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Clinical decision making and pain.

B R Ferrell1, M T Eberts, M McCaffery

  • 1City of Hope Medical Center, Duarte, California 91010.

Cancer Nursing
|December 1, 1991
PubMed
Summary
This summary is machine-generated.

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Nurses face clinical decisions and ethical dilemmas in pain management. Key challenges include assessing pain intensity, medication timing, and overcoming barriers like physician cooperation and time constraints.

Area of Science:

  • Nursing
  • Clinical Decision Making
  • Pain Management

Background:

  • Pain management is a critical aspect of patient care.
  • Nurses are central to decision-making processes in pain management.
  • Ethical dilemmas frequently arise in the context of pain relief.

Purpose of the Study:

  • To explore nurses' clinical decision-making experiences in pain management.
  • To identify common barriers to optimal pain relief.
  • To examine ethical and professional conflicts nurses encounter regarding pain.

Main Methods:

  • A preliminary study involving 53 nurses.
  • Nurses completed surveys detailing their experiences with patients in pain.
  • Data collection focused on actual clinical scenarios and decision-making processes.
Keywords:
Empirical ApproachProfessional Patient Relationship

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Main Results:

  • Common decisions involve pain intensity, medication timing, and analgesic choice.
  • Nurses rely on verbal and nonverbal cues for pain assessment.
  • Barriers include physician, patient/family, and nursing knowledge, as well as time limitations.
  • Ethical dilemmas encompass over/undermedication, conflicts, and opioid side effect concerns.

Conclusions:

  • Nurses' decision-making in pain management is complex, influenced by various factors.
  • Barriers and ethical conflicts significantly impact the delivery of optimal pain relief.
  • A tentative model for pain management decision-making is proposed for further research.