Compulsory Assessment

5. Zwakhalen, S., Hof, C., & Hamers, J. (2012). Systematic pain assessment using an observational scale in nursing home residents with dementia: exploring feasibility and applied interventions. Journal Of Clinical Nursing, 21(21/22), 3009-3017. doi:10.1111/j.1365-2702.2012.04313.x

Pain is not just a symptom, but a specific problem that needs to be treated. Pain is a neurologic response to unpleasant stimuli. What is the gate control theory of pain? What are the classifications of pain? What are some ways to manage pain?

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

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.

As a student, it is important to build a foundation in implementing these guidelines, so that when they graduate, they can provide competent patient care. Nursing students perform pain assessments regularly while in clinical, so it is important to be familiar with the tools that the North Bay Regional Health Centre uses, so that when reporting findings it is with tools that the hospital approves of. It is also important to know a variety of tools and when it is appropriate to use each one. Performing comprehensive pain assessments and being aware of how the interprofessional team and/or patient has decided to manage potential pain can help form a basis for reference for future nurse. In future practice it is important to respect a patients wants in regards to pain management and to be able to implement both pharmacological and non-pharmacological pain management interventions.

To address this the nurse will need to still complete a pain assessment using the current scale of 0-10 and if the patient does not meet the requirements for a pain intervention the nurse needs to also document why there was not an intervention

The empathic communication between patients and provider cannot be established because of various reasons including provider barriers, patients barrier and environmental

The interventions will be aimed at reducing as far as possible all factors that decrease the threshold and promote those that increase it. It is of no use to judge the pain of others. Nursing care should recognize the presence of the painful experience of the patient, listen carefully and evaluate the factors that condition. Assess the response to analgesics as important as identifying the intensity of pain at the start of the intervention, it is reassessing its evolution time and under the treatment plan is implemented. In hospitalized patients should ask about pain at frequent intervals, every four hours or at least once per shift, and always after administration extra to check their adequacy and effectiveness dose. What drug it was effective and what dose is information that should not be left to memory for later transmission. Its systematic registration history is essential for inter-coordination. Moreover, the patient transmits real interest on the part of professionals and reinforces the therapeutic relationship and

During the intraoperative phase, identifying outcomes related to patient care during surgery is paramount due to the fact the patient is under anesthesia and completely dependent on the surgical team, and the nurse acting as their advocate. Examples of identifying outcomes prior to surgery would include; the prevention of electrical burns from cautery equipment, proper positioning during the procedure to prevent nerve or skin damage. Collaborating with other members of the surgical team regarding this information, and utilizing evidence-based nursing knowledge is necessary for the surgical plan. My responsibility as a nurse is to alleviate suffering during the intraoperative phase and as the patient’s advocate ensuring no further injury occurs.

Pain is formally identified as a problem of global proportions by WHO and postoperative pain is one of the most common types of pain that has raised a public health concern by various societies in Australia, USA and Europe. It affects roughly 40% of surgical patients who experiencing a moderate to severe pain. It is important that graduate RNs have the knowledge and clinical skills to care for these patients as management of acute post-op pain has posed a significant challenge in surgical specialities for the past 50 years.

Pain re-assessment should be done in a timely manner to The reassessment of pain Lachman (2012) affirmed that patients may endure by some nurses practice in their delivery of care. It is imperative that nurses must perform pain assessment in a timely manner for evaluating patient’s level of pain and for developing a new plan for pain management if possible. Failure to reassess or any delay in care practice may be considered as negligence and a violation of the principle of the beneficence This inexperience can cause more harm to patient than any support.

Appropriate pain treatment is essential in providing quality care to patients. Pain is a universal phenomenon caused by varying biological and psychosocial factors. The role of nurses in pain management is to understand pain’s subjectivity and utilize the tools that can aid in assessments, delivery of relief, maintenance, monitoring, and control. This paper will discuss ten items patients should know about regarding pain management. Different standpoints are presented based on used of opioids pain therapy, alternative methods, and psychosocial aspects. Cultural barriers in pain management and ways to address those barriers will also be discussed. The aim of a nurse in managing pain is to deliver

The medical consultation is considered to be one of the most important phases in the care of a patient (Bennet, 1979; Beck et al., 2001). Especially in long term illnesses, health care professionals have a close relationship with their patients; the main reason is because of the nature of this relationship itself, as they are both involved in illness in their own different ways (Bennet, 1979; Ong et al., 1995; Pendleton & Hasler, 1983; Molleman et al., 1984; Morrison, 1994; Usherwood, 1999). Through this relationship, health professionals and patients are constantly exchanging information (Ong et al., 1995; Morrison, 1994; Usherwood, 1999); patients are the ones who experience illness and discomfort, and are seeking for both care (feeling