Archive for the ‘pain control’ Category

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Readers Comment on Vicodin, Percocet Ban

July 17, 2009
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By wonker, via Flickr.

In his July 6 post on the proposed Vicodin, Percocet ban, AJN editor Jacob Molyneux wrote, “A number of clinicians and patients have expressed alarm at the potential loss of Vicodin and Percocet, both of which are mainstays of pain management in the U.S.” He cited pain expert Carol Curtiss’s concern that such a ban could have “even more drastic implications than most people yet understand,” then asked readers, “Should we worry?”

Some commenters think so:  nester writes

If suddenly the combos become unavailable and pain relief is that much harder to come by, every Tom, Dick, and Harry with a sprain is going to flock to the ER for the good stuff… not once, but daily until the pain is gone or they are refused treatment.  If you can’t go to just any doc to get narcotic pain relievers, the pain relief specialists will have lines out the door also.

And Abigail Nobel says, “Educate before banning these affordable, essential components of pain control. Why should everyone suffer for the carelessness of a few?”

But Judy Newberger says that although she initially agreed with the ban, an interview with an elderly patient who was given Percocet and was already taking acetaminophen changed her mind.

Labels were not read, discharge papers were not thoroughly reviewed. Did no one review what meds he was on before they sent him home? I now am FOR removing Rx and OTC combination pain and other combination meds with acetaminophen.

Thanks to all for your thoughts. There will undoubtedly be more to say, and as always, we invite you to say it here.

–Sylvia Foley, AJN senior editor

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Proposed Vicodin, Percocet Ban: Part One of Double Whammy for U.S. Pain Control?

July 6, 2009
By wonker, via Flickr.

By wonker, via Flickr.

Some crucial context may have been left out of last week’s widely reported story that an FDA advisory panel has recommended bans on Vicodin (hydrocodone plus acetaminophen) and Percocet (oxycodone plus acetaminophen), two popular combination drugs used to treat pain. The panel’s concern is the liver toxicity of acetaminophen, an ingredient in a number of other prescription drugs that would also be banned if the FDA adopts the panel’s advice.

A number of clinicians and patients have expressed alarm at the potential loss of Vicodin and Percocet, both of which are mainstays of pain management in the U.S. In fact, says Carol Curtiss, MSN, RN, BC, a nationally recognized speaker on pain and symptom management and a past national president of the Oncology Nursing Society, the proposed ban could have even more drastic implications than most people yet understand. Read the rest of this entry ?

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Dying in Agony in America’s Nursing Homes – Case Study Poses Ethical Quandaries for Nurses

June 1, 2009

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“Oh, that hurts! You’re hurting me. Please, please, just leave me alone. Please stop.” These were the words of Louis Daly, a friendly, cognitively alert African American man in his late 80s, as nurses were changing the dressing on his stage IV pressure ulcer two days before he died. (This is a real patient; his name and other identifying details have been changed.)

So starts “Dying with a Stage IV Pressure Ulcer” in the January issue of AJN. Read the rest of this entry ?

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The Psychology of Burn Pain: What Nurses Need to Know

May 13, 2009
The June issue of AJN includes the second part of a two-part article on burn pain (here’s the first part; for the best versions of both parts, click on “article as PDF”). Addressing the psychological component of this pain is key to the patient’s recovery. Below are some tips from Frank Costello, a clinical nurse specialist on a burn unit at Weill Cornell Medical Center in New York City, who spoke with editor-in-chief Diana Mason. (A podcast of the full interview with Costello can be found here.)

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