A nurse learns about vital signs early in education; how to check a pulse, count respirations, and take a temperature. Assessing pain is not as concrete or as easy to identify however, a nurse gains experience in assessing pain through education and experience. The purpose of this paper is to demonstrate how a nurse’s experience level, using Patricia Benner’s Novice to Expert Theory, can correlate to better pain control in patients post-operatively.
Clinical Significance Post-operatively more than 80% of patients deal with pain (Chou et al., 2015). Many factors contribute to how a patient perceives and tolerates pain. In many post- operative wards, the nurse is the frontline in helping the patient address needs for pain control. Pain
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Nurses, by the nature of the profession, spend more time with the patient than any other health care professional. Given the amount of time spent as primary caregiver, the nurse develops an important relationship or connection with the patient. The nurse plays a critical role in gathering an accurate assessment of the patient’s pain experience. This assessment and interventions for pain control develop over time in correlation to the nurse’s clinical experience. Benner's (1982) theory novice to expert focuses on how a nurse gains knowledge through education and experience. Five levels are used to describe the progression of nursing expertise in a clinical setting: novice, advanced beginner, competent, proficient, and expert (4). In the novice stage nurses lack experience and confidence to perform actions independent of guidelines and rules (Benner,p. 403). A novice nurse, without asking if the patient is in pain, may not acknowledge that a postsurgical patient in the recovery room has pain if the patient is laying quietly in bed although their blood pressure and heart rate have increased from preoperative levels. The advanced beginner, having had more experience with postsurgical patients may notice the patient's blood pressure and heart rate changes and believe the patient is in pain however, the nurse may conference with other nursing staff to confirm the assumption. Competent nurses begin to predict situations and patterns from previous experience and use time management skills more effectively (4, 124). The competent nurse will monitor blood pressure and heart rate continuously while assessing for other indicators of pain such as guarding or facial grimaces. In the fourth stage of Benner's Model the proficient nurse is able to see the situation as a whole, rather than bits and pieces. The nurse knows what typically occurs in the
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
Physical pain is more easily addressed by the administration of medication or a non-pharmaceutical intervention like repositioning, or the application of heat or cold. Nursing care on a general medical unit is about patient and family centered care which is in alignment with Kolcaba’s Theory of Comfort. A large portion of the patients seen on this type of unit have multiple comorbidities and challenging social situations that require assessment of their past health history, their support system, and their current living situation. All of this is taken into consideration in multidisciplinary rounds where data that is collected is communicated to all disciplines and a plan of care developed for each patient. The unit which I currently manage assembles our multidisciplinary unit daily. Needs are identified and assigned to the team members who include social work, care management and therapies in addition to the nurses and the providers. Since the team meets daily there is an opportunity to evaluate the effectiveness of the interventions prescribed. Nursing care management is integral in this work as part of the assessment, planning, and coordination of care in the hospital
Winfield, H., Katsikitis, M., Hart, L. and Rounsefell, B. (1989). Postoperative pain experiences: Relevant patient and staff attitudes. [online] 34(5): pp.543-552. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8V-45WYV7R-7G&_user=10&_coverDate=12%2F31%2F1990&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=35e6b5e8c8f803b487b35d4ae3b06cef&searchtype=a[ [accessed 8/5/2013]
...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...
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
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.
Lindley, P., Pestano, C. R., & Gargiulo, K. (2009). Comparison of postoperative pain management using two patient-controlled analgesia methods: Nursing perspective. Journal of Advanced Nursing, 65(7), 1370-1380. doi: 10.1111/j.1365-2648.2009.04991.x
The general idea of, K, is that a nurse must have knowledge in the diversity of cultures, ethics, and education. The significance of this faction being that if the nurse is cognizant of the patient 's culture, beliefs, family values, support systems, and education level, a more thorough and comprehensive plan of care can be formulated. The premise of, S, is that a nurse must be skilled in the ability to communicate with and advocate for the patient, assess for and properly treat pain, and incorporate the needs and concerns of the patient and their family. The significance of this group and development of these skills include the achievement of pain control, increased rehabilitation periods, and an increase in patient/family satisfaction. The theme of, A, requires that a nurse maintains an open attitude toward the patient and to respect and validate the nurse-patient relationship, which will aid in a positive nurse-patient
Stomberg, M., Sjöström, B., & Haljamäe, H. (2003). The Role of the Nurse Anesthetist in the Planning of Postoperative Pain Management. AANA Journal, 71(3), 197.
As a medical / surgical RN, I provided care for the elderly, the infirm, the mentally challenged, the young, and the psychologically disturbed. The wide variety of patients exposed me to the effects of life style choices, health care choices, and the resulting impacts to the patient as well as to the family of the patient. This experience has fully matured my view of the awesome responsibility that we, as health care professionals, have been charged with, and it has furthered my desire to obtain the skills necessary to provide more advanced care for my patients. In addition to exposure, maturity and experience, my career as a medical / surgical RN has also sharpened my critical thinking abilities and provided insight on observing signs and symptoms that a patient may be unware of. Furthermore, as a charge nurse I learned the importance of collaborating with other health care professionals in order to provide the highest level of care available. In summary, my career as an RN has provided valuable experience, maturity, exposure to impact and outcome, enhanced my critical thinking abilities, and improved my collaboration
Certified Registered Nurse Anesthetists (CRNA) are high trained nurses who use their developed training in the use of anesthesia to alleviate patient pain and discomfort due to medical procedures. Nurse anesthetists have been providing anesthesia for more than 125 years, dating back to the early Civil War. ("Nurse anesthetist," 2014). They undergo rigorous training post nursing licensure that allows them to hold a high position in the nursing field working beside surgeons, anesthesiologist, dentists, podiatrist, and many other skilled healthcare professionals ("Nurse anesthetist," 2014). Pain management is one of the main aspects in any procedure, if not the most important to the patient, therefore giving nurse anesthetists a wide spectrum of work settings in the medical field that they can practice in.
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
...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.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).