Official journal of the Canadian Association of Critical Care Nurses / CACCN
-
Off J Can Assoc Crit Care Nurs · Jan 1997
ReviewAn innovative approach to pain management in critical care: therapeutic touch.
Nursing research suggests that pain in critically ill patients is inadequately controlled and has deleterious effects. The critical care nurse must depend on the patient's perception of pain and its expression in physiological and behavioural responses. Ventilatory support, fluctuating levels of consciousness, hemodynamic instability and severity of illness are often barriers to the expression and interpretation of pain. ⋯ Therapeutic touch (TT), one innovative approach, is proposed as an adjunct to pharmacological intervention TT is a non-invasive, holistic practice that promotes comfort, relaxation, stress reduction and heating. Clinical studies suggest that TT prolongs the interval between analgesies. The authors highlight the 10-year clinical experience of a critical care nurse practising TT in a 30-bed critical care and trauma centre.
-
Off J Can Assoc Crit Care Nurs · Jan 1997
Review Case ReportsThe use of limited critical care resources: an ethical dilemma.
The following article consists of a review of the literature surrounding the issue of persistent vegetative state (PVS) patients and resource allocation. The author attempts to analyze the question: Should limited critical care resources be used on PVS patients at the risk of denying those resources to others? The author explores such factors as: prognosis and recovery in PVS, life expectancy, and quality of life. As well, resource availability and ICU costs involved in sustaining the life of a PVS patient are examined. Finally, principles such as non-maleficence and beneficence; as well as the critical care professionals attitudes toward this issue; and the moral, ethical, and emotional dilemmas are discussed.