Reflective accounts

Chronic pancreatitis

A CPD article enhanced Anita Skinner’s knowledge of the assessment and management of chronic pancreatitis.

A CPD article enhanced Anita Skinner’s knowledge of the assessment and management of chronic pancreatitis

Picture: iStock

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article examined the pathophysiology, diagnosis and management of chronic pancreatitis, including how nurses can address its main symptoms, particularly chronic pain. Having recently cared for a patient with chronic pancreatitis, I was prompted to research the condition further by reading the article.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

Chronic pancreatitis is a long-term inflammatory condition that is strongly linked to alcohol misuse and cannot be cured. The article explained that it is thought that alcohol damages the sphincter of Oddi, the small ducts and acinar cells, and may lead to the development of pancreatic stones that block the pancreatic ducts, causing inflammation and scarring. 

The article stated that the presentation of chronic pancreatitis varies among patients, but commonly involves abdominal pain and incomplete breakdown of nutrients in the gastrointestinal tract. Pain usually occurs in the epigastric region, often radiating to the back. I learned that for most patients, chronic pain is the most debilitating symptom of the condition.

Having cared for patients with chronic pancreatitis, I was aware that pain management is often complicated by alcohol and/or drug misuse and the stigma associated with the condition. I learned that while some of the treatments for chronic pancreatitis must be undertaken in hospital, such as the removal of pancreatic stones, there are interventions that nurses can provide in the community, for example offering psychological support.

How did you change or improve your practice?

After reading the article, I ensure that appropriate nursing interventions for patients with chronic pancreatitis are included in their care, such as: managing acute pain with analgesics; monitoring fluid balance; improving nutritional status; and regularly assessing the skin for infection, inflammation and breakdown.

I also intend to support patients by assisting them to prepare for any surgery they require, providing advice on nutrition and alcohol intake, and encouraging them to make use of any local support networks.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

Reading the article has improved my knowledge of chronic pancreatitis and ensured that I provide evidence-based care, which is relevant to the theme of practising effectively. 

The theme of prioritising people states that nurses must challenge discriminatory attitudes. The article emphasised that while alcohol misuse is the main cause of chronic pancreatitis, there are other causes, and that nurses should not discriminate by assuming the patient’s condition has resulted from alcohol misuse.

Anita Skinner is a manager at Avante Care & Support, Kent

This reflective account is based on NS871 Johnstone CC (2016) An overview of the management of patients with chronic pancreatitis. Nursing Standard. 31, 13, 54-62. 

Write your own reflective account

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