Because it's true for Sickle Cell Patients Why

  1. I was told the following:

    Why large dose is needed for SC Patients
    Cytochrome P45 2D6 Polymorphisms and Predicted Opioid Metabolism in African-American Children with Sickle Cell Disease

    -Some patients with SCD clear medications through their bodies quicker than others because of the way the Liver Metabolizes (processes) it in patients.

    It goes straight to the liver and it does not get to the body processing it to help with the pain!
    -Some may also have increased tolerance to some medications due to increased exposure to them.

    If this is learned by Nurses and Drs, why isn't it understood and why do some nurses prolong the pain by not giving meds on time?

    Why do Nurses talk about SC Patients being drug seekers, when actually their pain is not under control?

    Why don't Nurses understand that if the patient over sleeps and wakes up screaming it's because without the regular interval of pain meds the pain increases and is overwhelming?
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  2. 13 Comments

  3. by   AJJKRN
    Have you personally taken care of many sickle cell patients during crisis?

    What has been your experience?
  4. by   iluvivt
    This article suggests that those SC patients that repeatedly fail out patient pain management should have CYP2D6 genetic testing. This may explain why some SC patients are recalcitrant to pain medication but it does not explain why some nurses are resistant to properly medicating these patients during times of crisis.
  5. by   hppygr8ful
    I have never failed to understand how nurses who regularly care for a certain population of patients don't take any effort to learn about that condition. I know some nurses do make the effort but usually when people complain about how annoying a particular type of patient is it seems they don't know anything about the pathophysiology and mental health issues surrounding a particular population.

    Hppy
  6. by   Kratoswife
    Quote from iluvivt
    This article suggests that those SC patients that repeatedly fail out patient pain management should have CYP2D6 genetic testing. This may explain why some SC patients are recalcitrant to pain medication but it does not explain why some nurses are resistant to properly medicating these patients during times of crisis.
    I can tell you the harsh reality of it.

    It's because the patients are African American.

    Many studies show that healthcare workers including physicians believe AA's have a higher threshold for pain.

    So they won't take their pain into consideration as someone with fairer skin.

    Please research this, it's such a sad recurrence.
  7. by   JKL33
    Quote from Kratoswife
    Many studies show that healthcare workers including physicians believe AA's have a higher threshold for pain.
    I am interested in reading these studies. I am able to access them myself if I know which ones you're referring to.

    Thanks!
  8. by   Kratoswife
    Quote from JKL33
    I am interested in reading these studies. I am able to access them myself if I know which ones you're referring to.

    Thanks!
    Okay great!

    You can place the question in Google, and make sure that they are peer reviewed studies.

    Good luck on your research.
  9. by   JKL33
    Quote from Kratoswife
    Okay great!

    You can place the question in Google, and make sure that they are peer reviewed studies.

    Good luck on your research.
    We discussed racial disparities in healthcare in a class I took recently but unfortunately didn't discuss the findings you mentioned; I had already searched a few healthcare-related scholarly databases and didn't come up with results that seemed on-topic before I posted my inquiry to you. Didn't have more time to devote to it right then and just thought you might know of well-done research off-hand.

    Sorry if that somehow offended.
  10. by   Kratoswife
    Quote from JKL33
    We discussed racial disparities in healthcare in a class I took recently but unfortunately didn't discuss the findings you mentioned; I had already searched a few healthcare-related scholarly databases and didn't come up with results that seemed on-topic before I posted my inquiry to you. Didn't have more time to devote to it right then and just thought you might know of well-done research off-hand.

    Sorry if that somehow offended.
    I'm not offended at all! Good luck on your research!
  11. by   Anonymous865
    Quote from JKL33
    We discussed racial disparities in healthcare in a class I took recently but unfortunately didn't discuss the findings you mentioned; I had already searched a few healthcare-related scholarly databases and didn't come up with results that seemed on-topic before I posted my inquiry to you. Didn't have more time to devote to it right then and just thought you might know of well-done research off-hand.

    Sorry if that somehow offended.
    I have not read any studies showing that health care workers think AA have a higher pain tolerance.

    I have read studies that show for similar surgeries, injuries, etc. that European Americans are given more analgesics than African Americans and Hispanics.

    Other research has shown that in laboratory pain studies African Americans have a lower pain threshold than European Americans.

    Even with cancer pain 59% of African Americans did not receive the WHO recommended standards for analgesics for their pain.

    Here's a link to a paper that summarizes a lot of the research on ethnic, racial, and cultural differences in pain and pain management. I found it very interesting. Since you are interested in ethnic differences in health care, you might enjoy it.

    Ethnic differences in pain and pain management
  12. by   Anonymous865
    Quote from JKL33
    We discussed racial disparities in healthcare in a class I took recently but unfortunately didn't discuss the findings you mentioned; I had already searched a few healthcare-related scholarly databases and didn't come up with results that seemed on-topic before I posted my inquiry to you. Didn't have more time to devote to it right then and just thought you might know of well-done research off-hand.

    Sorry if that somehow offended.
    If you come across any related studies, please post a link. I'd be interested in reading them too.
  13. by   JKL33
    Quote from Anonymous865
    I have not read any studies showing that health care workers think AA have a higher pain tolerance.

    I have read studies that show for similar surgeries, injuries, etc. that European Americans are given more analgesics than African Americans and Hispanics.

    Other research has shown that in laboratory pain studies African Americans have a lower pain threshold than European Americans.

    Even with cancer pain 59% of African Americans did not receive the WHO recommended standards for analgesics for their pain.

    Here's a link to a paper that summarizes a lot of the research on ethnic, racial, and cultural differences in pain and pain management. I found it very interesting. Since you are interested in ethnic differences in health care, you might enjoy it.

    Ethnic differences in pain and pain management
    Thank you. That linked paper is one that I ended up reading over the summer. I have observed differences in treatment of pain, but have not felt that the differences were attributable to the idea that healthcare workers truly believe that AAs had a higher pain tolerance/threshold. My concern, rather, has been that the disparity may be related to simply not believing the pain report.

    Study Links Disparities in Pain Management to Racial Bias | UVA Today

    This is a more interesting read:

    Racial Bias in Perceptions of Others’ Pain
  14. by   Anonymous865
    Quote from JKL33
    Thank you. That linked paper is one that I ended up reading over the summer. I have observed differences in treatment of pain, but have not felt that the differences were attributable to the idea that healthcare workers truly believe that AAs had a higher pain tolerance/threshold. My concern, rather, has been that the disparity may be related to simply not believing the pain report.

    Study Links Disparities in Pain Management to Racial Bias | UVA Today

    This is a more interesting read:

    Racial Bias in Perceptions of Others’ Pain
    Thanks for posting the links. I'm eager to read them. I find this subject fascinating.

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