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Ethical Reflections Assignment NURS 501
While I worked at Walter Reed National Military Medical Center, I had a patient with
chronic compression of his celiac artery, which resulted in constant excruciating abdominal pain
that was only relieved with IV narcotics. During the patient’s initial hospitalization, he had to
receive several abdominal surgeries with the hopes that it would improve his condition and bring
him some level of relief to manage his pain from day to day. Unfortunately, despite his surgeries,
his pain persisted. Fortunately, we were able to manage his pain well enough after he recovered
from his surgery to be discharged to a facility that we had where servicemembers could stay for
extended periods if they were receiving additional treatment. Regularly, this patient would have
episodes of excruciating acute on chronic abdominal pain exacerbations. He would then present
to the emergency department and request narcotic pain medication. At this point, it was routine
for him to present to the ED whenever he had a pain crisis. This time had been different because
they were giving him a more difficult time getting a prescription. Additionally, they were
counseling him on the overuse of opioid pain medications. When we discussed this after he was
admitted to our unit, he explained that this was his final time dealing with this process. He
wanted to come off all narcotic pain medications he had been receiving “cold turkey” so that he
could go back home to his family. This was the first time in my career that I felt I could not
provide my patient with the best care. This was not necessarily because I was not providing
quality patient care. Still, it was instead because of the stigma my patient had been given, only
because his pain was not being effectively managed. That evening was challenging for me
because my patient was actively going through withdrawals because of his long-term opioid use
for pain management. He was having nonretractable nausea, vomiting, and diarrhea while having
uncontrollable chills. He could only experience relief by curling up into a ball in the shower
while water ran over him.
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Ethical Reflections Assignment NURS 501
The situation I encountered with my patient felt like a grave ethical injustice and a failure
in pain management and overall satisfactory patient care. Although pain management is a
complicated thing to treat, this whole situation could have been approached more proactively.
There were many breakdowns in communication between all levels of disciplinary care, from the
providers in the Emergency Department to the inpatient and surgery departments. The patient's
pain management needs were not adequately addressed, and this experience has taught me to be
much more aware of my patient's pain management needs and to be an advocate for them early
on in their care plan. The patient's reliance on narcotic pain medication could have been
significantly reduced if acute pain services had been consulted and better pharmacological pain
management modalities employed. Moreover, opioid narcotics do have an essential role in pain
management, but there are also ways to use other pharmacological pain management modalities.
There is a need for proactive pain management, and we need to be more compassionate and
respectful towards our patients and try to understand the root of their issues. According to
provision one of the ANA code of ethics, we should treat all patients with dignity, respect, and
compassion, and in a recent position statement on the nurses’ professional responsibility to
promote ethical practices (Stokes, 2023). The protection and the promotion of human This
experience has taught me the importance of following this provision, which is crucial in
providing satisfactory patient care. Some other factors that contributed to the difficulty of
managing this patient's pain are that surgery is only found to have a success rate between 50 and
86% (Woestemeier et al., 2023). Furthermore, upon my research on this condition, it is
exceedingly rare and can be misdiagnosed as psychogenic abdominal pain and is mainly
diagnosed in females (Urata et al., 2022). My biblical worldview regarding this particular patient
scenario is one of sympathy and compassion, 2 Corinthians 1:3-4, which states, “Praise be to
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Ethical Reflections Assignment NURS 501
God and father of our Lord Jesus Christ, the Father of compassion and the God of all comfort,
who comforts us in all our troubles so that we can comfort those in any trouble with the comfort
we receive ourselves receive from God” (ESV, 2016). This appropriately reminds me that we
need to lead our patient interactions with compassion. The things that can be done in the future
are to take the patient’s chief complaint seriously and agree with the patient. I will do my best to
ensure they feel heard and treated appropriately. In conclusion, this experience has made me
more aware of the need for effective pain management and the importance of adequate
communication between disciplinary care providers.
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Ethical Reflections Assignment NURS 501
References
Bible Gateway (2001).DThe Holy Bible: English standard version(2016 ed.). Crossway Bibles.
Stokes, L., PhD.J.D.R.N. (2023). ANA Position Statement: Nurses' Professional Responsibility
to Promote Ethical Practice Environments.Online Journal of Issues in Nursing,28(1), 1
13.https://go.openathens.net/redirector/liberty.edu?url=https://www.proquest.com/
scholarly-journals/ana-position-statement-nurses-professional/docview/2779948719/se-2
Urata, E., Fujikawa, H., & Ishimaru, N. (2022). Celiac Artery Compression Syndrome: An
Overlooked Cause of Abdominal Pain. Balkan Medical Journal, 39(1), 71-72.
https://doi.org/10.4274/balkanmedj.galenos.2021.2021-9-100
Woestemeier, A., Semaan, A., Block, A., Arensmeyer, J., Dohmen, J., Kania, A., Verrel, F.,
Mücke, M., Kalff, J. C., & Lingohr, P. (2023). Prognostic factors for the long-term
outcome after surgical celiac artery decompression in MALS. Orphanet Journal of Rare
Diseases, 18. https://doi.org/10.1186/s13023-023-02952-7
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