Effective pain management starts with assessmentWhen assessing pain, nurses may ask the patient, “On a scale of one to 10, what is the maximum level of pain that you can endure if you walked down the hall?” This will enable you to adopt a suitable pain management approach based on the level that the patient has indicated which will ultimately reduce his pain level.
After that, you can identify the patient’s pain location and the severity of the pain. This will allow you to form a better understanding of the cause of the pain and from there, will enable you to consider what can bring relief to him. When the characteristics of the pain has been evaluated, you would most likely be able to review any potential factors that may intensify the pain and also identify medical comorbidities such as diabetes and cancer which might have played a part in contributing to pain.
When managing patients’ pain, your goal should be to promote optimal function. Hence, it is crucial that you determine the kind of activities that the pain has prevented the patient from doing. In view of this, you may also set the goal of ‘the client will achieve a satisfactory level of pain relief within 24 hours’, which will lead to the patient reporting of less pain and hence will be able to carry out Activity Daily Living (ADL) activities.
Offering non-pharmacological interventionsInitiating pain therapy requires a holistic health approach, since pain affects a person’s physical and mental functioning. Therefore, whenever a patient experiences pain, there are non-pharmacological as well as pharmacological strategies that you can offer.
Several non-pharmacological interventions are initiated by nurses. These include cognitive-behavioural and physical approaches that are used together with pharmacological measures.
The goals of cognitive-behavioural interventions are to change patients’ perception of pain, to alter pain behavior and to provide patients with a greater sense of control. Some examples are prayer, distraction, relaxation, guided imagery, music and biofeedback. Meanwhile, chiropractic and acupuncture therapies are examples of physical approaches.
Anticipate the pain medication scheduleEven though physicians are the ones who are responsible in prescribing the medication, it is the nurse’s responsibility to have good judgement in the use and management of analgesics to ensure that patients get the best pain relief possible. There will be three types of analgesics prescribed by the doctor, including nonopiods (acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS)), opioids (narcotic) and adjuvants, which is a variety of medications that enhance analgesics or have analgesic properties.
As a nurse, when you receive an order, your subsequent action is to determine patient’s allergies, identifying either if the patient is at risk for using NSAIDS as there was a history of GI bleeding or renal insufficiency, or at risk of using opioids for patients who had a history of obstructive or central sleep apnea.
Educate patients about how to manage their pain after being dischargedAlthough patients’ pain levels are successfully controlled during hospitalisation, the pain may still return after their discharge. Some patients fail to take their pain medications as prescribed in an attempt to cut down on expenses. Therefore, before discharge, a nurse should strictly instruct the patient to follow the medication schedule.
Nurses need to carry out effective pain management, as this is part of patient care. In achieving better clinical outcomes for every patient, nurses must follow the best nursing practices in pain management so that their pain will be effectively alleviated. MIMS
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