Legal And Ethical Issues In Acute Care

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Assessment & Management of Patient’s Pain in Acute Care
Pain management in nursing care is huge and there are many factors to consider when caring for patients with chronic and acute pain. Moreover, there are many legal and ethical issues regarding pain management. McCaffery (1968) defined pain as “whatever the person experiencing pain says it is, existing whenever the person says it does.” As nurses we are trained to assess pain and initiate the appropriate interventions both pharmacologic and nonpharmacological, however, most pain relief is achieved by the administration of opioid analgesics such as oxycodone and morphine.
Ethical issues regarding the use of opioid analgesics could be challenging. Some patients display drug seeking behaviors, …show more content…
According to one study, 5.1 million people in America abused prescription painkillers (NIDA.gov). The CDC (2014) claims that 46 people die each day from overdose of prescription painkillers in the United States. Between 1997 and 2006, retail sales of opioids increased dramatically. Sales of hydrocodone increased by 244%, oxycodone by 732%, and methadone by 1177% (Hahn, 2011). The numbers are truly staggering and the need for policy change is critical. While many patients with chronic pain can safely benefit from a prescribed opioid analgesic, a large number of these patients is vulnerable to abuse and addiction.
On the other hand, patient’s fear about addiction, physical dependence, and tolerance can also hinder effective pain management. Patients who fear addiction to pain medication will often refuse or deny medication although pain might be present. A study found that the greatest barriers to pain control were fear of addiction and the notion that medication should be saved in case the pain gets worse (Naveh, Leshem, Dror, & Musgrave, …show more content…
Therefore, the patient’s self-report of pain is the most valid means of assessment (Wagner & Harden-Pierce, 2013). The mechanism of pain is regulated by the nervous system and involves four processes: transduction, transmission, perception, and modulation. Transduction involves the initial mechanical injury and or stimulus, which causes the release of sensitizing chemicals. These chemicals activate nociceptors and generates action potential. Transmission is the process by which the pain signal travels from the periphery to the spinal cord and then to the brain. Perception is the conscious experience of pain. Modulation is the activation of descending pathways that exert an inhibitory effect on the transmission of pain (Lewis, Dirksen, Heitkemper, & Bucher, 2014).
Personal Knowing
Because there are so many facets and ethical concerns to pain and pain management, it is a cause for anxiety. There is a fine line to the proper administration of opioid analgesics and over medicating patients. There is also the concern of creating addicted patients. Over-prescribing in the United States has become common practice; however, there is a clear need for policy change when it comes to pain management and the overuse of prescription narcotics.
Aesthetic
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