da Cunha, B.F. (2015). Ethics and undertreatment of pain in patients with a history of drug abuse. MEDSURG Nursing, 24(1), 4-16. PMID: 26306351 Go to Dykes Library, e-journal finder, put in MedSurg Nursing, select 2015, this article is in the Jan/Feb2015 Newsletter.
You will need to select another article on an ethical issue of your choice. See Assessments for further instructions.
Review:
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only
You are caring for a 63-year-old male who had a left hip replacement two days ago. On the patient’s chart, you read the patient has a past medical history of appendectomy, foot surgery, diabetes mellitus type II, obesity, and previous opioid use with concerns for abuse.
You go in to assess the patient. When you ask the patient his pain level, he states having sharp pain at a nine on a zero to ten scale on his left hip. The patient has orders for oxycodone Q 4 hours PRN, and it has been 4.5 hours since he last had any. He has not been asking for any pain medication since he last had it 4.5 hours ago.
You tell the patient you can get him his oxycodone dose as you want to be sure his pain is controlled so he can get up and walk with the physical therapist in an hour. The patient’s wife states “he can’t take any opioids, he was addicted in the past, and we do not want him addicted again. He hasn’t taken any pain medication in the past three years so now is not a good time to start this again.” The patient is grimacing in pain.
Refer to the article by da Cunha (2015) and The ANA Code of Ethics when answering the following questions. Include support from at least one reference, both in text and in a reference list, or other credible sources in your discussion.
What are some of the risks of uncontrolled pain for the patient in the case study and how does knowing these risks impact you in acting ethically?
Do you think this patient is exhibiting any of the following? Tolerance, physical dependence, addiction, pseudo addiction, or none of these? Why?
Refer to Table 1. (Using Ethical Principles to Guide Pain Management Decisions) in the article by da Cunha (2015). Answer each question as it applies to the patient in the case study.
Refer to Table 2. (Guidelines for Safe, Effective Pain Management) in the article by da Cunha (2015). How can you apply these guidelines to working with the patient in the case study?
Review the Code of Ethics for Nurses (ANA, 2015). Which provision would provide the most support for you as the nurse for navigating this situation?
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-only
da Cunha, B.F. (2015). Ethics and undertreatment of pain in patients with a history of drug abuse. MEDSURG Nursing, 24(1), 4-16. PMID: 26306351
