Stay, Breathe with Me by Helen Allison

Author:Helen Allison
Language: eng
Format: epub
Publisher: She Writes Press
Published: 2016-03-13T05:00:00+00:00

ACUTE PATIENT CARE IS NOT PALLIATION

Admission to High Cross Hospital deprived Alfredo both of palliative care and the peaceful comfort and security of his home. And Sofia’s attempts to improve her husband’s hospital care met with the disapproval of hospital staff. Tension between Sofia and hospital staff mounted. And Alfredo suffered the consequences.

Alfredo occupied a single room next to the nursing station on the Neurological Unit. On this unit his world was no longer familiar or secure. As if nameless, he was regarded by his caregivers, not as a person, but as a series of complicated, neurological symptoms. Alfredo’s pain was mismanaged and out of control. And yet the nature of his pain was fully documented in his palliative care pain regimen. The palliative management of Alfredo’s pain had been developed through meticulous assessment of his illness during the many months he had spent at home under the care of his wife, his doctor, and the palliative nurses.

On admission to High Cross Hospital, Dr. Emerge replaced Alfredo’s pain regimen with a pro re nata (prn, or as-needed) prescription of hypodermic morphine to be given if necessary or as required. But a prn doctor’s order for the relief of advanced tumor pain is inappropriate, vague in meaning, and invites the possibility that the medication will not be given when it is required. Furthermore, prn prescriptions for pain seldom stand alone and are usually combined with other analgesics for the relief of acute pain.

Cancellation of Alfredo’s palliative care regimen indicated that Dr. Emerge lacked knowledge in the care of a fatally ill patient with unremitting pain. The doctor’s prn order for Alfredo was further proof of his lack of knowledge.

Chronic pain cannot be managed by the interpretation of others, nor can it be based solely on the assumptions or value judgments of caregivers.

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