorded and summarized on sheets of paper. This data will be important in preventing future occurrences of similar problems. The data will also be important in helping to ensure effective pain management in patients with substance abuse history in the future. CONCLUSION In conclusion, the objective of this research is to address the issue of pain management in patients with substance abuse history by overcoming barriers to effective pain management in patients with substance abuse history. In addition, there are other researchers who have done similar research on pain management in patients with substance abuse history. An example is Rubria Marine de Price who explained that the problems facing pain management in health institutions include harsh treatment by medical practitioners towards patients with substance abuse histories, system barriers, lack of knowledge and misconceptions of treatment of patients suffering from pain resulting from substance abuse and lastly, the fear of side effects when administering certain drugs to the patients. The expected outcomes of this research are evident. It is expected that the patients will abandon their secretiveness, medical practitioners in health institutions will bring to an end the discrimination and alienation of patients with substance abuse history, there will be abolition of harsh treatment by nurses and doctors towards patients, technology will be enhanced in hospitals and more experienced medics will be involved in ensuring effective pain management in patients with substance abuse history. If all these are put in place, effective pain management of patients with drug abuse history will be achieved. References Dix P, Sandhar B, Murdoch J, MacIntyre P.A. (2004) “Pain on medical wards in a district general hospital.” Source: Royal Devon and Exerter Hospital, Barrack Rd, Exeter. Grant, M. S., Cordts, G. A., & Doberman, D. J. (2007) “Acute pain management in hospitalized patients with current opioid abuse”. Topics in Advance Practice Nursing Journal, 7(1), 1-12. Retrieved April 10, 2009 Kolcaba, K. & DiMarco M. A. (2005) “Comfort theory and its application to pediatric nursing”. Pediatric Nursing. 31(3):187-94. Morgan, B. D. (2006). “Knowing how to play the game: hospitalized substance abusers’’ strategies for obtaining pain relief. Pain Management Nursing, 7(1), 31-41. Waldman, Steven D. (2006). “Pain Management” Philadelphia: Saunders. Read More