Posts Tagged ‘pain control’

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Posttonsillectomy Pain in Children: Safer, More Effective Treatment Strategies

February 26, 2014

By Shawn Kennedy, editor-in-chief

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One of the CE articles in the February issue is “Posttonsillectomy Pain in Children.” It might seem like a no-brainer—ice-collar, cold fluids, and acetaminophen with codeine, right? WRONG. As the article indicates, there’s a lot more to managing this stubborn, sometimes severe pain.

For one thing, there’s been a big reversal in choice of pain medication. Acetaminophen with codeine, long a mainstay in managing children’s pain, is no longer recommended—in fact, the FDA issued a black box warning last year saying that codeine should not be used because its metabolism rate in one subset of children can cause excessive sedation. Reports of three deaths and a case of nonfatal respiratory depression in children who received appropriate doses prompted the warning. Read the rest of this entry ?

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When There’s a Disconnect Between Good Nursing Practice and Reality

December 6, 2013

Recently I spoke with other nurses about our personal experiences with hospitalization and those of family members, and the conversation turned to disappointment with nursing practice and nursing care. In fact, whenever I’ve asked, every colleague has disclosed a similar experience. Some say that they’d never leave a family member alone in a hospital.

We need to acknowledge that there is a disconnect between what we know to be good practice and what is often the reality—even in facilities with Magnet accreditation. There are far too many instances in which nursing practice is substandard.

shawnkennedyThis is a heads-up about Shawn Kennedy’s editorial in this month’s issue of AJN, excerpted above. You should read it. The article, “Straight Talk About Nursing,” is free. There are no easy answers to the issues it raises. That’s all the more reason to discuss them openly.

In AJN, we often focus on examples of best practices and insightful, compassionate, engaged care. And we get that there are many institutional obstacles that undermine nurses in their attempts to provide quality care to patients. But even so, we’d be remiss to pretend we don’t hear about, and sometimes personally experience, care that simply falls short. This is scary, at least to me. Patients depend on nurses in so many ways. So have a look at the article and let us know your thoughts, as a nurse or as a patient.—Jacob Molyneux, senior editor

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Different Gods, Different Ideas of Compassion: A Clergywoman’s Story of the Doctor Who Wouldn’t

December 23, 2009

Jeanine was in her 60s. She wasn’t a church member and I barely knew her. A neighbor had called me to the hospital-Jeanine’s husband was dead, and there were no family or friends at her side. Trying to get my bearings, I leaned over her and recited the words of the Twenty-third Psalm: “The Lord is my shepherd …. Yea, though I walk through the valley of the shadow of death, I will fear no evil ….”

“Help me,” Jeanine moaned. Her eyes opened and then closed. I knew she was pleading for release from her pain.

“Jeanine, I’m so sorry,” I whispered. I hurried to the nurses’ station. When a young nurse looked up, I asked if she could do more to relieve Jeanine’s pain.

“Nothing more to do,” she said, looking back down at an open ledger.

The above is an excerpt from the Reflections essay in the December issue of AJN. It’s by a retired clergywoman who tells of a moment early in her career that brought her face to face with a doctor who believed in a very different kind of God than her own. Click the link above to read the essay in entirety.  

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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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