The Legal And Ethical Framework ( Atkins, Britton & De Lacey 2011

In this paper I am going to identify some the legal and ethical issues in My Sister’s Keeper. Some of those issues include emancipation of a minor, genetic engineering, and limited termination of parental rights. I will be giving my opinion on these matters also.

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

Privacy Act 1988’s purpose is to standardize how personal information is collected, stored, used, disclosed and how this information is accessed. There’s 13 Australian Privacy Principals that relate to Government and Private sectors handling information. Stipulations for credit reporting, and health and medical research professions accessing and managing information when unable to seek consent.

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

Patients can become hypertensive during induction, positioning, or tumor resection (12). Chronic catecholamine excess causes volume contraction and patients can become severely hypotensive, as in this case, if adequate volume resuscitation is not performed (12). It is prudent to evaluate for adverse events following hypertensive and hypotensive episodes. Serial neurological evaluations, CT brain, electrocardiograms, or serial cardiac enzymes may be warranted. Complications of surgery are primarily due to severe preoperative hypertension, high secretion tumors, or repeat intervention for recurrence (13). In one study, adverse perioperative events occurred in 32 percent of cases (14). The most common adverse event was sustained hypertension in 25 percent of the patients. There were no perioperative deaths, myocardial infarctions, or cerebrovascular events. Despite premedication of most patients with phenoxybenzamine and a beta-blocker, varying degrees of intraoperative hemodynamic lability occurred

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

The purpose of the research study was to determine if registered nurses are using evidence-based practice standards for assessing pain in special populations such as different cultural backgrounds and those with chronic pain syndromes. The research hypothesis states that registered nurses utilized evidence-based practice standards when assessing pain in special populations such as those with different cultural backgrounds and those with chronic pain syndromes. The null hypothesis states that registered nurses do not use evidence-based practice standards when assessing pain in special populations such as those with different cultural backgrounds and those with chronic pain syndromes. A survey study was completed to determine if registered nurses

Step one, Geraldine pains will be monitored and documented at a regular interval by asking her to score her pain on a scale of (0-10) with 0 meaning zero pains and 10 being highly in pain. This will help in evaluating her cancer-related pain symptoms, which may involve viscera, nerve, or bone tissue. Use of rating scale aids helps in assessing level of pain and provides a tool for evaluating the effectiveness of analgesics, enhancing patient control of pain. Geraldine’s reported and unreported pain will be assessed. The discrepancy between reported and nonverbal cue can give us clues to the degree of pain, the effectiveness of

(REARDON, ANGER & SZUMITA, 2015.). There are two ways to assess pain which they have been used for long time. The first way is Visual analog Scale. The second way is Numeric Rating Scale which means patient should rate their pain in scale of (0-10) zero is no pain and 10 is the worst pain. REARDON, D. P., ANGER, K. E., & SZUMITA, P. M. (2015). However, “the nurse also judged patiens’ pain based on their appearance and mobility, and investigated any potential complications by conducting physical examination. The nurses often rechecked the pain levels in order to clarify and ensure that the recorded pain levels corresponded to the causes of the pain and suffering” (Chatchumni, Namvongprom, Eriksson, & Mazaheri, 2016) patients also may report no improvement for their pain even though with high dose of opioid and ask for high dose of opioid while the nurses noticed them sleeping or

Despite recent advances in information regarding perioperative care, postoperative pain continues to go undermanaged. Postoperative pain is the pain patients experience after a surgical procedure. According to Gan, 80% of all people who undergo surgeries experience postoperative pain, and 75% of them rate their pain at a moderate, severe, or extreme level (as cited by Cooney, 2016). Furthermore, inadequately managed pain can lead to patient dissatisfaction, decreased patient outcomes, and overall higher cost of care (Penprase, Brunetto, Dahmani, Forthoffer & Kapoor, 2015). In order to provide higher quality pain management,

Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80).

Equipotent dose for ondansetron and ramosetron are unknown which makes it difficult to decide optimal dose. There are no established parameters to measure the severity of nausea, because it is a subjective symptoms and a valid visual analog scale or severity grade is needed. Except for intrathecal fentanyl, no other opioids were used in our study; perioperative opioid use is known to exaggerate PONV, the findings of our study should be used cautiously in patients whom opioids are used preoperatively. Our study was conducted in female patients undergoing gynecologic surgeries under spinal anesthesia. Extrapolation of our results to other patients having various surgeries under different methods of anesthesia requires further

What a tough fifty year old patient to treat. Her intolerance to pain medication noted in the history and physical preoperative record. The acute visceral pain from the hysterectomy crucially needs to be treated. Morphine Sulfate(MS) is the usual first choice to treat severe pain, furthermore intravenous would be a routine route for operative patients for immediate relief, passing the body’s first-pass of the liver, though all opioids including MS is metabolized in the liver and then eliminated through the urinary system (Arcangelo & Peterson, 2013). Patients with renal insufficiency may have increased and extended respiratory depression when administered morphine, as well

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).

Pain is defined as an unpleasant sensory and affective experience associated with tissue damage. Pain is a major symptom in many medical conditions and is one of the most sited reasons why people seek medical assistance (Peterson & Bredow 2009). When pain is poorly managed, it can delay healing and recovery. Using the proper nursing assessment skill is very important to assess a patient’s pain level, and determine the best intervention to reduce or eliminate it. Middle range theory like Pain: a balance between analgesia and side effects and the theory of unpleasant symptoms (TOUS) helps interrupt and serves as a tool that can be used in daily nursing practice.