The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Nov 1997
Case ReportsGoing one step further: skilled pain assessment and the art of adjuvant analgesia.
Evolving pain management practice has two phases: 1) the development of confidence and competence in prescribing opioids at whatever dose is needed to control pain; and, 2) advanced assessment skills and understanding when adjuvant analgesics must be employed with or without opioids to manage certain types of pain. A growing reliance on opioids alone is illustrated in case study by a nurse pain consultant. Dramatic improvements occur in patient function and coping when clinicians move beyond the sole utilization of opioids to understand the importance of skillful assessment of the patient's experience and the artful use of adjuvant medications.
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This article is designed for hospice leaders and volunteers to explore creative ways to deal with the stagnancy that can occur in volunteer programs. Specific strategies, such as nurturing caregivers, transitioning into a gift-based program, and integrating spirituality and creativity into volunteer efforts, provide the focus of the article.