Pain In Critical Care

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

Research has shown that there are several organizations and active advocates who are working on pain management problems to face this public health issue. The following establishments involve: The American Academy of Pain Medicine, Institute of Medicine, and American Pain Society and many for-profit and nonprofit organizations are also working at different level towards pain management. Most specifically, the IOM has been devoted to studying pain and its consequences on individuals, the healthcare system, as well as on government (IOM, 2011).

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.

“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,

To most people, pain is a nuisance, but to others pain controls their life. The feeling discomforts us in ways that can sometimes seem almost imaginable. These feelings can lead to many different side effects if not dealt with or diagnosed. These effects can include depression, anxiety, and incredible amount of stress. The truth about pain is that it is vital to our existence. Without the nervous system responding to pain, we would have no idea if we were touching a hot stove, being stuck by a porcupine’s needles, or something else that could leave a lasting effect upon our bodies without us even knowing anything about it.

What is pain? If you ask someone to tell you the definition of pain they will typically state something that hurts. Registered nurses should know the definition of pain and how it can be identified on their patients. However, Abdalrahim, Majali, Stomberg, and Bergbom (2010) propose that nurses did not receive adequate education in pain management and suggest the lack of knowledge hinders their ability to adequate control their patients’ pain. Therefore, the unethical treatment of pain can be traced back nurses.

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).

The major concepts of this theory are defined theoretically since the use of these definitions is from a broader theoretic concept. Therefore, an operational concept could be developed from them. There is consistency in the use of these concepts throughout the theory of acute pain management with examples given using the same language as well as maintaining the integrity of the concepts.

Effective pain control is a key component when caring for a patient in the acute care setting. Knowing the patients pain level and if they are experiencing pain you must have them describe it. This is to ensure that it will be treated appropriately. Although, there are many interventions that can take place including pharmaceutical and alternative non-pharmaceutical measures. There are several barriers that can get in the way of the patient receiving the correct care for their pain. These barriers can be related to the health care system, the providing professional of the patients, their families or community.

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

Pain management is an essential component to patient care and nursing procedures. Recognizing the detrimental effects of unrelieved pain, The Joint Commission on Accreditation of Healthcare Organizations (JACHO) has recommended standards of pain management, especially with regard to assessment, monitoring and treatment (Harsoor, 2011). Research shows pain too often goes untreated, undertreated, or poorly assessed. In some settings, it has been found that pain has gone undertreated in up to 80% of patients (Walid et al, 2008). Children, the elderly, cancer patients, and postoperative patients are all populations that are at an increased risk for pain and subsequently poor pain management. Pain has a significant effect on a person’s mental status,

This article explained that good pain management is known to produce many benefits for the postoperative patient. However, the article goes on to explain that treating postoperative pain is still a major issue with inadequate postoperative patient pain relief remaining high. The article discussed how the Joint Commission declared pain the “fifth vital sign”. And that the Joint Commission has determined not all pain could be eliminated, but that goal-related therapy may be suitable. The article concluded by explaining that there was a need for evidence-based

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.

Engwall (2009) defined pain as a "symptom and a warning that something is wrong in an organism” (p 370). Rathmell et al., (2006) maintained that fear of uncontrolled pain can be a traumatic situation for a patient undergoing surgery. Moreover, Pellino, et al (2005) sustained that “pain is a multidimensional experience, consisting of not only physical stimuli but also psychological interpretations of pain” (p. 182). Alleviating peri-operative pain is traditionally achieved with the use of pharmacological interventions. analgesia can incur undesirable side-effects like drowsiness, nausea and vomiting. Controlling the pain by complimenting analgesics with the use of non-pharmacological interventions, might ameliorate patients’ response to pain with fewer resultant side-effects. Thus, the need to evaluate the effect of non-pharmacological measures such as music, relaxation, hypnosis and others is highly solicited in the evolving heath system (Pyati & Gan, 2007).