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Biomedical subjects

M E Greipp

Publications and source records attributed to M E Greipp.

14 recordsLinked to original sources

Undermedication for pain: an ethical model.

Ethical decision making for, and with, clients experiencing pain and needing narcotic analgesia is especially problematic as evidenced by research findings. This article demonstrates the application of Greipp's model to ethical decision making for clients experiencing pain. Particular attention within this model is given to learned potential inhibitors of the nurse as they influence the outcome (decision). The application of this model to decision making and pain management will generate further scientific inquiry by identifying the areas of breakdown in ethical decision making for and by clients experiencing pain so that remediation strategies may be planned.

Beneficence

Greipp's model of ethical decision making.

Nurses need to become more aware of everyday ethical decisions and the many factors which influence them in order to develop skills in this cognitive process. This author's model of ethical decision making has been designed and developed to illustrate an overall conception of the interaction between nurse and client within an ethical framework. This model lends itself to the examination of all factors which enter into the ethical decision making process: descriptive, normative and meta-ethics.

Beneficence

New thoughts on reflex sympathetic dystrophy syndrome.

Chronic pain caused by a sympathetic nervous system aberration must be considered separately from chronic pain resulting from carcinoma, arthritis, neuropathies and other delineated pathology. Because the pathophysiology of these conditions and their associated pain can be explained, treatment modalities can be planned specific to the affected individual and targeted toward the altered physiology. If the pathophysiology is not clearly defined or understood, as is the case in reflex sympathetic dystrophy and other idiopathic pain conditions, then prescription and remediation become a challenge for the healthcare professional and client. New thoughts on the clinical findings, pathogenesis, diagnosis and prognosis are evolving, with inherent implications for neuroscience nursing.

Humans

Reflex sympathetic dystrophy syndrome: a retrospective pain study.

While reflex sympathetic dystrophy syndrome (RSDS) research is lacking and the pathophysiology remains obscure, it is known that it affects all age groups with the common overriding complaint of severe, unrelenting, burning pain. It seems to be triggered by trauma (major or minor), including more central events such as myocardial infarction, cerebrovascular accident and tumours. Diagnostic characteristics of RSDS are: spontaneous burning pain, hyperalgesia, vasomotor disturbances, exacerbations by emotional upset, occurrence either spontaneously or after minor injury, occasional spontaneous resolution, extension to other body parts, and relief by sympathetic denervation. The problem may recur after earlier resolution. The problem for this author, and others, is the discrepancy between what appears in the literature and what is evidenced in clinical practice. What is being observed is a large number of individuals with RSDS who are not easily treated or cured. The problem for some clients becomes one of total body involvement, with severe incapacitation related to the constant and intense nature of the pain and the accompanying alterations in mobility. This author and two colleagues designed and conducted a study of clients registered with the RSDS Association to delineate the magnitude and long-term effects of RSDS in this sample.

Adolescent

Reflex sympathetic dystrophy syndrome: pain that doesn't stop.

This article describes reflex sympathetic dystrophy syndrome and how the nurse's role in early identification of the syndrome can help break the vicious pain cycle these patients experience. Nursing care plans must be directed toward providing emotional support and encouragement, maintaining and/or restoring mobility, and establishing adequate pain control.

Female

Klippel-Feil syndrome.

Nurses working with orthopaedic clients and pediatric populations may be the first to recognize the classic triad of Klippel-Feil syndrome: short neck, limitation of neck motion, and low occipital hairline. Klippel-Feil syndrome is a congenital malformation of the cervical vertebrae, with limited treatment options. Client/family education is vital to monitor and maintain function and to prevent neurologic deficits resulting from the fusions, accidents, or trauma.

Activities of Daily Living

An innovative approach to orientation: faculty preceptors.

The Faculty Summer Preceptor Program was instituted in the summer of 1987 to assist with the orientation of more than 200 newly employed graduate nurses at Thomas Jefferson University Hospital in Philadelphia. Plans had to be made to assist the staff in assimilating this large number of orientees without disrupting patient care delivery. Preceptorships were used extensively in nursing services during the past 10 years. A major advantage of using faculty is that they are very familiar with new graduates' skills, anxieties, and needs, and the faculty role closely corresponds with the role of the preceptor. The faculty is a "ready made" resource for nursing staff orientation.

Humans

Nursing preceptors--looking back--looking ahead.

With existing staffing shortages, it is time to rethink positions on important issues affecting nursing practice. One of these issues is the use of preceptors for orientation needs. Nurse educators need to decide if preceptor programs, complete with a well-defined selection, preparation, and reward process are in place.

Humans