POLL: Do you think cancer pain is properly managed?

[caroladybelle, BSN, RN]

Okay, I really hope you're joking... cause that is sick.

-Dave

I honestly kid thee NOT, Dave!!!!!!!!!!!!!!!!!!

[fab4fan]

Thanks, Dave. I also tried the, "the pt is terminally ill, so your point is moot" and "pain is a natural antagonist to resp depression" , but as I said, this was a doc that was a few IQ points short of being mentally challenged, so nothing I said worked.

When we can get to the point that pts with CNMP are treated as compassionately as terminal pts, ah, that will be a good day. But that's a long row to hoe.

[Dave ARNP]

When we can get to the point that pts with CNMP are treated as compassionately as terminal pts, ah, that will be a good day. But that's a long row to hoe.

AMEN

AMEN

AMEN

AMEN

AMEN!

-Dave

[Hellllllo Nurse, BSN, RN]

As a general rule, my Oncologists do an awesome job.

However, frequently when other MDs are involved, the end of life care goes down the tubes. We all know the story, family in denial at the end of "the long trip home" asks MD the feared question, "Isn't there ANYTHING ELSE that you can do?" and MD gets the much loathed renal/neuro consult. Neuro "thinks patient is oversedated" and takes away pain meds. Renal sees patient as a bunch of screwed up electrolytes yearning to be corrected and the patient gets a restricted diet (that they need like a hole in the head), fluid restrictions (like they can tolerate anything but liquids), and huge Mag/K+/Neutro Phos/Calcium pills (that they vomit up ...if they can swallow at all) and NO SEDATIVES!!!!!

I think that the family issue (You are going addict Daddy to Demon Drugs!) is a more difficult one to surmount. And you can educate the family, till the cows come home....and it gets completely undone from a wellmeaning consultant with MD at the end of his name.

Ain't it the truth!

[Hellllllo Nurse, BSN, RN]

Let's not forget the docs who agree to have a pt put on hospice, then order IV hydration for a pt who hasn't eaten in God-knows-how-long. Then, the docs just don't understand when the pt swells up like a balloon. Hint hint, docs- inability to tolerate food > low albumin > decreased oncotic pressure > anasarca when you order too much uneeded IV hydration!

Some "comfort" care.

[jemb]

The docs where I work are great! Our problem, too, is educating the patient/family that it is ok to take the meds. Some are afraid of getting addicted . Others think that a certain amount of pain is "normal", so until the pain becomes unbearable, they won't take the med.

(And, Caroladybelle, I believe you 100%. In fact, just reading your post gave me flashbacks to the little southern town where I was raised!)