Duty and Breach of Duty in the Drug addicted Patient
Nurses have certain moral and ethical duties to their patients. Duty is established when the nurse accepts responsibility for direct care and treatment for an individual. (Constantino 2005, P.21) Most nurses that work in a clinical setting, are not able to choose their patients. However, when they accept the patient that is assigned to them, they are then responsible for that patient. They become their advocate. Nurses have strict standards of care, and ethical codes that must be adhered to. According to Iyer 2003, “The concept of breach of duty, occurs when nurses fail to provide an expected standard of care within their specialty, while providing care or treatment to a patient under their care. One of the duties of a nurse is to manage a patient’s pain. Managing pain can become further complicated when the patient is addicted to drugs. Pain can be one of the most subjective symptoms that a human being can have. The International Association for the Study of Pain (IASP) provides a technical definition of pain "An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” (Merskey, 1994) Margo McCaffery may have said it best. She said that pain is defined as ”Whatever the person experiencing the pain says it is, existing whenever the person says it does.” (Potter, Perry, Stockert and Hall, 2013) It is important to remember that perception of pain is unique to every individual. According to the nursing standards of care, it is the nurses duty to provide patients with adequate pain relief. This standard still applies to a patient with a drug addiction problem, although it can be more difficult to treat their pain. It is a fact that some people come to a clinical setting in search of drugs. However, this is not always the case . The nurse must address any misconceptions that they, and any other healthcare providers in contact with the patient might have. Any preconceived ideas can have great impact on the care that these patients receive. You must stay objective and make treating the pain a top priority. Depending on the drug addiction, patients can have higher tolerances to pain medications and therefore require more of the drug. it is important to build a relationship with the patient. Asking the right questions is a crucial step in treatment. Knowing what type of drug they are addicted to, and how often it is used, can help to determine the baseline for the patient. It will also help in determining which medication is appropriate, and how much they will need. Voicing concerns about their addiction and how the medication will affect them is perfectly acceptable. Also, the patient may be treated concurrently for any addiction or psychological issues. Many healthcare workers are afraid of treating patients with addiction problems. They are afraid of overdoses, litigation or making a patients addiction worse. However, actual rates of addiction are much lower than many people would expect. Take opiate addiction for example; according to a study of 800 primary care