A preliminary Care Coordination Plan is a vital part of treatment, as it ensures the appropriate integration of services into the process and effective interactions between care professionals and their patients. The purpose of care coordination is to maintain the mentioned constituents’ correct functioning, intended to facilitate the recovery of patients and comfort their residence in a health facility. It is possible to reduce the level of patients’ uncertainty in the success of recovery and relieve the tension between them and medical staff through coordination planning. It also enables to focus on the most significant, in particular circumstances, factors to ensure the most optimal resource distribution. Moreover, according to World Health Organization (2018), this approach enables the provision of “person-focused care across various settings,” which is vital in dynamic environments, when a situation can be changed over time. In the circumstances, when a dedicated case management staff has been relocated and the community is deprived of their care, the preliminary care coordination plan is due. Its development and effective implementation will assist in addressing the specific health concerns of patients in the new situation.
It is possible to notice that regardless of the community and residents who recover there, pain management is significant to ensure the success and comfort of the treatment. According to Tick et al. (2017), “The impact of pain is felt at many levels ranging from the effects on the individual, families, the healthcare system, employers and the community at large” (6). It implies that pain is the factor that influences every singular patient and the entire community as well, while its complexity makes it difficult to manage the direct and indirect consequences. Tick et al. (2017) state that pain affects “physically, neurologically, psychologically, socially, spiritually, economically, and symbolically” (6). Therefore, it is complicated for the community to sustain expenses, the inadequate pain management cause, while the patients are vulnerable in many other ways. The pharmacological methods are not directly considered in this plan, as the use of pain medications, such as opium ones, is a distinct area of concern. The coordination planning is focused on non-pharmacological methods, which also have high efficiency and are of great use in communities and hospitals. Moreover, the community faces budget deficiency, which implies that the priority is affordable equipment complemented with manual practices based on well-established pain management strategies.
The outlined health concern is complicated with several factors that should be precisely considered to reflect them in the preliminary care coordination plan correctly. Constraints on meeting nurses’ moral obligation to assist in patients’ pain reliving and suffering it causes. According to ANA Center for Ethics and Human Rights (2018), among these difficulties are “moral disengagement, knowledge deficits, biases, environments not conducive to optimal practice, and economic limitations” (2). It implies that nurses experience moral distress in the event of not being able to provide adequate relief, regardless of the numerous reasons. Deterioration of nurses’ mental health directly affects the quality of care and worsens the pain management system.
The factors that contribute to the situation and depend on nurses are knowledge deficits and biases (ANA Center for Ethics and Human Rights, 2018). Despite not considering pharmacological methods of pain management, the moral issues related to over or underestimating the level of pain are the problem of great importance. It influences the level of attention a particular community resident obtains. Because of the inadequate distribution of resources, the critical situation in which patients with severe pain levels do not have enough support may arise.
The factors that do not depend on nurses are: not conducive to optimal practice environments and economic limitations (ANA Center for Ethics and Human Rights, 2018). It is apparent that a process of recovery requires a certain level of comfort that should be achieved. It includes physical and emotional environments, which are essential for adequate pain management but are sometimes equally complicated to maintain. Economic limitations contribute to the severity of the problem, making communities refuse necessary equipment or medications. Therefore, it might be helpful to focus on eliminating the nurses’ distress through psychological support, reducing the negative influence of other factors, and responding to patients’ physical, psychosocial, and cultural needs.
There are various non-pharmacological evidence-based strategies to manage pain. Some of them, which can potentially be implemented in this preliminary care coordination plan are: physical interventions such as massage, contrast temperature therapy, acupuncture, and progressive muscle relaxation (Nobani, 2018). The psychological interventions are cognitive behavioral therapy, mindfulness-based stress reduction, and biofeedback (Nobani, 2018). Finally, social and cultural interventions include spirituality and religion, and music therapy (Nobani, 2018). It is possible to state that the mentioned strategies do not have the same effects as medications do. Still, they positively influence patients’ bodies and minds, facilitating their recovery and providing relief from their pain. Manual techniques are based on reducing muscle stress and improving patients’ well-being, while cognitive therapies positively influence their’ moods (Nobani, 2018). Simultaneously, access to religious literature, facilities, and conversations makes some patients feel more comfortable, while music affects almost every individual and can be used to manage the pain.
Goals of the Preliminary Care Coordination Plan
The patients with acute pain, such as those who have cancer, are paid less attention in this coordination planning, as it is expected that chronic discomfort is more common among community residents. The goals are to provide patients with relief and facilitate the process of recovering at minimal costs, considering community residents’ various necessities. Firstly, it is necessary to provide nurses with psychological help that will enable them to continue caring for community residents. The mentioned non-pharmacological methods of pain management are not expensive and require knowledge rather than equipment. However, all the nurses may not have enough experience to perform all the techniques, such as massage, acupuncture, or contrast temperature therapy. Therefore, the second goal is to establish educational courses with invited experts. Thirdly, the community may require support from their residents’ family members that raise the goal to engage them in daily practicing or additional financing of the facility because of the budget-cutting. Finally, it is necessary to improve the community’s environment by establishing walks to local facilities, such as parks and churches, that will be beneficial overall.
List of Resources
Despite the scarcity of financial resources and the reduced medical staff, there are other sources of necessary support in the process of care that will be helpful in pain management. Local places such as playgrounds, parks, fishing spots, forests, or picnic areas, can assist in several methodic implementations, such as cognitive behavioral therapy and mindfulness-based stress reduction. It is possible to collaborate with associations, such as animal care, educational and civic events groups to meet the psychosocial needs of patients. Institutions, such as libraries, museums, and media will be also beneficial, while support from family members can financially assist the community, or provide residents with additional social interactions that also are a part of the entire care process aimed to manage the level of pain.
ANA Center for Ethics and Human Rights (2018). The Ethical Responsibility to Manage Pain and the Suffering It Causes? ANA Center for Ethics and Human Rights.
Nobani, A. M. (2018). Non-Pharmacological Pain Management. Hamad Medical Corporation, published in book “Pain Management in Special Circumstances”.
Tick H, Nielsen A, Pelletier K, Bonakdar R, Simmons S, Glick R, Ratner E, Lemmon, RL, Wayne PM, Zador, V. (2017). Evidence-based Nonpharmacologic Strategies for Comprehensive Pain Care. A Consortium Pain Task Force White Paper. The Pain Task Force of the Academic Consortium for Integrative Medicine and Health.
World Health Organization (2018). Continuity and Coordination of care A Practice Brief to Support Implementation of the WHO Framework on Integrated People-Centred Health Services? World Health Organization.