Dynamics (Pembroke, Ont.)
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Dynamics (Pembroke, Ont.) · Jan 2005
ReviewImproving pain management for critically ill and injured patients.
The under-treatment of pain continues to be a problem in patient care. Evidence shows a significant percentage of patients suffering with acute and chronic pain, despite the treatment options available. ⋯ As health care professionals, nurses have a responsibility to advocate for patients and provide the best pain management possible. Efforts to improve pain management will help avoid complications, such as chronic pain syndrome, while improving comfort, function, and quality of life.
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Critical care involves caring for complex and acute needs of patients with life-threatening conditions. Despite skilful interventions, there are times when the care needed by patients and their families is primarily palliative. In this article, the author focuses on examples of ways nurses can make the palliative care they provide exemplary. ⋯ This article includes a description of key ways critical care nurses may address the needs of patients who are palliative. Specifically, the themes of helping people live on, individualizing care, defending human dignity, sensitive listening, sharing hope, and keeping the promise to never abandon are described. These themes all fall under the overarching theme of simple gestures, which is also described in this report.
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As most Canadians die in hospital, the final contact of family members with their loved ones is frequently in an unknown and uncomfortable environment. Family members are integral to the end-of-life decision-making process and are vital contributors to the comfort of dying patients. A quantitative study was conducted in three critical care areas where the stated goals were to provide not only quality care to patients, but also support to families. The researchers sought to determine levels of satisfaction with care, visitation, support, comfort and pain measures. ⋯ Consistency in nursing care and provision of information to family members may be difficult in the fast pace of an ICU, but are reasonable program objectives considering the positive influence this has on perceptions of care. Further, flexible visitation policies which maximize access between family members and both their dying loved one and health care professionals appear to have a beneficial effect on satisfaction.
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Dynamics (Pembroke, Ont.) · Jan 2005
Developing leadership skills in critical care nurses: a case scenario--part two.
During a recent CACCN board meeting, directors were challenged with developing an approach to a difficult case scenario. In a situation in which a group of nurses have angered some of the other nurses who work in the same unit, the directors were asked to identify core problems and suggest possible solutions and potential barriers to this problem. ⋯ A number of possible solutions and the associated strengths and weaknesses, as well as the barriers to implementing the solutions were identified. In summary, critical care nurses must continue to advocate and lead the way toward strong leadership, modeling of appropriate behaviour and effective communication--all of which contribute to stronger team development and, ultimately, result in better, safer patient care.