Nurses and Depression: An Essay

Nursing and depression are a strange pair of entities that intersect at various points of the compass. Yet the nursing profession continues to walk an uneasy line between comprending depression as a patient symptom and experiencing depression  as a career side effect. Today nursing stands at a pivotal place in history, with academia, the origins of medicine, and progress pulling the threads of nursing theory every which way.

Nursing is a time-honored institution whose origins claims famous feminist icons such as Clara Barton, Margaret Sanger, Mary Breckenridge, and Florence Nightingale. But the feminist mystique itself has oudistanced the treatment and conventional wisdom surrounding depression as a medical concern. Depression, and the treatment of depression, for many people, can be a difficult concept to grasp. Depression is a psychiatric disorder of the mind and psyche which affects persons undergoing medical treatment, but can also originate as a harbinger of other diseases. Depression has almost become a slang term in the pop culture vocabulary used casually to descrive feeling “down”. Yet as a medical denominator, the presence of depression  is serious business.

Depression can be a symptom as well as a diagnosis. Yet the physical side of the medical and nursing fields can often override the psychological of many wellness crises. Conventional wisdom usually trumps academic progress. Commercial pharmaceutical treatment usually beats out long-term alternatives, and little endorsment is given to nontherapeutic analysis. The medical institution as a whole functions mostly to heal the body, and the psycho-analytic milestones in healing don’t keep pace with the limitation of treatment access options for the afflicted. Dabbling in depression doagnosis is seen as specialist referral stuff. Medical professionals are all too familiar with these “rules of the road”.

Both doctors and nurses are more comfortable in general discussing medical symptoms according to a pathology of pure anatomy and disordered functions of the body. This is their clinical training taking over. This is understandable, as many facets of the psychological applications of depression treatment color between the lines of many disciplines. And ad hoc experimentation in the world of treatment for depression is uually not rewarded from a multiple of perspectives.

Too often, physicians skip over depression as a treatable illness and focus on the more concrete diagnoses of the body. In many cultures, psychological illness still carries a stigma from periods of civilization where too little was known about the causes and origins of depression. The onus of depressive symptoms as ‘”madness” still  remains.

Early man used drugs, societal separation, and medicinal forms of witchcraft to “treat” early forms of depression. Later cultures shipped mad people offf to sea, in groups, on a Ship of Fools”., Relying on God to guide their destiny. Sigmund Freud and Carl Jung introduced a standardized form of psychological vocabulary to the medical world, and contemporary man has distinguished himself by pursuing depression in its various guides as a clinical and scientific study for decades.

Today, studies connect depression and everything to sleep deprivation, opiate addiction, anorexia nervosa, Post-Traumatic Stress Disorder, and more. Prevention of depression and observing symptoms of depression, are now a key element of physician treatment advice. The dynamic of career choice has affected medical workers, doctors, and nurses as the practices began to take on occupational definition since the late 1600’s. Medicine  as a discipline has undergone radical reforms from it’s early days. The “physicking’ of another person began to take shape not just as a career for learned man, but as an occupation for educated men and individuals in search of a paying career. While the first doctors of this type were from the most elite classes of scholar and the most wealthy set of people in every culture, religion as  a passport to medical practice admitted religious elders to the treatment of others in more than one tribal civilization around the globe.

Many early teaching institutions centered around the scholastic training of doctors, priests, and teachers. The estimation of a physician was often ruled by his breadth of knowledge of medical studies and material of a religious nature. The indoctrination of a scholar in religion was thought to cement the ethics required to operate a medical practice and found the personal ethos necessary for treatment of other persons, conscious or unconscious. The access to the metaphysical world that many cultures connect with physical wellness allowed this transmutation of disciplines to coexist for many centuries.

The ethics associated with physicianship caused male scholars in the early 1700’s to pledge their scholastic faith in religion, as a going rates of “dues” cementing Christian ethics to the science of treating the bodies of other people. But as Calvinism, the teaching s of Martin Luther, and other religious doctrines took shape, the emergence of a new class of doctor purely to treat the physical malady emerged. The doctor as pure scientists emerged. Marie Curie and her husband were examples of this kind of doctor, who practiced their science without allowing religious culture to dominate their thinking. Doctors were thought of as esteemed members of the community, the equal of all but the highest echelons of the social order. Doctors are respected in every type and section of population where high level of education, practice of any differentiated culture, and necessary acknowledgement of the body of knowledge required and the commitment necessary confers a certain prestige.

In the succeeding centuries, academic studies have dominated the world of organized medicine. Then the business world took over mass medicine, and the world now has become a globalized client of large scale medical insurance companies. The patient is not always the client, as doctors usually are the ones that pharmaceutical companies look to for sponsorship of their treatment of new type of medications. It is the nursing profession, and nurses in particular, who deliver the front line of medical care and therapeutic attention to patients. It is the nurses in the medical world who are the ones that patients interact with the most.

But as the nursing career as a lifetime occupation has developed as a paying gig, the culture of acceptance and respect may not have been as evolved. The participation in medical profit for nurses has not followed along with that enjoyed by physicians working half the amount of time per week.  While nurses do the “heavy lifting” of patient care, their compensation is not commensurate with the time spent and sacrifices required of someone who has embarked on a nursing career. Nurses may work unpaid overtime, stay late, and do extra work, but nursing pay generally doesn’t always reflect this contribution. Ensuing generations of nurses will decide if more reform is in order.

 

 

 

 

 

 

What Nurses Need to Know About Cutting

Chronic consitions anf acute care crises are not the only area in which nurses serve their patients. Nurses must be vigilant to observe compulsive and dissociative disorders beginning among their patients in care. When a patient is at risk for harming themselves, the situation becomes a health care crisis.

Patients under monitoring will exhibit patterns of normal behavior. Then changes in a patient’s habits will stand out.  One aberrant behavior that signals the need for attention is cutting. Cutting may sound odd, even absurd to most people when first encountering the medical disorder. But cutting is no laughing matter. It can affect housewives, adolescents, students, and profession people of all ethnicities  and at every education level.

Yet the  problem of cutting is more widespread than thought at first, although experts cite early underreporting as a major factor. Many caregivers may not wish to risk their position on an intervention. Irregular nursing staffing can result in turnover that prevents consisted reliability between caregivers with an opportunity to see cutting symptoms.

Cutting is a problem that has become a recognized part of the vocabulary of disorders and psychological signs of emotional distress in people. Striking mainly juveniles and adolescents, cutting is a practice where the physical mutilation of the skin serves no purpose but abuse. Cutting flourishes in environments where body checks and inconsistent observation is the norm.

Both women and men suffer from cutting. The inclination will start small, and the disorder will build as the victim of cutting behavior learns to harm themselves routinely. Cutting may be hidden by hobbies such as carpentry, fishing, sports, and crafts where cuts and abrasions can be shrugged off as casual. Where cold weather can conceal skin condition, nurses should urge patients to change into a gown for evaluation. Many doctors who skip the full-body evaluation can miss the signs and symptoms of cutting right under their nose.

Cutters are trying to treat their emotional pain. The individual will start to experiment and transfer feelings of emotional pain to a physically concrete manifestation of cuts, bruises, lesions, in areas not regularly seen by others. This is regularly in the lower arms and forearms, which can be hidden by long sleeved clothing. The individual will withdraw from normal social activity if it reveals their cutting scars or lesions.

Therapy for cutting involves multiple disciplines. Treatment involves  confronting the cutter in a safe space and  from their caregivong usually takes the form of two tiers of treatment. Skin cuts are treated for infection and bandaged, and mild painkiller is prescribed. Psychiatric examination and counseling make up the other part of treating cutters.

It would seem that those in metaphorical pain would avoid seeking actual pain. Yet for many this is bringing their pain into the open. Wound care nurses should be wary of patients who pick at scabs or worsen wounds and lesions between dressings.   Yet the exhilaration and catharsis of the cutting ritual allows the individual to achieve emotional release from psychological pressure. Cutters can form bonds with website friends online part of the cutting world.

Cutting is usually done by persons who feel helpless to control important aspects of their lives. Cutting is generally a shameful secret they hide. Cutters should not be condemned, but take in recommending the case for treatment. Friends should report this to a doctor or physician for further investigation.

Signs and symptoms of self-injury may include dermal scars that can be seen in those who have been practicing the self-abuse of cutting for some time. Referrals to the appropriate speciaist are encouraged.

Cutters may distinguish themselves by having sharp objects like pins, knives, switchblades, or razors on hand. They may be seen to wear long sleeves on their arms  and long pants unseasonably in hot weather. Cutters often exhibit difficulties in having close friends near, or holding long-term friendships or have difficulties in interpersonal relationships. The intimacy and familiarity required in these relationships make it difficult for the cutter to hide the cutting habit.

The habit of cutting may become a compulsion for some , one they wish to hide. Conditions in the cutter’s life may lead them to question their existence and voice thoughts of hopelessness or confusion. Stressful life events such as loss of a loved one, decline in social contacts,and new changes in negative life experience may signal a potential for cutting.

The patient or individual will mull over questions about his or her personal identity, such as “Who am I?”, “Where am I going?,  “What am I doing here?” They may exhibit panic and confusion when confronted with obstacles.  Nurses should be alerted to patients with pronounced skin conditions and the above mentioned problems.

Patients involved in cutting behaviors will experience behavioral and emotional instability, such as uncontrolled crying or mood extremes.  Cuters may ecperience problems with impulse control, and be subject to violence aggressiveness or other taboo behaviors. Cutters form a new routine, replacing the chaotic unpredictability of their problems with the “control” of the cutting instigation.

There may be a detectable change in patients, from an external viewpoint. . A patient who usually goes out for a walk or shops with friends and suddenly elects to stay in or avoid phone calls may be a patient considering cutting or performing the cutting practice as a way of coping. The cutter’s disorder is marked acute when the individual finds solace or relief in cutting.

Nurses should discuss with the charge nurse, roommate, staff nurses and social if they have overheard the patient make statements of helplessness, hopelessness or worthlessness. Futility and despair are the emotional hallmarks of a cutter. Intervention is only possible if the caregiver or nurse steps in and speak up.

Nursing and the Wound Care Dilemma

Wound Care in recent years has become big business. As a medical specialty group wound care has grown into a competitive market of the larger medical services provider industry. Wound care has also made a name for itself by providing mobile services. For many at-home patients and institutional clients without in-house debridement doctors, this is a winning solution.

But many patients receiving wound care by such onsite providers have to wrestle with a whole new set of problems. Because of the frequency and the proximity of the new surgeon’s provider visits, this brand-new physician now rules over the patient’s care plan. This random new doctor now is the most influential surgeon in the patient’s orbit.
In the medical world, certain conventions of eminence and integrity are assumed. A physician is generally esteemed by the level of education attained, the prestige of their academic credentials and their source, and the work history performed after graduation. The prestige of the places a physician works after graduation and the relative importance of their work experience determines the opportunities in the medical industry. This also predicates their authority in future patient care giving advice.
The occupational issues the physicians will come up against in the medical community will be a reflection of their formal training. But a position in wound care is due to years spent practicing in the field of wound care medicine. This standing
comes after years, sometimes decades working in professional medical care. Patients receiving wound care services almost never choose the doctor or know anything about them, unlike other types of doctors.
Mobile wound care surgeons analyze the condition of the skin. They measure and record the size depth and breadth of wounds and infected areas. The debridement surgeon can advise new courses of treatment. The wound care surgeon can also discontinue applications if treatments he or she finds detrimental or causeless. They may dismiss effective regimens without a second thought.
Soon the orders for the wound care may bear no similarity at all to the most successful and most impactful wound care regimens the patient has known. No other services can be authorized anymore. The patient is cornered. Then in addition to the discomfort and trauma of heavy infections, the wound care patient is twice over a victim. He or she will be left scratching their head, wondering ‘How did I get here?’

Medical provider services are part of an industry that makes money not doing its job. The more disorders, wounds, lesions, and infection that occur, the more money the hospitals, clinics, and services providers make. Of the gargantuan corporate behemoths that run modern medicine, all of them run on a modern theme: Sickness is an income opportunity.

Wound Care is a segment of an industry that nevertheless subscribes to business drivers that try to curry relationships with their business-to-business clients. In this particular, the patron is the long term care facility or Home Health corporation the patient belongs to. This means that a side contract is attached to the agreement between the physician and the patient. In the B2B world, this means that the interests of the facility and their case management prerogatives come before the wishes of the patient. While the patient may be under the impression that they are in partnership trying to improve their wound care ailments, the real boss of the situation is the facility or Home Health provider management.

This is a dilatory arrangement, as the patient will take consideration of other providers’ advice, including that of the PCP, assuming ongoing wound care success. They may discuss and develop the care plan with a projection of straightforward cooperation from the wound care service. But this assumption may be unwarranted. After making communications with other physicians regarding treatment, medication, and new therapies, the patient may find that the care plan is the victim of a hostile takeover.
Now the patient has heard so many different opinions about her case she feels seasick. After years of listening to persuasive opinions about treatments, the pendulum never rests. There is an endless cycle of wound care referral, the provider’s care initiation, the physician’s kindly bedside manner and befriendment. Then comes the sales pitch, the heavy sell, the isolation from other treatment doctors, and then the coup de gras. The wound care physician announces “It’s my way or the highway”, and the patient wonders how they got into this mess.
Now, all the documentation sets up the wound care provider as the decision-maker of the care plan. Nurses would do well to assist patients in coping and dealing with their doctors double-crossing them. Nurses and counselors should update case managers and family members if the observe patients feeling upset and confused by unsuccessful efforts to make their wishes understood. The concept of respecting resident rights is one that nurses should apply very seriously to all their charges.

The wound care physician now holds the upper hand and if the patient does not obey orders, the doctor can fault the patient for not being compliant. This can discredit the patient with the medical insurer. Documentation like this can risk the patient losing their medical coverage.
All of the assurances and advice that the patients received when other physicians were following the along the case somehow now gets lost. And it is surely a sheer coincidence that the recommendations of the most recent wound care visits dovetail with the least cost scenario for wound care treatment.
Nurses should recognize when patients feel distressed about any treatment they are receiving. But the impetus of hospitals and long term care facilities is to allow the business drivers of any medical care instituion have the last word.
Nurses today must decide whether to honor patient wishes or put the fiscal gains of their employer first.
This is the wound care dilemma for nurses. To step forward, and help, or do nothing, and hinder the situation. Nurses must acknowledge when the transparency and quality of patient care is compromised by the absence of patient consideration. Nurses must also operate with loyalty toward their employer. For nurses experiencing the above referenced type of scenario, serious reflection should ensue. These issues should make nurses everywhere advocate for patients who are getting manipulated by the ‘system.’
And professional nurses will serve their ethics best by obeying traditional standards of nursing handed down by generations. Namely, to put patient health, welfare, and recovery above all other considerations. Monetary and otherwise.

Pyoderma Gangrenosum

Pyoderma Gangrenosum is a serious condition of the skin commonly denoted by cellulitis, ulcerous lesions, or wounds. Daily or weekly dressings are required as well as frequent I.V. infusions to combat secondary infections.
Pyoderma Gangrenosum is an exclusive diagnosis. This is unfortunate, as it leads many temporary and urgent care physicians to bypass the seriousness of the damage by referring to the lesions as ulcers, skin tears, and other superficial tissue damage events to the dermis and subdermis. Pyoderma Gangrenosum lesions are characterized by erosion of healthy via an enlarging or group of lesions. As the skin and nerves deteriorate the intense and the copious drainage make the patient’s life difficult.
Pyoderma Gangrenosum treatment plans require an extraordinary commitment of resources, supplies, nursing hours, consult dates, I.V. PICC line insertion, and even hospital stays or Emergency Room visits. The consult visits can become highly technical and a patient with Pyoderma Gangrenosum is well served to obtain a client advocate to meet their needs.
While Pyoderma Gangrenosum does present a flat-edged, wide-lesion wound area similar to some kinds of bed sores, they are much more infectious and extremely susceptible to Sepsis, C. differens infections and contagious MRSA infections. Pyoderma Gangrenosum patients should observe the best possible hygiene and infection control standards possible. Powdered, sterile, and/or Latex-free gloves must be worn by physicians and consultants present at an examination of the wounds or during any wrapping or re-wrapping of the wounds.
General advice given to patients with Pyoderma Gangrenosum is to diet, lose weight, exercise, and elevate the legs if the affected area is in bilateral lower extremities. Daily or twice daily dressing changes may be ordered as the drainage demands. Because the drainage causes the periwound to succumb to ongoing maceration, when the patient feels the bandages fill with liquid, they must report this to the nurse for a wound care session. Nurses must grow accustomed to checking in with the patient about how the wounds are draining and when another dressing is due. Such patients should be monitored for pain to allow direct contact with the wounds at the scheduled wound care time.

Gloves should be worn by all nursing staff during dressing changes, and even by the patient. Washing and shaving of the skin in the periwound may be necessary. Bathing should only take place immediately before a scheduled dressing change to preserve best standards of infection control.
During the wound care dressing change session, light bathing of the periwound skin can be conducted before placement of sterile topical gels and creams. For the heated skin symptom that often accompanies Pyoderma Gangrenosum, Silvadene silver cream has been shown effective to soothe the extreme pain present at the wound sites.
Because of the erosion of skin and nerve tissue during infection, a regimen of nerve pain medication is advised. Baclofen or Neurontin may be part of a 24 hour cycle of pain medication. NSAID therapy can also be used to lessen potential dependence on PRN opiate painkillers. As the Pyoderma improves or the skin infection conditions worsen, this regimen may need to be adjusted.
Pre-medication may be required for dressing changes when nerve and tissue damage has been severe. The pre-medication order should be arranged by the debridement doctor, the consulting physician, or the patient’s Primary Care Provider. Perspiration through hair follicles draws bacteria into the skin. Shaving and bathing of patients should be coordinated with nursing aides or personal residence staff accordingly.
Any situation where total cleanliness of the wound dressing area and sterility of medications is not present should be reported to the wound care team or the charge nurse immediately.
Although the Pyoderma lesions may present as what some nurses might consider mere “Pressure ulcers” that is not what they are.

Pyoderma Gangrenosum is not “gangrene”, as more ignorant members of the medical field are slow to grasp. Instead the Latin term refers to the spread of the immune disease through the tissues. Pyoderma can often be co-existent with systemic infections such as respiratory tract infections, colitis, cystic acne, and sepsis.
Treatment of Pyoderma Gangrenosum is a multipartite, multilayer effort best done with cooperation of the primary care provider, dermatologist, infectious disease specialist, vascular surgeon, and wound care team. The more sophisticated physicians in metropolitan and urban areas will have the experience treating pyoderma.
The systemic approach to ridding the body of pyoderma gangrenosum is to introduce as many cycles of antibiotic therapy as possible. Identifying the treatment method and material to be used is best done using blood tests and wound culture analyses from the affected lesions.The concurrent treatment for extreme site pain, nerve pain, and control of blood sugars must keep time with the infectious disease treatment.
A typical treatment therapy might be Vancomycin and Doripanem via intravenuous infusion, Bactrim
daily as oral antibiotic, and topical treatment of the skin lesions using the complementary spectrum of hydrogels as appropriate.Other nedications may be assigned as they register in sensitivity to the bacteria from the lab culture.
Sometimes Doxycycline or Cyclosporine is used to treat the Pyoderma condition. A key part of any treatment plan for a systemic condition of Pyoderma Gangrenosum is Prednisone. This use of a steroidal supplement can functiom to arrest the immune system disorder that causes the Pyodermic lesions to erupt. While an initial dose of Prednisone therapy can effectively battle back the worst of new lesions forming, the ongoing struggle to keep blood sugar low continues. Without controlled blood sugar, infection treatments will have
The would culture lab result will point the wound care team in the right direction concerning the effective treatment plan and schedule for wound care changes. One new and trending treatment is Tacrolimus to temper swelling and infection control. New studies have shown that Tacrolimus mixed with the Hydrogel Mupirocin retain highly effective resistance to pseudomonas, a common secondary infection.
Because Pyoderma starts as a lesion with no origin, many physicians and nurses speculate about the patient having contracted Pyoderma Gangrensum through contact
with pets or other animals. Dogs, for example, have been diagnosed with Pyoderma Gangrenosum. Due to the very high probability of bacteria contagion, victims of Pyoderma Gangrenosum cannot live with pets and expect any certain degree of recovery.
It requires a well-educated and proactive physician set to envision and implement a care plan for this disrase. The therapeutic relief of Pyoderma Gangrenosum. needs a patient and consistent evaluator of the effectiveness of current therapies. The patient may not always be ready to hear that a certain medication, device, or treatment is no longer working. In some cases a patient suffering from Pyoderma Gangrenosum will be referred to an amputation and limb preservation clinic for evaluation.

Chronic Pain Syndrome

A severely challenging condition threatening patients today is chronic pain syndrome. This occurs when various parts of the body and mind come together is a constantly recurring cycle of pain throughout the body. When it occurs, chronic pain syndrome can also affect certain areas of the body after they have been injured, wounded, or operated upon. The pain can be general or it may be concentrated, such as in the temples, legs, hands, or chest and back. A skilled physician experienced in observing chronic pain syndrome can assign this diagnosis and track the symptoms in their quality, severity, and consistency.
The hard part about treating chronic pain syndrome is that to many people it sounds like the typical complaining any patient might do. But the persistence of this kind of pain, its general presence, and the way it avoids being treated by drugstore or over-the-counter painkillers is one clue that chronic pain syndrome is present. Another trait of chronic pain syndrome is that it can subsume after a burst of general health, but then after a period the overall condition can suffer. The patient’s health will weaken and then the chronic pain syndrome can re-emerge when the patient’s overall sense of well-being or general health correspondingly weakens.
For reasons such as these, people in the main confuse chronic pain syndrome with “getting run down”. People in good health maintain regular cycles of endorphins and a balance of hormone. But depression and chronic pain sufferers actually alter the chemicals in their body and brain over a period of time when their behavior alters. Self-injury and accidents can occur as patients become more clumsy and careless dealing with another day in pain. Their impulses to deal with their stress and pain do not take healthy roads and the results can be seen in the way people stop taking care of themselves.
But with chronic pain syndrome, damaged nerves can keep up live pain enactions upon the central nervous system and mind long after the flesh and other damaged or diseased areas have been repaired. The axons of neurons keep firing and “informing” the brain of pain that in fact is no longer being inflicted. The patient feels pressure and the slightest sensation with a magnification that few nurses initially can credit. Just getting dressed, driving, and/or working activities can be physically and mentally impossible for some patients with chronic pain syndrome.
This can affect patients recovering from a long disease, suffering from other conditions at the same time, or suffering from chronic pain as a complication of other conditions, wounds, or diseases of the body. The physical treatment of the chronic pain syndrome also involves attention paid to the creative fulfillment, intellectual stimulation, connection to nature and energetic physical endeavors of the patient to put balance back into their routine. But many patients suffering from chronic pain syndrome are not ready for these interventions yet.
Not by medication alone can chronic pain syndrome be treated. And in some cases, patients will report as few as a two to three hours a day or even in one week when they can handle activities such as writing, reading, reviewing accounts, discussing business affairs, or even concentrating on complex ideas or complicated matters. The patient recognizes this loss even as they battle it being lost. The mental attitude of a chronic pain syndrome patient cannot convert chronic pain into nothingness, but a sharpened perspective and a better-motivated alertness to the positive side of things can assist in keeping the chronic pain from controlling and ruining one’s life.
Nurses taking care of patients with chronic pain syndrome will have some difficulty moving them out of a mode of lethargy and into a spirit of motivated exercise. Movement is a key way to change the ingrained tendencies toward “moping” and dwelling on the pain that chronic pain syndrome involves. Patients such as this need to be urged to get out once in a while, make lists of things they like to do and schedule them. Sufferers of chronic pain syndrome must take an active role in combating the wear and tear of the disease. The behavioral aspect of their choices can overtake their neurobiological symptoms.
Chronic pain patients, especially the elderly, develop patterns of coping with their pain that may not seem helpful to outsiders. But survivors of wounds, attacks, diseases, and other complicated life events will nurse problematic chronic pain conditions for the rest of their lives. This is in contrast to the acute care approach to many painful issues in the otherwise straightforward assistance that urgent care patients receive. But long-term care and elderly patients will usually have an onset of chronic pain syndrome with the severely worsening of arthritis, osteoarthritis, sciatica, and back pain.
Unfortunately, not a lot of physicians train or prepare their patients on how to deal with chronic pain syndrome psychologically. Pharmaceutically the plan of care can treat the pain as it occurs or worsens. But the ongoing struggle with the challenges of chronic pain syndrome, complex and long standing, are unique to the individual patient in many cases. Because many chronic pain sufferers avoid public places, noise, chaotic events like concerts or music clubs, and unpredictable and physically demanding environments, they develop a coping system of this avoidance and they become viewed as “shut-ins”. The outsider observes the behavior of avoidance and misses the fact that there is reason and a pattern of behavior behind it. The patient is just trying to avoiding trigger situations where their chronic pain can be set off.
Nurses can keep an eye on their chronic pain syndrome patients and counsel them about their health. Nurses and case managers can provide helpful advice about how to spend their free time as well as enhance the attention paid to details other than their vital statistics and medication schedules. Such patients may be suffering from depression because of their inability to deal with their chronic pain syndrome. Nurses spend a good deal of time talking with patients. They hear how the patients speak of themselves. These patients may need to learn to interrupt negative belief systems, they may need encouragement and praise, and they may need to find ways to reward themselves and learn new ways of spending their time.
Sufferers of chronic pain may give out signals that friends and relatives do not understand. And chronic pain sufferers do not like to advertise how much pain they are in. They can mask their problems with overeating, Internet surfing, “quick-hit fixes” like smoking, video games, light movies or soft drinks. These activities can hijack feelings of serious ongoing pain in extremities, the temples , in the lower back or neck, et cetera. Sufferers of chronic pain may not understand that they have a serious problem, and may simply put their issues down to emotional problems or being unsuccessful at functioning to a higher standard.
Patients dealing with chronic pain syndrome will plot ways to avoid dealings with their pain by avoiding exercise or going out, to compare themselves unfavorably with others. They know their health is in decline, they just may not understand why. Chronic pain victims will isolate themselves and often appear erratic and eccentric. Chronic pain sufferers can cope with sudden and uncontrollable pain by stomping their feet,(to displace nerve pain) drinking, (to numb the nerve pain) watching TV, (for distraction), playing music (to give the pain white noise to play against) , and/or driving too fast, (because they can’t control the pain in their limbs and leg nerves). Or, when suffering from unpredictable intensities of chronic pain patients may cancel appointments and social engagements because they can’t anticipate when the pain will peak.
The solution to a problem with chronic pain is to concoct a care plan with many moving parts . This plan then becomes the patient’s responsibility to keep those moving parts improving and going, growing and becoming better. These are significant goals that can alter the quality of life for sufferers of chronic pain syndrome. The many motifs in a successful care plan for chronic pain syndrome are simply a roadmap to access all the information involved and plot a best case scenario. A nurse can assist any patient in the parts of the care plan they feel most comfortable with. Sometimes just visualizing a better frame of mind or achieving small goals can be helpful to the health of the patient. Nurses should refer their patients showing symptoms to chronic nerve pain specialists, or care plan managers.

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