Answer:
The situation of a patient with sickle cell anemia, and especially when facing a sickle cell crisis, is critical in regards to the level of pain that these patients experience. There are those whose pain is acute, while others suffer it chronically, and yet others with a mixture of both. Some patients, who do not develop tolerance to pain medication, such as opioids, will only seek pain relief help when the pain, caused by infarction of the tissues due to the occlusions caused by the disease, in vessels, and thus tissues, gets intense. However, there are people who become tolerant, and begin to become known by healthcare professionals as "drug seekers". The problem here is the lack of knowledge on the part of professionals, on how pain can affect the person, and how pain is felt differently depending on the person and the severity of the lession caused by an occlusion. This lack of proper knowledge is what leads some professionals to judge the person who constantly alters his level of pain perception to justify being given more medication.
However, the nursing staff here plays a critical role in two ways, first, ensuring education of the patient on the different ways that pain can be managed by the patient, without becoming oversdosed on opioids, and the second, on educating the personnel who works with these patients.
As such, one intervention would be to teach the patient about the different types of pain relievers that he can use, that will at least soften the pain. But more importantly, there is work to be done, on the part of the nurse, on teaching the patient how to handle pain without any medication, and there are breathing techniques, and meditation techniques, that will help the patient learn to place his/her pain in the proper proportion, before doping himself/herself with opioids.
But in response to the second question, the intervention of the nurse must be on both the patient and the team that works with the patient. As said before, education is the key, and this is a vital role of nurses. The nurse must also ensure that her team learns about how the disease works, where the pain comes from, why this patient is constantly seeking pain meds, and how each of the team members can play their own role in helping the patient manage his pain.
