The ethics of postoperative pain management: Mapping nurses' views.

AIM: We explored the positions of nurses working in hospitals regarding the acceptability of refusing to give a repeat dose of painkiller to a postoperative patient who requested it. These positions were compared with that of lay people, physicians, and other health professionals. DESIGN AND METHODS: Factorial design was used to assess the impact of 6 situational factors: the patient's age, the current level of pain as assessed by the nurse, the number of requests, the level of risk associated with the administration of a repeat dose, the outcome of surgery, and the giving of alternative mild analgesics. We implemented a combination of scenario technique and of cluster analysis. Data were collected from April 2013 to December 2015. PARTICIPANTS: 138 registered nurses, 32 nurse's aides, 33 physicians, 23 psychologists, and 169 lay people participated in the study. RESULTS: We found 4 qualitatively different meaningful positions. A plurality of participants (57% of nurses) considered that refusing was not acceptable, irrespective of circumstances. A substantial minority of participants (but 52% of physicians) considered that refusing was acceptable only if the level of pain was low and the risk was high. Other participants (mostly lay people) considered that refusing was always acceptable each time a risk of side effects, either serious or simply mild, was present.

Positions of French Nurses Regarding the use of Hypnotherapy to Relieve Pain in Postoperative Settings.

The objective of this study was to carry out a detailed mapping of the different personal positions of French nurses concerning the practice of hypnotherapy. Factorial design was used to assess the impact of 4 situational factors: type of postoperative care and degree of pain associated with it (chemotherapy, wound cleansing and bandaging, or body grooming that leads to pain on mobilization); whether paracetamol (also known as acetaminophen) was administrated along with hypnosis or not; professional credentials of the hypnotherapist; and patient's identity (adult, young person, elderly person, or young person with learning difficulties). A combination of scenario technique and cluster analysis was implemented. Participants were 91 registered nurses and, for comparison, 19 nurse's aides, 9 physicians, 5 psychologists, and 77 laypersons. Seven qualitatively different positions were found. Only a minority of French nurses were convinced that hypnotherapy is an indisputably acceptable practice in postoperative care. Most of them were indifferent to the issue as long as pain medication was used. Nurses' views appeared to be similar to physicians' views.