Barriers to Effective Pain Management
Introduction
Pain is a fundamental and inevitable form of human suffering, the experience which is unique to every individual.
Nurses have a unique role in alleviating the pain experienced by their patients. With their professional knowledge and regular close contacts with patients, they are ideally placed to listen and respond to any concerns. Taking time to assess the individual will allow for the development of a thrusting relationship between the nurse and patient. Accurate assessment and documentation can help to chart the multi- dimensional nature of the pain, aiding decision making and patient care planning (Mcguie 1992).
Adequate control of pain is only achieved in 50% of patients
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However, it is imperative that the doctor carriers out a physical examination of the patient on admission to identify the pathological causes of the patients pain. This is an imperative part of pain management and is much needed to facilitate the planning of care.
The more experienced the nurse is the more inclined they are to underestimate severe pain. The less experienced nurse is more inclined to overestimate an individuals pain.
The doctor’s lack of confidence and knowledge may result in him or her avoiding discussions relating to analgesia and changing the drug or dose of the opoid, irrespective of the nurse’s belief that it for the best interest of the patient. Doctors that are lacking in knowledge have a tendency to prescribe analgesia below the therapeutic level of the pain and are often reluctant to act upon the nurse. This is a serious issue that must be addressed as the nurse is often the person who knows the most information about the patient as they provide a 24 hour round the clock care to the patient.
It is clear that these poor practices arise from a number of inter- related reasons. However the lack of knowledge and effective team work seems to be the central issue. In order to assure effective communication is brought to the clinical practice, efforts to increase group learning and confidence of health care professions is much needed. Role play may improve health care professional’s
Having a personalised and holistic approach to a persons pain and discomfort needs good teamwork. E.g. Nurses and care workers may be able to help to support the person with physical pain. By using effective
pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain
Appropriate assessment and management of pain should be paramount to nurses working in the elderly care sector.
Pain is one of the most common reasons people consult a physician, yet it is frequently inappropriately treated [St Stauver JL, 2013]. To deal with this dilemma, nurse practitioners can play an important role on the pain care team, particularly as primary care clinicians spend less time with patients and are increasingly reluctant to provide care for pain patients. As frontline providers, they can take the time to perform a thorough patient assessment and physical examination and follow through with pain treatment, while also playing an essential role in patient education and assessing and monitoring the patient’s opioid risk. Their primary goal is to develop a therapeutic relationship with patients, providing the time and space for patients to tell their pain story [Hughes, 2013], which they then can communicate to the rest of the team and which forms the basis for all subsequent decisions about treatment.
According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,
This paper will examine the the nurses and pain assessment in the hospitalized patient. The paper will focus on pain and pain management and the need to assess pain. How much percentage of the population in the U.S. are experienced pain, and how much of the population abuse the pain medications. There are many barriers which hinder nurses from perform accurate pain assessment. These barriers are nurses experience, competence, perception and manipulation. Pain is subjective, but pain assessment tools and nurses’ perception may contraindicate with what the patients stated. Thus, the paper will try to find solution to accurate pain assessment during hospitalization, especially with abuse of opioid.
Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.
Assessing pain is a very important first step. Having the correct assessment techniques and tools is very important to diagnosing and treating the pain. Acute pain is typically a symptom of something else, so correct assessment will lead the care provider to the underlying issue, D’Amico and Barbarito (2016) identify many tools used for the assessment of pain, discussed later in the paper. Treatment of acute pain should be handled differently than other types of pain due to acute pain being a short-term process of healing. The
As a nurse there are many variations of the pain assessment I could undertake with Mrs Jones. (Herr & Garand, 2011)
Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80).
So I bring up this controversial topic again, about both mental and physical health and how important it is to take some time out of our crazy busy lives as nurses just to sit with our patients for a few minutes to discuss their pain. By pain, I mean both mental and physical pain. The purpose of this paper is to discuss a situation I was involved in as a nursing student in the clinical setting and how I can critically analyze this situation using Carper’s Fundamental Patterns of Knowing in Nursing (1978). This model has helped many practitioners to consider what they learn throughout reflection on their experience within a holistic way.
The American Pain Society (APS, 2008), defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (p.1). According to McCaffery (1968), “pain is whatever the experiencing person says it is, existing whenever he says is does”. Pain is a complex, multidimensional experience. It is present in all clinical settings and in many different patient groups. It is one of the main reasons why people seek medical attention. Many health professionals involved in pain control (Lewis, Heitkemper & Dirksen, 2004). In order to measure the level of knowledge of medical and nursing staff about pain management in critical care patients and the economic impact I make
In the context of the caring relationship, nurses perform a primary role in the assessment and management of pain and other
Nursing is the holistic helping of persons with their self-care activities in relation to their health. I agree Vargina Henderson in her definition of nursing and nurses role, According to Henderson, 1966 “Nursing is primarily assisting the individual in the performance of those activities contributing to health and its recovery, or to a peaceful death”. Varginia Handerson, 1964 stated that “the nurse must get inside the skin of each her patient in order to know what he needs”. from this statement I conclude that nurses play an important role in promoting patient quality of care. Nurses play an important role to promote pain management practices for patients, a critical component of the nurse’s role in pain management is pain assessment, medications administration, organizing and delivering patient care activities, advocating for patient rights, educating patients and contact with physicians regarding changes in patient conditions; these nursing functions are critical in the management of pain. So, we can’t imagine nursing discipline without nursing
Pain is a type of fuel that someone can resort to too keep going. Pain is a useful tool to get what you want. You can crush a person’s soul with pain or you can free it. You can be at the top of the world if you use