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Nursing theory on pain management
Reflection about pain management in nursing
Nursing theory on pain management
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In a pain assessment, the pain is always subjective, in a verbal patient; pain is what the patient says that it is. Nurses must be able to recognize non verbal signs of pain such as elevated pulse, elevated blood pressure, grimacing, rocking, guarding, all of which are signs of pain (Jensen, 2011). A patient’s ethnicity may have a major influence on their meaning of pain and how it is evaluated and responded to behaviorally as well as emotionally (Campbell, & Edwards 2012). A patient may not feel that their pain is acceptable and they do not want to show that they are in pain. For some people, showing pain indicates that they are weak. Other patients will hide their pain as they do not want to be seen as a bother or be seen as a difficult patient. …show more content…
Pain behaviors can vary widely and may be culturally bound. Some patients when in pain cope by turning inward, explaining their pain as a personal and private experience. Other patients may be verbally expressive, sometimes crying and screaming (Callister, 2003). The many socio-cultural variables can make accurate pain assessment a challenge for the nurse. Nurses should not assume that just because someone says they are not having pain does not mean that they are not in pain. If someone denies pain, but is showing non verbal signs that indicate the patient is in pain, the nurse should follow up with the patient and ask questions about pain in different ways, and explain why proper pain management is important. A patient who is in pain will not recover as fast as one whose pain is under control and can prolong their hospital stay (Jensen, 2011).
The nurse should educate the patient of the importance of pain control and how controlling pain is essential to a patient’s wellbeing and recovery. It needs to be a balance of what the patient says and what the nurse observes and interprets while always respecting the wishes of the patient. Nurses have a variety of assessment tools available to assess pain in their patients. One dimensional pain scales such as visual analog scale, verbal descriptor scale, numeric pain intensity scale and the combined thermometer scale all measure the intensity of the pain (Jensen, 2011). Other pain scales such as McGill pain questionnaire, brief pain inventory, and brief pain impact questionnaire take into account aspects beyond intensity (Jensen 2011). There are additional pain assessments specialized for children, older adults, patients who are unable to respond, and patients with opioid tolerance (Jensen, 2011). The nurse should be familiar with these methods of pain assessment and know the appropriate use of each. Incorrect medication and treatment choices due to inaccurate or poor pain assessment cause patient suffering (Jensen,
2011). Nurses are an advocate for the patient, and should be prepared to assess pain in all different levels to help their patients.
Phantom pain refers to the phenomenal experience of pain in a body part that has been amputated or deafferented (Flor, Nikolajsen & Jensen, 2006). The characteristics of phantom pain have been described to occur in quick and sudden attacks of pain shooting up and down the amputated limb as well as cases of constant, excruciating pain whilst intensely perceiving the amputated limb to be cramped or postured abnormally (Katz, 1992). Approximately eighty percent of amputees report suffering from or at least experiencing some level of phantom pain post amputation; therefore it is a prominent issue (Flor, Nikolajsen & Jensen, 2006). Phantom pain is neuropathic pain that has no individual trigger but instead a plethora of psychobiological aspects of neuroplasticity that contribute to the cause of phantom pain (Grusser, Diers & Flor, 2003). The following will: outline the role of the peripheral and central factors associated with phantom pain and discuss the cortical reorganisation of the somatosensory cortex in relation to phantom pain.
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
In her book “The Body in Pain: The Making and Unmaking of the World,” Elaine Scarry begins by making the immediate point that pain is difficult to express. She states all languages, including English, fail to provide a means for communication when it comes to physical distress. Scarry takes into account that different cultures may express pain differently. Some have the tendency to verbalize their pain more than other cultures, which are taught that the expression of feeling pain is a sign of weakness. However, despite the cultural differences amongst groups of people, she states no culture, nation, or country, has successfully created a language for the vocalization of pain in today’s society. She does mention that in ancient Greece, there are accounts of drawn-out w...
Opiates are a class of drugs that are used for chronic pain. Opioids are substances that are used to relieve pain by binding opiate receptors throughout the body, and in the brain. These areas in the brain control pain and also emotions, producing a feeling of excitement or happiness. As the brain gets used to these feelings, and the body builds a tolerance to the opioids, there is a need for more opioids and then the possibility of addiction.
At some point of life, virtually everyone experiences some types of pain. Despite the availability of standardized pain management methods such as using analgesics and opioids, patients might inadequately managed for pain if pain assessments are done inefficiently. Nurses are in a unique position to assess pain as they have the most contact with the child and their family in hospital. Getting a thorough pain assessment occasionally hard for nurses with the patients whom cannot collaborate. For example, pain in infants and children can be difficult to assess.
...amount of pain) is a great teaching tool for the patient who is able to self-report (Nevius & D’Arcy, 2008). This will put the patient and nurse on the same level of understanding regarding the patient’s pain. The patient should also be aware of the added information included with the pain scale: quality, duration, and location of the pain. During patient teaching, it should be noted that obtaining a zero out of ten on the pain scale is not always attainable after a painful procedure. A realistic pain management goal can be set by the patient for his pain level each day.
Nurse practitioner should be able to recognize these descriptors and take them as potential indicators of pain and clarify with further questioning.
Findings. Pain has many different meanings to many people. What is important to know as a nurse or health care provider is that pain is what the patient says it is. It is not the nurse or provider’s place to determine what the patient’s pain is but rather take an in-depth history and assessment. Using this assessment and history can therefore help treat your patient’s pain accordingly. Also pain theories have been proposed and used the implications of nursing practice in regard to pain.
This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.
...tein, G. and Stubhaug, A. (2008). Assessment of pain. British Journal of Anaesthesia. 101 (1), pp 17-24.
A doctor can only believe how much a patient is in pain by what they tell you.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).