Nursing needs its leaders to respond to Francis
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Why do we under-treat pain caused by advanced disease?
The National Institute for Health and Clinical Excellence has published a clinical guideline on prescribing opioids to relieve pain for patients receiving palliative care for chronic or incurable illnesses.
NICE said evidence suggested pain caused by advanced disease remains under-treated, with many patients worried about the long-term use of opioids, their side-effects and the possibility of becoming addicted.
Nurses should discuss concerns about addiction with patients who are being treated with strong opioids for pain relief when nearing the end of life, according to latest guidance.
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From Behind the Rituals
Why do you do the things you do? How much of nursing practice is based on ritual and myth and how much on sound evidence? If you have a ritual you’d like to discuss here, email nursingtimescomments@emap.com
Readers' comments (3)
Anonymous | 29-May-2012 4:45 pm
Because many patients are worried about the long term use of opioids, their side effects and the possibility of becoming addicted.
Pain teams and the palliative care teams are fantastic resources, patients often listen to them more than they do the ward staff.
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Ellen Watters | 30-May-2012 3:41 pm
Patients are often on other medications and many say they are reluctant to take any more. They do have concerns re addiction and overuse but Palliative care experts can allay these fears.
I am always suggesting to patients whose pain is not managed adequately to ask for a palliative care referral. But this has connotations of end of life so I am quick to dispel that stressing that a palliative care expert has a holistic approach and the focus of care is around quality of life. The priority being getting on top of symptoms, side – effects and complications caused by their cancer or by treatment for it AT ANY TIME in the course of their illness.
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Anonymous | 5-Jul-2012 7:45 pm
In the last year I have unfortunately had my nursing experience augmented by personal experience. My father died last year from pancreatic cancer and thanks to the doctors & nurses interventions he was able to stay at home with my mother. The information they received regarding his symptoms & medications was of great assistance in allaying his fears & allowing them to feel able to manage his pain as he wished.
On the other hand I feel helpless in relation to my partner's experience with advanced gastric cancer. I try to allay his fears that the morphine is addictive & instead to view it that it is better to use the analgesics prescribed to provide pain relief. He worries that he will become addicted, it will require larger & larger amounts for same effect and it will make him too drowsy to continue to work on a project that he is continuing to do as a freelance for his previous employer. It is a continuing reassurance that he needs to think to his health since if he is in pain it will add to his stress, his fatigue and he will not be in a position to be able to complete the work he wants.
The differences between these two gentlemen are related to their age, their outlook on where they are in their lifespan, culture & life experiences, different countries & healthcare and their acceptance of their mortality. To encourage informed decision making for people with cancer & suffering pain there needs to be a holistic approach which takes these points into consideration & involves those who are significant in their life.
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