Pain Management in Dying - Research Paper Example

?Running Head: Pain Management in Dying Pain Management in Dying [Institute’s Pain Management in Dying Introduction A human being is a temporary form of matter, which is born and must expire one day. Even though everyone is aware of this fact, few are properly ready to accept it or are prepared to face the situation. The reality of life and death is one of the most difficult mysteries to comprehend and is the toughest time for the dying person themselves and their loved ones. Since no one is able to anticipate the state of a dying person or understand the experience before facing it, they are never able to prepare themselves for the rigorous process that this entails. While some people face sudden deaths due to accidents or sudden illnesses such as a heart attack, some people suffer a slow and painful death where they are subjected to a hospital room and treatment until their last breath. Such patients are usually manifested with serious illnesses such as AIDS, cancer, tuberculosis, and many other fatal illnesses. The situation of being aware that their time is running out is terribly difficult for them and their loved ones, as their family members watch them slowly face their fate. All patients want to enjoy their last moments and make them as easy as possible, so that they can die with dignity instead of being in a state of suffering and immense pain. However, most patients suffer from chronic pain in their last moments which makes it immensely difficult and heart wrenching for them and their loved ones throughout the process. It is essential for medical practitioner’s to implement proper pain management techniques in hospitals to lessen the pain of the dying person. Moreover, family members must also play a role in reducing the burden through the implementation of psychological techniques to reduce death pain. Discussion Pain management and care of a dying patient is one of the most difficult tasks and experiences to go through. More often than not, this aspect of treatment for a dying patient is over looked or not given enough attention to. Doctors anticipate that a dying patient will be in a painful state, hence, they sometimes overlook the factor of attempting to reduce the pain, as they find this to be an ordinary or normal process and find other factors as more important in facilitating a dying patient and his/her family members. A study was conducted to find out the optimal barriers to proper care of the dying patient. A sample of family members who had been involved in the care of a dying patient in the last 2-5 months was interviewed to gather information about their satisfaction with hospital care. Most of the family members of the deceased reported high levels of confidence and approval at the medical care and attention provided to the dying patients. They also expressed that doctors were extremely sympathetic and cared for the patients needs and wishes as to the location of their last hours and the way they wanted treatment. However, the only problem they expressed was that of pain management and care and said that doctors and nurses were unable to make the patient’s last hours more comfortable and reduce the pain that the patient was suffering from (Tolle, Tildan, Rosenfeld, & Hickman, 2000). Another article titled, “Pain Management and Provider Liability: No More excuses”, speaks of the lack of attention towards pain management in general in patients in all conditions in hospitals, whether this is acute pain or chronic pain. It says that practitioner’s have a lack of training in the area of pain management and are reluctant to use drugs to ease pain for patients, causing them to unnecessarily suffer. The article also mentioned that nurses were reluctant to give dying patients proper pain management treatment because they were ill-trained in such practices and did not favor giving patients’ medication which may lead them to a quicker death. However, such practices are allowed and ethical in such circumstances when the patient is dying, to enable the patient to die with ease and dignity. Doctors and nurses are reluctant to use such medication and practices in case of lawsuits and because of a lack of concentration and knowledge about the use of such treatment (Carr & Cousins, 2007). Patients do not only suffer from physical pain while dying, but also suffer from immense emotional and psychological distress which adds to their pain. Most cancer patients and other terminally ill patients face psychological pressure and anxiety from the thought and fear of dying. It is the ethical obligation of all medical practitioners’ to help ease the patient’s discomfort, both physically and psychologically. Many times, patients are caused much more pain through psychological discomfort which alleviates their painful position. Enabling a patient to focus on other things besides their pain and helping them with psychological techniques to reduce the pain can be highly beneficial for a dying patient (Turk and Monarch, 2002). Moreover, such psychological therapy must not only be given to the patient, but to the distressed family members as well. The burden of watching a loved one die in a painful state can be a painful and psychologically tormenting experience. The right to die with dignity, ease, and with as less pain as possible is a fundamental human right, which is not recognized or acknowledged by practitioners. Practitioners must acknowledge and pose no more excuses to attending to such patient needs along with the other needs of a dying person. If treatment for such pain exists, it should be used (Turk & Monarch, 2002). Children with terminal illnesses who are on their death bed may have very different psychological needs than adults, and these needs must be attended to by the nurses or doctors appropriately. Application While children and adults have various needs during their last hours of life, especially pertaining to the physical and psychological treatment of pain, practitioners are reluctant to use drugs on dying patients which may lead them to a quicker death. Practitioners require proper training and education as to the best methods to reduce pain and lessen the psychological burden on the patient and family. They must be informed of all ethical practices which may be used to relieve a patient of their pain earlier than expected, even if it causes an earlier death by a few hours. A practitioner’s job is to lessen suffering and enable a patient to be in comfort and ease during their last hours (Olson et. al., 1988). A law should be drafted to enable practitioners to freely provide their dying patients with proper pain controlling treatment while on their deathbed. Hence, practitioners will not be as reluctant to use such practices. Moreover, practitioners should be tried in a court of law for negligence in the aspect of pain management, so that they will focus more of their attention towards this essential field of treatment and avoid unnecessary pain for their patients. Medical practitioners should also be familiar with psychological treatment for pain reduction which would include the implementation of the Gate Control theory and the Neuron theory, in which the practitioners psychologically closes all the extra gateways for the entrance of pain and enables the patient to focus their attention on other matters. Such treatment and such an environment should also be created for the family members of the patient to lessen their pain in the difficult circumstances. Conclusion While patients with various diseases are treated satisfactorily in a hospital, the least amount of care is shown to dying patients in the case of managing their pain. Research has shown that patients on their death bed experience alleviation in pain due to both physical and psychological factors. However, little has been done to train practitioners on this account and provide them with the necessary skills to deal with this situation. It is a practitioner’s duty to be of service to the patient even when all hope is lost and the patient is not applicable for any further medical treatment. It has been an observation that older aged patients who receive proper nursing care face less pain in their last hours than those who have suffered from negligence. Hence, it is equally important to provide for a patient’s emotional needs as it is for physical needs to the best of your ability (Gozalo & Miller, 2002). However, due to several factors such as medical insurance coverage, fear of lawsuits, fear of hastening death for a patient, lack of knowledge, lack of expertise, and lack of training; patients are made to suffer a painful death. Practitioners are hence negligent in providing them with timely treatment and do not feel liable for the discomfort caused. There should be proper reforms to improve the system and ensure that doctors and nurses are liable for their negligence in dealing with dying patients. Moreover, if medical treatment may be dangerous or it is difficult to prescribe the correct dosage of medication required to ease pain, psychological methods of easing pain should be adopted. An ample amount of research is required. References Carr, B. & Cousins, M. (2007). “Pain Management: A Fundamental Human Right.” Anesthesia and Analgesia. Volume 105, Issue 1, pp. 205-221. Gozalo, P., Lapane, K., Wu, N., Mor, V., & Miller, S. (2002). “Does receipt of hospice care in Nursing Homes Improve the Management of Pain at the End of Life? Journal of the American Geriatrics Society. Volume50, Issue 3, pp. 507-515. Olson, R. A., Holden, E. W., Friedman, A., Faust, J., Kenning, M., Mason, P. J. (1988). “Psychological Consultation in a Children’s Hospital; An Evaluation of Services.”Journal of Pediatric Psychology. Volume 13, Issue 4, pp. 479-492. Tolle, S. W., Tilden, V. P., Rosenfeld, A. G., & Hickman, S. E. (2000). “Family Reports of Barriers to Optimal Care of the Dying.” Nursing Research. Volume 49, Issue 6, pp. 310-317. Turk, D. & Monarch, E. (2002). Psychological Approaches to pain Management; a practitioner’s handbook. Springer. Read More