Nurse's role in pain management in palliative patients

Dugogodišnje kronične i maligne bolesti najčešće dovode do fizičke boli i mnoštva drugih simptoma koji uzrokuju strah, depresiju i izolaciju, što utječe na osobni integritet bolesnika. Palijativni bolesnici zahtijevaju posebnu pažnju cijelog interdisciplinarnog tima s obzirom da njihova bolest ulazi u zadnju fazu koje su u većini slučajeva svjesni, te se radi o emocionalno zahtjevnom i iscrpljujućem iskustvu za bolesnika i njegovu obitelj. To je situacija kada se uz medicinsku skrb i zdravstvenu njegu treba suočiti i s njihovim psihološkim potrebama. Skrb za palijativne bolesnike je veliki izazov za medicinsku sestru koji zahtjeva aktivnu, promišljenu i dugotrajnu skrb, a krajnji rezultat cjelokupna palijativne skrbi ne vodi izlječenju bolesti, nego olakšavanju mnogobrojnih simptoma i neminovnoj smrti bolesnika. Edukativni cilj ovog diplomskog rada je naglašavanje uloge diplomirane medicinske sestre/tehničara u zdravstvenoj njezi i skrbi za palijativnih bolesnika, timskom radu u kupiranju boli-prepoznavanju potreba, uočavanju i rješavanju raznih problema koji se javljaju u bolnim stanjima kod palijativnih bolesnika na svim razinama zdravstvene zaštite. Diplomirana medicinska sestra treba biti educirana iz područja palijativne skrbi, a kod problema boli mora znati prepoznati bol i razlikovati vrste boli prema dijagnozama, sve načine kako ju olakšati (medikamentozna i ostala terapija), na vrijeme uočiti probleme i nuspojave terapije za bol te koordinirati razne stručnjake unutar tima kako bi pružili optimalno smanjenje boli kod palijativnih bolesnika. Prikazana je važnost sestrinske skrbi i komunikacije za palijativne bolesnike i njihove obitelji/skrbnike. Naglasak je stavljen na specifičnosti kupiranja boli kod palijativnih bolesnika, te stručan fizički, psihološki i socijalni pristup diplomirane medicinske sestre palijativnom bolesniku.Long-term chronic and malignant diseases most often lead to physical pain and a host of other symptoms that cause fear, depression, and isolation, affecting patients ’personal integrity. Palliative patients require special attention from the entire interdisciplinary team as their disease enters a final stage that they are in most cases aware of, and it is an emotionally demanding and exhausting experience for the patient and his family. This is a situation when, in addition to medical care and health care, their psychological needs also need to be addressed. Caring for palliative care patients is a major challenge for the nurse that requires active, thoughtful and long-term care, and the end result of overall palliative care does not lead to cure of the disease, but alleviation of many symptoms and inevitable death of the patient. The educational goal of this thesis is to emphasize the role of graduate nurses / technicians in health care and care of palliative patients, pain relief - recognizing needs, identifying and solving various problems that occur in painful conditions in palliative patients. A registered nurse should be educated in the field of palliative care, and in case of pain problems she must know how to recognize pain and distinguish types of pain according to diagnoses, all ways to alleviate it (medication and other therapy), timely identify problems and side effects of pain therapy, and coordinate various experts within the team to provide optimal pain reduction in the palliative patient. The importance of nursing care for palliative patients and their family, as well as communication with the patient, his family and other team members is presented. Emphasis was placed on the specifics of pain relief in palliative patients, and the professional physical, psychological and social approach of the nurse to the palliative patient