3.5 Lack of Sufficient Knowledge in Pain Management Multiple articles make known the lack of sufficient knowledge in pain management and medication. Nurses in Batiha (2014) and Batiha (2012) confess how the nursing staff lack enough knowhow on how to manage pain in patients, despite its importance in the ICU setting. Lewis et al. (2014) reported a relatively low knowledge score of 18.28, after carrying out a knowledge deficit survey on 34 registered nurses, and 53.4% in the Wang and Tsai (2009) study. The Lewis et al. (2014) study discovered that many nurses, due to knowledge deficit, are misinformed about opioids and hence the reason behind their opiophobia (the tendency to fear administering analgesia to critically ill patients with the anticipation that the opioids may subject the patients to over-sedation, respiratory depression, and hemodynamics). These outcomes are in agreement with the findings outlined in other studies such as Erkes, Parker, Carr, and Mayo (2001); and Schreiber et al. (2014), who also claim high knowledge deficits among ICU nurses. Batiha (2014); Batiha (2012); and Kost (2004) attribute opiophobia to misinformation among nurses and lack of proper updates. Tawalbeh, Ahmad, Batiha, Manar, and AlBashtawy (2013); McLellan and Volkow (2016); and Joranson et al. (2000), however, clarify that nurses should not
Adults in the Critical Care Unit 24 be opiophobic because the reported effects of drug addiction have not surpassed 1 percent. Besides opiophobia, the nurses in Batiha (2014) were reluctant to give the elderly pain medication, with the fear that they will cause confusion or delirium. If the nurses had proper information on those medications, then they would have a different view and they would not leave the patient in pain, in fear of the side effects they would have on them. Incayawar and Todd (2013), however, assert that the reason behind the lack of sufficient pain management knowledge is due to inadequate education in this field of study. Wang and Tsai (2009) emphasize this point of inadequate education by outlining the differences in levels of education between clinical nurse specialists versus registered nurses; bachelor graduates versus diploma or certificate graduates. The evidence on inadequate education is also obvious in multiple articles such as Batiha (2012) and Batiha (2014), which indicates that many of the nurses did not have enough education on pain management. The study by Ufashingabire et al. (2016) also defines the different education levels between two different groups – the registered nurses and enrolled nurses. The study by Ufashingabire et al. (2016), was carried out in Rwanda (Africa), and aimed to assess the level of knowledge and attitude on Rwandan nurses, in respect to pain management on the ICU patients. A descriptive study was conducted on three hospitals with ICU facilities, two public hospitals, and one private hospital. The system in Rwanda identifies the nurses as either registered nurses, or enrolled nurses with the registered nurses higher in the rank. A standard questionnaire was prepared on the knowledge, and attitudes of nursing, with true or false questions. Out of the 69
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- The Land, Qualitative Research, ........., critical care unit