John Ryan’s pain specialist refers him to the community nursing service to have an initial assessment from the Outpatient Pain Clinic. The community nurse is about to undertake several visits to this new client’s home to accomplish the assessments and provide care and education. This paper will present the rational priorities of the assessments and the interventions during the community nurse’s initial and follow-up visit on the basis of the Levett-Jones’ Clinical Reasoning process.
According to Levett-Jones’ Clinical Reasoning process (2013), before the first home visit, the nurse should go through all the information about the patient, including John’s medical history, the results of previous observations, assessments and exams, current using
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According to the given information, John is suffering from significant ongoing pain for years and the pain is suddenly increasing. By undertaking pain assessment, the nurse could know the detail about John’s pain as in its intensity, location, onset, duration, variation and quality (Tollefson, 2012). Australian Centre for Evidence Based Aged Care (2012) suggests that untreated pain may cause by the health professional’s inadequate knowledge and lack of effective pain assessment. However, the possible consequence of untreated pain includes physical and psychosocial dysfunction (ACEBAC, 2012). 'Assessment is the first stage in the nursing process and must be the first stage in pain management (Mitchell, 2011, para.13) '. Therefore, a comprehensive pain assessment is critical for the nurse to identify the severity of John’s …show more content…
After the psychosocial assessment, the nurse identifies that John’s main issue in the psychosocial assessment is his sleep and rest, as he reports that he has woken up at night by pain. Byers, Lichstein and Thorn (2016) state that sleep disturbance is common in people with chronic pain, while about 53 % up to 88 % patients has the estimates of insomnia symptoms. ACEBAC (2012) suggests that lacking of sleep can cause a heightened perception of pain, which disrupts sleep in return. This indicates that pain perception and sleep have reciprocal influences to each other, which is a vicious circle. The community nurse’s goal would be to improve John’s sleeping quality, thus some nursing interventions need to be taken action. As the sleep disturbance may probably be caused by John’s pain, again the nurse can provide a medication education about his PRN diazepam and his pain relieve drugs, and refer this condition to his pharmacist. Secondly, There are various psychosocial therapies as non-pharmacological interventions recommended by Park (2012), for example, cognitive-behavioral therapy, hypnosis, relaxation, guided imagery, pain support group and pain education program. Andrews, Strong, Meredith and D 'Arrigo (2014) advocate that current materials suggest relaxation therapy and cognitive-behavioral therapy
Identifying patients correctly when providing Care: Nurses are supposed to have two resident Identifiers when trying to care for a patient for the first time and after that, one identifier is acceptable. Identifiers such as Room number or location are not acceptable. To ensure this is carried out correctly nurses must ask for two identifiers in situations such as specimen collection, when providing treatments or when collecting blood for clinical testing (containers must be labeled in front of the patient). The Purpose of this guideline is to ensure that the patients are been properly identified and that they are receiving the right treatments and medications (The Joint Commission, 2012).
Patients often have complex care needs, and often present with multiple co-morbidities or problems. The process of conducting a comprehensive nursing assessment, and the coordination of care based on these findings is central to the role of the Registered Nurse (NMBA 2006). Evidence-based interventions must then be planned and implemented in a patient-centred approach in order to achieve agreed treatment goals and optimise health (Brown & Edwards 2012).
This essay will demonstrate an understanding of the clinical reasoning cycle which describes the procedure by which nurses gather prompts, process the data, come to an understanding of a patient’s problem, design and implement interventions, assess results, and reflect on and learn from the process (Hoffman, 2007; Kraischsk & Anthony, 2001; Laurie et al., 2001). The clinical reasoning cycle consists of five main stages, it comprises of; considering the persons condition, collecting indications and data, processing the information, recognizing problems/issues and detailing the assessment (Levett-Jones 2013). Throughout this essay these five main parts of the clinical reasoning cycle will be discussed and put into context. The first step of
Pain is not always curable but effects the life of millions of people. This essay examines the Essence of Care 2010: Benchmarks for the Prevention and Management of Pain (DH, 2010). Particularly reflecting on a practical working knowledge of its implementation and its relevance to nursing practice. It is part of the wider ranging Essence of Care policy, that includes all the latest benchmarks developed since it was first launched in 2001.
...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...
At some point of life, virtually everyone experiences some types of pain. Despite the availability of standardized pain management methods such as using analgesics and opioids, patients might inadequately managed for pain if pain assessments are done inefficiently. Nurses are in a unique position to assess pain as they have the most contact with the child and their family in hospital. Getting a thorough pain assessment occasionally hard for nurses with the patients whom cannot collaborate. For example, pain in infants and children can be difficult to assess.
on Pain Care will evaluate the adequacy of pain assessment, treatment, and management; identify and
While sleeping medication is big business, research has shown that the most successful treatment for insomnia is really cognitive behavioral therapy. This approach to psychotherapy was first founded by such leading researchers as Albert Ellis and Aaron Beck. Beck's exceptional research, theoretical formulation and clinical methods were first published in a series of considerable books and articles in the 1960's and 1970's. Additional research since the publication of these books and articles has shown the usefulness and effectiveness of this treatment approach with regular psychological and physical disorders including anxiety, chronic pain and insomnia. The most noteworthy aspect of cognitive behavior therapy (CBT) for insomnia is that it in fact treats the cause of the insomnia itself and not just the indications as medication does. Additionally, CBT can be united with medication administration for patients who need quick relief or to help primarily break a pattern of insomnia. CBT works because the main cause of insomnia is over s...
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.
Effective treatment of cancer pain is essential for ensuring the best outcomes for cancer patients, in terms of physical, psychological and social aspects. Although there are no NICE guidelines for management of cancer pain, WHO guidance should be used to inform clinical practice. Careful assessment is a critical element of the process to ensure that patients are offered the treatment which is likely to offer the best outcomes, yet without providing a greater than necessary risk of complications such as tolerance and addiction to opioids. The main outcome that this paper highlights is that “Pain is what the patient says it is and exists when he says it does” (McCaffery 1983
This article has shown me that new strategies are needed to reduce sleep disturbances, improve sleep quality, and support the need for supplemental daytime sleep in hospitalized individuals. These strategies include monitoring patients’ sleep and assess quality of sleep and duration, resolving the problems of sleep disturbance, recognizing that nighttime noise, light, and other factors potentially interfere with patient sleep, minimize lighting in shared patient rooms and turn off lights earlier at night, frequently assess for pain and administer prescribed pain medications to minimize sleep disruption. This article taught me more about sleep cycles and disturbances in hospitalized patients. As a future nurse, I have to accurately assess the patients’ personal characteristics and health education needs, and share this knowledge with my classmates.
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
...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.
"A Guide to Taking a Patient's History” is an article published in an August 24th, 2007 issue of Nursing Standard. Written by H. Lloyd and S. Craig, the process of taking a history from a patient is outlined. Many aspects pertinent to obtaining a sufficient health history are discussed. In addition to providing a framework for completing a thorough health history, guidelines and interview techniques are explored.