Discuss the barriers to providing adequate pain management in a patient with advanced metastatic cancer in terms of the professional nurse.

Misses Smith is a 49 year old Hispanic female with right breast cancer status post complete mastectomy with

six cycles of radiation followed by chemotherapy. Five years breast CA survivor with recent re-admission to
the hospital for N&V, weakness, fatigue and SOB. Further diagnosis of lungs and bone involvement made. She
has 4 adult children with 4 grandchildren. She is CPR full treatment. She is planning on meeting with her
oncologist and IDT members on Monday for discussion of her prognosis and plan of care. Husband and few
relatives will be present at that meeting. She is Roman Catholic married thirty years ago at St Mathews
Catholic Church and volunteers every Sunday mass as an usher at the ten o’clock mass.

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