Maintenance dose[ 8 ] The National Institute for Health and Care Excellence NICE recommends that oral sustained-release morphine, not transdermal formulations, is first-line for maintenance treatment. Review the daily dose of sustained-release morphine and increase as required. The aim is preventing pain from occurring rather than relieving it.
Palliative Care of Heart Failure Introduction Given the option, most people would choose to die at home surrounded by those they love[ 1 ]. The latter may require support and resources to help them to cope[ 2 ].
This can be a significant burden upon the Primary Healthcare Team in terms of time and emotion but it can also be most rewarding. In addition the Care Quality Commission CQC has found significant variations in the quality of care received by, for example, people of different ethnic background, sexual orientation and social background[ 4 ].
Despite this inequality, the UK ranks first for the quality of palliative care in 80 countries around the world[ 5 ]. Each may bring its own challenges in terms of the provision of terminal care. Studies of end-stage chronic obstructive pulmonary disease COPD patients, for example, found that such patients tend not to ask for help actively and a discussion about support may need to be initiated by the healthcare worker[ 78 ].
It provides guidance in the care of dying people and is aimed at all clinicians everywhere - hospital and community. Five "Priorities of Care" are described and form the focus of care at the end of life.
These are universal and applicable irrespective of the place where someone is dying - whether a hospital, their own home, a care home or a hospice.
Sensitive communication takes place between staff and the dying person, and those identified as important to them. The dying person, and those identified as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
The needs of families and others identified as important to the dying person are actively explored, respected and met as far as possible. An individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, co-ordinated and delivered with compassion.
The Gold Standards Framework is a training programme supported by many authoritative bodies[ 11 ]. One of the key factors in managing terminal care is to institute such care at an appropriate time.
This involves an estimation of prognosis. The Gold Standards Framework has developed a Prognostic Indicator Guide to assist in this process, which starts with asking three trigger questions[ 12 ]: Would you be surprised if the patient were to die in the next months, weeks or days?
Do they have specific clinical indicators - eg, cancer metastases, increased frequency of steroid courses COPD? This benefits the individual and those close to them, as well as allowing appropriate care to be planned.
Dying at home For the patient wishing to die at home there must be adequate back-up.
This usually means a close person such as a spouse, long-term partner, close relative or a team of people who are available 24 hours a day.
Night sitter services are available but costly. The carer must be prepared to cope with the emotional and physical needs of the patient and these can both be very demanding. Team approach Care of the dying patient at home requires a team approach involving the GP, district nurses, perhaps Macmillan nurses and any other professionals with input.
This may include Social Services.
Very often a minister of religion will be visiting too. There should be a key worker who is the main point of contact for the patient, the family and the rest of the team.
The key worker is often not the most senior member of the team but is the important person who liaises and who ascertains that nothing is left undone or duplicated.Nursing Essays – Morphine Fantanyl Pain. Print Reference this. Disclaimer: This work has been submitted by a student. This is not an example of the work written by our professional academic writers.
You can view samples of our professional work here. Daily news focus. Exclusive: Former NHS nurses want forced adoption apology “This wasn’t a Magdalene Laundry, this was an NHS hospital with nurses in uniform,” reflects a former nurse and MP who is fighting for answers .
Nursing Essays – Morphine Fantanyl Pain. Print Reference this. Disclaimer: This work has been submitted by a student.
This is not an example of the work written by our professional academic writers. You can view samples of our professional work here. Nursing Essays – Heatherwood Nursing Subacute. Nursing Essays – Morphine Fantanyl Pain. Pain is physiological mechanism and a means of the body alert the person about either currently present or impending damage to it.
Published: Wed, 09 Mar Fentanyl is a prescription synthetic opioid analgesic prescribed for the treatment of chronic and severe pain. Pharmaceutical grade fentanyl is 50 to times more potent than morphine.
1 Street versions of the drug are often mixed with heroin and can be even more potent, and thus, more dangerous. Visceral pain is sensed by mechanical type of receptors and chemoceptors and pain originating from viscera is of diffuse and dull in nature.[5,6] Major part of post operative pain originates from nociceptors in the cutis and subcutis.[6,7,8].