This archive report was first published on 7 October 2019.
According to a study published on September 24, 2019, in the journal Pain Management Nursing, thousands of cancer patients in Kenya die in pain due to untreated moderate to severe pain. The World Health Organisation estimates that 80 per cent of Kenyans dying from cancer suffer from untreated pain.
Researchers at Kenyatta National Hospital (KNH) found that the main cause of untreated pain is the negative attitude of nurses towards cancer patients. The study, led by Dr Lister Nyasero Onsongo, a lecturer at the School of Nursing Kenyatta University, blames negative attitudes, poor training, and fear of using opioids among nurses as well as interference by relatives of some patients.
When asked about their approach to pain management, a study participant said, "When doctors come to review patients, most of the time they go alone. There is a negative attitude nurses have that when you accompany a doctor into the patient’s room you are like a maid." Nurses at the hospital view a transfer to the Oncology Unit as a punishment or demotion, reported the study.
One of the reasons for the negative view of the oncology wards is the high rate of deaths compared to other wards. The study suggests that this negative attitude plays a negative role in pain management.
Money and payments also feature prominently as one reason why nurses at KNH oncology wards are not keen on attending to their patients. They complained that unlike other nurses who work in specialised wards such as the Intensive Care Unit, cancer nurses are not paid extra for recognition.
Dr Onsongo involved 25 nurses working in KNH private wing and the general oncology ward in the study. Participants were nurses who spent at least 50 per cent of their clinical duties providing care to cancer patients and had worked in the unit for six months or more.
Participants said they forget to give patients the pain killer, morphine, as required because they have too much work and are too few, especially at night. However, Dr Onsongo suggests that this may not hold true in all cases.
Some of the nurses reported hesitancy in administering opioids in case patients become addicted or develop breathing problems. "We might cause respiratory distress, and then actually in a way we are speeding up the death process. We have patients who die in pain; everybody is usually afraid to give morphine; we just fear, it is a dilemma," said a nurse.
But they also blame patients’ relatives. "Relatives interrupt a lot. They can be so nagging, you are not able to figure out if it is the patient’s genuine pain or the relatives," said a participant.
