Case Study
As you read through the following case study, think about what type of questions you might ask your preceptee if the following ethical situation occurred while caring for a patient:
A 69-year-old terminally ill female patient cries out for help from her room. She tells the preceptee that her pain is unbearable. She says, "I need more pain medicine, it hurts too much, I can't sleep, I can't stand it any longer." She seems very anxious and irritable. The preceptee asks the patient to rate her pain on a scale from 0 for no pain to 10 for the worst pain, and the patient says her pain is a 9.
The preceptee reviews the physician orders and is surprised to see that a placebo has been ordered to be alternated with a low-dose pain medication. She approaches the physician with her concerns about the patient's poorly managed pain. He pulls up a picture on his computer of a man who was carrying another man, over his shoulder, as a means to get him to the hospital. He said, "In my country, one has to tolerate much more pain than Americans do, and no one complains. Here in America, there is so little tolerance for pain." He also said, "She has a history of being a drug addict, which is the real reason she wants these drugs. And I would hasten her death if I gave her as much pain medication as she wants." The preceptee suggests that he replace the placebo with pain medication but he rejects her suggestion. The doctor tries to reassure her that research has proven that placebos are effective in alleviating pain. He said, "the placebo works on the psychological part of the pain."
(Adapted from: The Right to Pain Treatment: A Reminder for Nurses Source: Dimensions of Critical Care Nursing June 2008, Volume 27 Number 3, p 93 – 101.)
A 69-year-old terminally ill female patient cries out for help from her room. She tells the preceptee that her pain is unbearable. She says, "I need more pain medicine, it hurts too much, I can't sleep, I can't stand it any longer." She seems very anxious and irritable. The preceptee asks the patient to rate her pain on a scale from 0 for no pain to 10 for the worst pain, and the patient says her pain is a 9.
The preceptee reviews the physician orders and is surprised to see that a placebo has been ordered to be alternated with a low-dose pain medication. She approaches the physician with her concerns about the patient's poorly managed pain. He pulls up a picture on his computer of a man who was carrying another man, over his shoulder, as a means to get him to the hospital. He said, "In my country, one has to tolerate much more pain than Americans do, and no one complains. Here in America, there is so little tolerance for pain." He also said, "She has a history of being a drug addict, which is the real reason she wants these drugs. And I would hasten her death if I gave her as much pain medication as she wants." The preceptee suggests that he replace the placebo with pain medication but he rejects her suggestion. The doctor tries to reassure her that research has proven that placebos are effective in alleviating pain. He said, "the placebo works on the psychological part of the pain."
(Adapted from: The Right to Pain Treatment: A Reminder for Nurses Source: Dimensions of Critical Care Nursing June 2008, Volume 27 Number 3, p 93 – 101.)