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Nursing theory on pain management
What might effective pain management depend upon
Nursing theory on pain management
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Moaning, grimacing, and crying, is what I walked into during my first day of my preceptorship. As a new nurse, I knew I would be exposed to different situations in my career, but this was the first time I had met a patient in a situation unlike any other I had experienced. The patient I encountered, had a tracheostomy, was vented, and had a muscular dystrophy that made her fully dependent on the nurse. During my first inspection and assessment of the patient, she had already developed stage II bed sores on her buttocks, which caused her extreme discomfort and pain in any position she was in. When trying to see what I could do for her, one of the biggest concerns she addressed, was pain control and being able to express her concerns and needs,
When helping to relieve a pain that the patient states they have, it can help them to recover more quickly, and enables them to do activities that may have been prevented while they were in pain. In the article it states, that with adequate pain management, it would in turn decrease the length of stay, lower readmission rates, earlier overall recovery, improved quality of life, and decrease the costs for the patient and within the healthcare system (Glowacki, 2015). Due to her condition worsening while in the hospital by developing pressure ulcers, this caused a longer stay for the patient which in turn, cost the hospital more money and prevented the patient from getting better to get discharged. One organization, like the American Pain Society, are helping to come up with better ways of educating healthcare professionals to assess a patient’s pain. Healthcare professionals need to be well educated with the following: recognizing patient’s perception of pain, previous experiences with pain, spiritual and religious beliefs, and sociocultural components (Glowacki, 2015). A change also needs to be implemented to improve pain assessment, and to prevent any lapse in administration of pain medication, which can in turn increase the pain or lead to uncontrolled pain. (Glowacki,
Enns, C., Gregory, D., (2007). Lamentation and loss: expressions of caring by contemporary surgical nurses. Journal of Advanced Nursing 58(4), 339-347
Management of pain is very important when it comes to palliative care patients, considering that 55-95% of this patient population requires analgesia for pain relief (Creedon & O’Regan, 2010, p. [ 257]). But what is considered pain management? And why does pain continue to be inadequately treated? According to the article on chronic non-cancer pain in older people: evidence for prescribing, in the past few decades significant improvements have been made to the management of pain in palliative care. However, it is universally acknowledged that pain on a global scale remains inadequately treated because of cultural, attitudinal, educational, legal, and systemic reasons (Creedon & O’Regan, 2010, p. ...
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.
A. Chronic pain signifies a developing public health issue of huge magnitudes, mainly in view of aging populations in developed countries (Russo).
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
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
In the medical profession, personnel are asked to make judgments or draw conclusions based on measureable results. Physical assessments, vitals, CT scan, MRI, biopsy are all activities engaged in to prove abnormalities and make decisions as to the way forward. So having hunches are not considered reliable and rightly so. To decide to give a particular medication because of a mere hunch can lead to serious errors. However, pain which is now considered a part of the vital signs is based on the patients’ philosophy or view point and we (nurses) are told not to ignore but respond. This is highly subjective. It’s viewed how the patient sees it and not as tangible or measurable as the other ways of proving when something is abnormal. The situation to be presented will disclose a patient’s ordeal due to a nurse’s approach to or understanding of pain management. It will also assess whether the nurse responded in accordance to protocol.
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients; however, Fitzgibbon and Loeser (2010, p.190) stress that pain may often be undertreated, even in the UK. Foley and Abernathy (2008, p.2759) identify numerous barriers to effective pain management, among which are professional barriers such as inadequate knowledge of pain mechanisms, assessment and management strategies.
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
Pain and suffering is something that we all would like to never experience in life, but is something that is inevitable. “Why is there pain and suffering in the world?” is a question that haunts humanity. Mother Teresa once said that, “Suffering is a gift of God.” Nevertheless, we would all like to go without it. In the clinical setting, pain and suffering are two words that are used in conjunction. “The Wound Dresser,” by Walt Whitman and “The Nature of Suffering and Goals of Medicine,” by Eric J Cassel addresses the issue of pain and suffering in the individual, and how caregivers should care for those suffering.
Many years from now, I will take this experience with me to better myself as a nurse. I know for the future that it is in my patient’s best interest, if I collaborate with other health care professionals. In order to maintain patient safety, I must always remember to work together with my fellow collogues to obtain a positive working environment. In order to be a good nurse, I need to always understand that I am part of a team to help those in need. I want to incorporate providing efficient care to each and every patient the best way I possibly
Results: Preoperatively, patients’ levels of pains were at an average of 8.6 out of 10. After leeching procedures, pains were significantly reduced to an average of 3.5 out of 10. Not only did the pain dramatically decrease, but there were dermatological signs of improvement.
Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept. Good, 1998, related that there was a balance between analgesia and side effects in which two outcomes can be deduced: (1) a decrease in pain, and (2) a decrease in side effects. These outcomes can be studied further or more detailed concepts can be deduced from them.
Luckily, I am very comfortable with patients, which made providing care very easy. I was not afraid to go into other patient’s rooms if they rang for help. I would try my best to help the patients; however, if I needed help I was not afraid to ask a fellow student or nurse on the staff. It is very important to be able to talk to patients and work as a team with fellow coworkers as it made the job easier. On the other hand, I need to go over mother and baby assessments to become more familiar with both. I was able to complete the assessments; I now need to do so in a timelier manner while ensuring I do not forget any key areas. Lastly, it is vital that I continue to go over patient teaching prior to clinical. Being comfortable with the patients made the teaching easier, though I need to become more familiar with all the material that needs to be taught.
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).