Under Medicating Clients - Research Paper Example

Running Head: Article Summary Undermedicating Article Summaries Dominiece Lacroix Nursing 4367 Stephanie Pierce, Glenn Landry October 4, Introduction The Nursing profession is mainly essentially attempts to minimize patients’ painful suffering. A majority of the ailments that occurs to people encompasses pain for which they take resort to medical treatment. Though scientific advancements in the field of medical care have enabled the discovery of analgesic drugs to be used at the time of operations yet they fail to remove the pain totally. A survey conducted reveals that 63 percent of a sample of 115 operative patients complained of post-operative pains. It is observed that even after five to seven days after the surgery has been conducted the patients still writhe in pain. The nurses follow the doctor’s prescription relating to undermedication of pain, which includes small doses of analgesic drugs. To this extent, it is observed that the analgesic drugs prescribed by the doctor possess a dosage range from 5-10 milligram. The nurses administering such dosages are increasingly found to go for small dosages even at the cost of the patient suffering from acute pain. Further observation suggests that patients receive only 36 percent of the prescribed analgesic to the next day after the surgery has been made. Herein, a nurse can be morally and professionally liable for not being able to reduce the patient’s painful suffering even after having the needed professional experience required. (Hunter, 2000, pp.379-380) Implications for future Nursing Practice in regards to Undermedication of Patients With respect to presenting a discussion on future nursing practices in regards to undermedication of clients a case study is given. In the case, presented two patients both forty years old are taken. These two patients had undergone an abdominal surgery two days before. In the assessment conducted for the two patients separately firstly vital signs such as pulse beat, blood pressure and respiratory pressure is measured. Secondly, the two patients are asked to rate their pain on a scale of 0 to 5. For the first patient it is observed that his pulse beat was 90, blood pressure was 140/86 and respiratory pressure stood at 22. The first patient rated his pain to be four on the zero to five scales. In the case of the second patient it is observed that the pulse beat stood at 70. His blood pressure was recorded to be at 120/80 and respiratory pressure stood at 14. When asked to measure his pain on the zero to five scales like the first patient he also rated his pain to be at four. In the pursuit of the assessment made the two patients are given 10 milligrams of morphine through an intra-muscular injection. The patients are asked to rate their pain after four hours of the dose being administered on them. It was observed that both the patients rated their pain at 3 to 4 on the zero to five scales after three hours of the morphine injection given. Moreover, the patients also did not show any signs of respiratory problems or sedations to the drug administered. The assessment technique used by McCaffery and Ferrell (1992) underlined the several risks involved like addiction to the drug, respiratory problems, analgesic tolerance and other such side effects. The survey questionnaire was presented before a team of 166 nurses at a workshop for being completed. It was expected to reveal the outlook of the nurses in undermedication of the drug. In regards to the vital signs observed it is found that the first patient’s blood and respiratory pressure along with the pulse beat were elated. For the second patient it was slightly lower than normal. However, the patients had shown the same ratings in regards to their pain. To this end, the feedback given by the nurses stated that they depend more on the vital information and on the facial expressions of the patient’s suffering of the pain. They rely less on how the patients evaluate their pain. Thus, the second patient’s suffering of the pain was given lesser importance by the nurses than of the first owing to the fact that the second patient had shown less than normal vital signs. It was observed that around 89 percent of the nurses at the workshop held the first patient’s suffering at four on the zero to five scales. On the other hand, only 70 percent of the nurses recorded four on the scales for the second patient’s pain sufferings. It was held in this respect that sufferings of the patients is a subjective matter and hence due importance must be given on how the patient evaluates his suffering. Further, as observed that even after three hours of the administration of 10 milligrams of morphine the patents recorded a moderate to high level of pain. Thus it is held that in such cases the level of morphine administration can be increased to 15 milligrams to let the pain subside. (McCaffery and Ferrell, 1992, pp.43-45) Undermedication of patients-An Ethical and Professional Issue According to Hunter (2000) the inability of the nurses in rightly addressing the patient’s need in reducing the suffering is taken as an act of moral negligence. On grounds on such moral negligence the patients can get further harmed in addition to their ailments. Grounds of moral negligence become applicable to the nurses for they are expected to rightly anticipate the level of the sufferings involved by dearth of their experiences and rightly address such. It must be understood in this regard that the giving of lower doses of the undermedicated analgesic drug by the nurses has some positive intentions adhered to it. The nurses by no means tend to harm the patients. Thus they feel right to administer lower doses of such analgesics to reduce the occurrence of any side effect. However, the level of moderate to high pain suffered by the patients tends to underscore such intentions. In regards to the professional responsibility of the nurses they must try to understand the level of patient’s suffering and not depend on their personal views on such. They must rightly consider the reduction of the pain as a matter of medical success. Further, they must enhance their knowledge through experiences of pain medications. (Hunter, 2000, pp.380-381, 384) Undermedicating Clients –Effects on Healthcare The sub-optimal use of analgesic drugs is known in the medical field as Oligoanaelgesia. It is caused by many such contributing factors of which a primary concern is laid on the knowledge and attitude of the nursing staff in reducing patient’s discomfort. A survey conducted to assess the knowledge factor of the nurses in regards to pain management revealed that 61 percent of the nurses gave the right answers to the questionnaires framed. Moreover, it was also recognized that the younger breed of nurses reflected more knowledge than their older counterparts. As regards to the knowledge of drug management, only 51 percent of the nurses gave the right answers. In addition to such the nursing staff rely more on their own intuitions rather than on the patients need for better medication. Fear of injecting analgesic drugs to the patient’s body also act as a barrier to providing better health care services. Owing to the above factors it is found that only around 60 percent of patients get proper treatment of their pain in the Emergency Departments of the hospitals. (Duignan & Dunn, 2008, pp.30-31) Undermedicating Clients-Importance in Nursing Practices The relying of the nurses on facial expressions of their clients, the patients in rightly administering the level of analgesic has been found to give results based on confusion. It is because if such clients tend to be children then facial expressions supposedly related to pain can also accompany the sense of hunger or fear. Moreover, a shy child may not rightly signify his suffering by crying or shouting. Thus, a survey conducted on this angle failed to give ground on the nurse’s idea of non-verbal expressions as indications of the level of pain. In addition to the above case the nurses were even found to rely much on non-analgesic treatment for pain management. They used distraction and relaxation techniques like music to ward off the patient’s mind from the pain and suffering. However, these are some temporary processes and must be supported by proper medication by consulting physicians. Undermedication of the clients thus is seen to be highly dependent on nursing practices, which needs to be changed. The lack of knowledge of the nurses in regards to pain management combined with the false attitudes of self-intuition rather than relying on the patient’s words makes the patient’s feel negatively in regards to healthcare services. (Eufemia & Puntillo, 1999; Shaw, 2006) Conclusion The undermedication of drugs in the medical profession can be viewed as a crime. It leads to the increased sufferings of the patients in addition to their ailments. The nurses are found to be quite indifferent in regards to their patients suffering due to pain. They continually administer lower doses of the analgesic given. Moreover, some of the nurses use their own intuitions to assess the level of suffering and tend to use non-pharmacological measures. This practice must be brought to immediate halt through strict monitoring and rendering of appropriate measures when conducted. Rather, proper consultation with the physicians must be made by the nurses in order to provide an effective treatment to reduce the level of suffering. Moreover, the nurses should also be given proper training on drug management to eliminate the drug-phobia from their mind. References Duignan, M. & V. Dunn. (2008). Barriers to Pain Management in Emergency Departments. Emergency Nurse. 15(9). Retrieved on October 29, 2010 from: http://content.ebscohost.com/pdf19_22/pdf/2008/FTW/01Feb08/30037730.pdf?T=P&P=AN&K=30037730&S=R&D=aph&EbscoContent=dGJyMMTo50SeqLc4zdnyOLCmr0ieprFSsKq4TLCWxWXS&ContentCustomer=dGJyMPGstE%2BvqrJMuejjhe3q41Pj3u2L8gAA Eufemia, J. & K. Puntillo.(1999). A Survey of Nursing Practice in the Assessment and Management of Pain in Children. Pediatric Nursing. 25(3). Retrieved on October 29, 2010 from: http://web.ebscohost.com/ehost/detail?vid=6&hid=9&sid=4352c409-a3f8-48d4-877f-ae1b486666a9%40sessionmgr104&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=aph&AN=2328262 Hunter, S. (2000). Determination of Moral Negligence in the Context of the Undermedication of Pain by Nurses. Nursing Ethics. 7(5). Retrieved on October 29, 2010 from: http://content.ebscohost.com/pdf10/pdf/2000/31K/01Sep00/3864506.pdf?T=P&P=AN&K=3864506&S=R&D=aph&EbscoContent=dGJyMMTo50SeqLc4zdnyOLCmr0iepq9Sr6a4Ta%2BWxWXS&ContentCustomer=dGJyMPGstE%2BvqrJMuejjhe3q41Pj3u2L8gAA McCaffery, M. & B. Ferrell. (1992). How Vital are Vital Signs? Nursing92. Retrieved on October 29, 2010 from: http://content.ebscohost.com/pdf17_20/pdf/1992/NRS/01Jan92/4891793.pdf?T=P&P=AN&K=4891793&S=R&D=aph&EbscoContent=dGJyMMTo50SeqLc4zdnyOLCmr0iepq9Ssqi4TK%2BWxWXS&ContentCustomer=dGJyMPGstE%2BvqrJMuejjhe3q41Pj3u2L8gAA Shaw, SM. (2006). Nursing and supporting patients with chronic pain. Nursing Standard. 20(19). 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