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Potential dilemma that one may face in APRN role
A potential ethical dilemma that I may face in my role as a family nurse practitioner is the use of opioids to treat chronic pain in patients. This would present an ethical dilemma of acting following the nursing principle of nonmaleficence. Nonmaleficence is a nursing ethical principle that involves the avoidance of any action that could harm patients (Bernhofer 47). This principle presents a tough ethical problem because it is important to choose an appropriate treatment method that will not harm the patient but that will relieve the pain. The controversy surrounding the use of opiates would also present an ethical problem. Their side effects include nausea, somnolence, addiction, constipation, and dependence (Candiotti and Gitlin 1678).
Situation summary and potential solutions
A family nurse practitioner could be afraid of the possibility of causing harm while treating chronic pain because many pain treatment remedies have adverse side effects. However, nurses need to understand that treatment of pain causes a lot of discomforts. Therefore, failing to treat it effectively could cause long-term effects that can be more painful than the side effects of the treatment method used. For instance, such pain can adversely affect the physical and emotional wellbeing of the patient. Collaboration with other healthcare professionals can help patients to deal with treatment. For instance, therapy, hypnosis, and relaxation techniques can help patients cope with pain effectively. Family nurse practitioners can therefore work with physicians, psychotherapists, and psychologists who can deal with the various aspects of pain and its treatment. For instance, studies have shown that chronic pain is associated with psychological responses (Rosenblum 409). These healthcare professionals can teach patients how to perform deep muscle relaxation, move attention away from the pain, and evoke pleasant images and thoughts that bring feelings of relaxation. The psychologist can help the patient deal with the emotional aspect of pain. These skills empower the patient to cope with the pain and the side effects of treatment.
Potential cost and benefits
The potential cost to the proposed solution includes additional financial charges, risk of dependence, and probability of addiction. It is challenging for a patient suffering from chronic pain because, in many instances, the distress caused by the pain can lead to loss of interest in many activities, grief, and hopelessness. This makes it difficult to convince the patient to accept a risky and controversial treatment remedy. The aforementioned solution is costly and risky. The treatment would require the consent of the patient and the family. On the other hand, the benefits include better coping by the patient, a higher quality of life, improved body control, and improved health outcomes. Collaborating with other professionals would help the nurse to prevent harm to patients that could occur in the form of anxiety, depression, or suicide.
Opposition to one’s position
The decision to use opioids to treat chronic pain would be opposed by physicians and family because the safety and effects of opioids are controversial. The long-term administration of opioids for the treatment of chronic pain is controversial and has caused doubts regarding their role and efficacy. Studies have shown that they are effective pain relief drugs. However, they are associated with diversion, addiction, dependence, and abuse (Rosenblum 412). Physicians would oppose their use because of their side effects, and the controversy surrounding their use, safety, and effectiveness.
References
Bernhofer, Esther. “Ethics: Ethics and Pain Management in Hospitalized Patients.” The Online Journal of Issues In Nursing. 17.1 (2011), 45-52. Nursing World. Web.
Candiotti, Keith, and Melvin Gitlin. “Review of the Effect of Opioid-Related Side Effects On the Treatment of Moderate to Severe Chronic Non-Cancer Pain: Tapentadol, A Step Toward a Solution?” Current Medical Research and Opinion 26.7 (2010): 1677-1684. Print.
Rosenblum, Andrew, Lisa Marsch, Herman Joseph, and Russell Portenoy. “Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions.” Experimental and Clinical Psychopharmacology 16.5 (2008): 405-416. Print.
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