ANNP 8030 Clinical Management FNP

ANNP 8030 Clinical Management FNP essay assignment

ANNP 8030 Clinical Management FNP essay assignment

  1. You must reply to one article posted by a peer in your group.
  2. You must post by the due date stated on the course schedule.
  3. Your reply must be thoughtful, well presented, in complete sentences and applicable to the topic at hand (not just “I agree or disagree”). Reply should be approximately 100-250 words. Ideas include but are not limited to the following:
    • An alternative opinion (please provide a reference for your opinion if needed). For example, if you discuss something you read in another article that differs from the article on which you are commenting, cite the article for reference.
    • You can discuss applicable clinical interactions (positive or negative) regarding the topic that you may have seen in practice (remember HIPPA- no patient identifiers).
    • You may discuss how this article may apply to clinical practice of APNs.
    • You may discuss what you learned from the article that may inform your future practice.

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How we fail black patients in painhttps://www.aamc.org/news-insights/how-we-fail-black-patients-pain (Links to an external site.)As I was searching for a relevant article to discuss I ran across an article that effected me emotionally and ethically as a provider. As my significant other is African American and my primary profession as a role as a certified registered nurse anesthetist I found it compelling to research and discuss this quite disturbing topic. As quoted by the author, “about half of white medical trainees believe such myths that black people have thicker skin or less sensitive nerve endings than white people. Black peoples nerve endings are less sensitive than white peoples , black people skin ids thicker and coagulates more than white peoples .“ As a result of some of these racial bias there has been  studies documenting extreme racial disparities in how pain is assessed and treated amongst the African American population.

The African American population is perceived as “ stronger” than white people accounting for racial bias in perceptions of another’s pain. Research by Todd, et. Al also demonstrated that in relation to white people with the same ailments, black people were given less pain medication. In addition, if they were given pain medication at all it was given in significantly lesser amounts. Furthermore, the study found that  black patients were significantly less likely than white patients to receive analgesics for extremity fractures in the emergency room (57% vs. 74%), despite having similar self-reports of pain. This disparity in pain treatment was seen even among young children. A study of nearly one million children diagnosed with appendicitis revealed that, relative to white patients, black patients were less likely to receive any pain medication for moderate pain and were less likely to receive narcotics which were recommended. In addition, In a study by Staton et al. patients were asked to report how much pain they were experiencing, and physicians were asked to rate how much pain they thought the patients were experiencing. Physicians were more likely to underestimate the pain of black patients (47%) relative to nonblack patients (33.5%.The  disparity in assessment and management of pain leaves the possibility of  the obvious at overmedicating the white population and in turn under medicating  the black population where both present a serious dilemma and pose serious risk to all patients in healthcare.

Possibilities for this could be that the provider assesses the black person and need for pain but doesn’t treat it for reasons related to non compliance, access to health care or there own personal bias. What is more interesting is that racial and ethnic differences  in pain management are not premeditated or intentional. Health care providers as a group do not consciously make decisions as to who deserve pain relief and who should suffer. As history has shown inequalities among races are the result of many influential factors that are deep seeded and complexed in nature, that unconsciously the healthcare provider doesn’t even realize that they have. In addition, we as providers know, the assessment of pain is subjective. Additionally, when pain isn’t caused by an obvious medical condition or acute trauma, the health care provider relies on tacit knowledge and on their own judgment, which can be influenced by personal perceptions and biases. In addition , assessment of pain is different in each case. A persons presentation can be loud or very stoic making it more difficult to assess adequately. Social media, advertising and the news have even made it more difficult not to develop a personal bias for certain races or culture. Healthcare providers are not immune from these influences and must be able to acknowledge that these exist and set these bias aside.  In my opinion, every human irregardless race, age, culture, attitude, religious belief or ethnicity deserves the same level of care as the next.  It starts with one person at a time to make change. Health care institutions today have recognized  these disparities and are making valiant efforts to change societies traditional beliefs. It is our job as APN to recognize that these disparities exist and put an end to this disgraceful level of care. Reply

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Ann Tomlinson

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Reference Sabine, J.A (2020). How we Fail Black Patients In Pain. AAMC-Association of American Medical Colleges. https://www.aamc.org/news-insights/how-we-fail-black-patients-pain (Links to an external site.)

 

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