Pain Assessment Strategy For Nurses: Importance And Techniques
Acknowledging Pain in Patients as the First Step
Discuss about the Society of Clinical Oncology Statement.
Pain assessment can be described as an evaluation of the reported pain and the factors that exacerbate or alleviate the pain. This also includes the treatment and responses towards the pain. Responses towards the pain vary widely among the individual due to its dependence on the psychological and the physical factors. The method of pain assessment includes the: description of the pain by the patient; the other parameters are noted like the location, the intensity of the pain and the duration; the various events that preceded the pain (Lichtner et al., 2014). This study is based on the pain assessment strategy and the various steps that are involved in the analysis of the pain.
the code of the professional conduct for the nurses in Australia states in the conduct statement 8 that nurses that preserve and promote the privilege and the trust must be in accordance with the people that are receiving the care. Nurses have the responsibility of actively preserving the dignity of the people by practising respect and kindness for the powerlessness and the vulnerable people in the clinical setting. These significant amount of powerlessness is due to the pain experienced by the patient and thus acknowledging the same is an obligation of the nurses (Nursingmidwiferyboard.gov.au, 2018). Acknowledging the pain of a patient is the first step of identifying the condition of a patient. The pain experienced by the patient is quantified only through the communication of the same by the patient. A registered nurse cannot understand if any patient is undergoing pain if the pain is not accurately described by the patient himself or herself. The experiences of pain are the various indicators and signs of uneasiness and acknowledging the same provides a relief to the patient. This step is very initial step and it includes only a self-reporting patient who will be able to convey his or her experiences of pain. It is also important to note that acknowledging the pain of the patient provides the patient with a verbal confirmation (Nursingmidwiferyboard.gov.au, 2018).
Therapeutic interpersonal relationship is one of the basic and most important of part of all types of the health care interactions. This facilitates the development of a positive patient and nurse experiences. Therapeutic interpersonal interaction has the potential to enrich and transform the patient’s experiences. Considering the increasing approach of the patient centred care, it is important to therapeutically engage with the health care professionals so as to improve the health-related outcomes (Cleary et al., 2012). Research has shown that therapeutic engagements has resulted into influencing the interpersonal relationships. When therapeutic interaction is increased, it has resulted into a priority within the healthcare system. Different types of studies suggest that the development of the therapeutic interpersonal relationships has resulted into fortifying relationships, and also leads to increasing the nurturing of relationships between the patient and clinician communication and engagement. The perceptions of nurse and patient relationship and the patient care experiences concludes that communication is a foundation of patient’s perception of interpersonal continuity (Pinto et al., 2012). Establishing the therapeutic patient interaction comes at the step 2 of the of the pain assessment strategy because it is after acknowledging the pain, a line of communication has already developed between the nurse and e patient, thus building on the same momentum it is best to establish a mutual respect, trust and nurturing hope and faith.
Establishing Therapeutic Interaction with Patients
The 3rd step in the pain assessment strategy is the understanding pain experience, assessment plan and treatment options that are available with respect to the patient’s pain condition. After the assessment of the pain experienced by the patient it is necessary to frame a plan which is act as an assessment of the pain itself. There are different types of tools that are available for the assessment of pain like the FLACC tool which stands for (face, legs, activity, cry and consolability), Wong-Baker face scale for pain, visual analogue scale. These tools act as the ways through which pain are assessed effectively when the patients are not able to communicate properly (Rch.org.au, 2018). The FLACC tool is generally used for the child, infant neonate that range from age 3 to 18. These are active part of the pain assessment plan and the next adjacent step within this purview is the treatment options for the patient affected by pain. The treatment options that are available for a patient will be dependent on the type of ailment and the associated pain with it. The critical thinking and reason of the pain management involves 5 different dimensions like the sociocultural components, cognitive or affective, sensory and physiological (Glowacki, 2015).
The traditional pain assessment tools are very subjective in nature. There are a number of pain assessment tools that are for the healthcare professionals so that the patients can describe their pain intensity and rate them as well. tools like the self-report, behavioural pain assessment tools are the best way through which pain can be assessed, monitored effectively. it has been found that the majority of the nurses prefer to use the self-report questionnaire for the pain management study. The verbal descriptor scale and the numerical ratings scale are used by the majority of nurses in the clinical setting. studies show that abbey pain assessment scales and behavioural pain assessment scales are used by a majority of the nurses (Weininger et al., 2012). The self-report pain assessment scales are used due to its deep integration within the clinical setting, while the behavioural pain assessment scales are used with the communication difficulties like dementia. The self-report is the multidimensional and the unidimensional self-report tools are the best and reliable measure of pain as long as the patient is capable of responding to the questionnaire. In a timely manner, the self-report questionnaire is the best way that can be solved in faster way. The intensity of pain is the most important way to quantify pain in the dimension of the experienced pain (Gregory & Richardson, 2014).
- History of pain onset- history of the pain onset can have described as whether the patient has experienced the same kind of pain before. How frequently the patient was experiencing the pain in the past. Was the pain mild or it was severe and how it impacted the patient. History of pain is similar to medical records and it gives an insight into the pain itself (Unruh & McGrath, 2013).
- Location – the location of the pain deals with the specific part of the body which is experiencing pain and pinpointing such a part will always lead to better assessment of pain and subsequent treatment (Nam et al., 2015).
- Duration- the duration of the pain is actually an indicator of how critical is the situation. If a patient is suffering from pain for a longer duration of time, then it can be inferred that the health condition of the patient might not be in a proper condition (Boezaart, Davis & Le-Wendling, 2012).
- Characteristics of pain- the characteristics of pain can be described as what is the nature of the pain and how is the quality of pain. Whether the pain is mild or severe and how the pain is affecting the internal body parts and as a result how the pain is affecting the patient (Rockett et al., 2013).
- Aggravating factors- this is one of the assessment criteria and how the pain is actually hampering the deteriorating the health of the patient is assessed in this part. What are the factors that are increasing the intensity of pain is the main focus here (Ng et al., 2014).
- Relieving factors- this is more of a solution dependent assessment. What are factors due to which is getting reduced and how it is actually affecting the patient (Haque et al., 2012).
- Treatment options- this is also a solution dependent variable. Assessing the treatment options are one of the major aspects of pain assessment. The factors that will help in the reduction of the pain is taken into account into the pain assessment (Schnipper et al., 2015).
Pain Assessment Tools and Treatment Options Available for Patients
the equipment used for the assessment of a medical condition demand the same to be sterilized due to its application for the assessment of human ailments and health conditions. An example can be cited which can better describe this situation. A tumour cells can be painful if it outgrowths and becomes oversize. The pain from such tumour cells are often inferred as cancerous. Thus, for the analysis of the cells it is important to note that biopsy test is carried out in order to assess whether the cells are cancerous or not. For surgical process to be carried out in aseptic manner, medical equipment is used that are sterilized so that test can be carried out in a safe way (Stratman, Elston & Miller, 2016). Thus before using the equipment it is important to keep them clean and sterilized. The same equipment is used and thus such equipment needs to be sterilized again in order to reduce contamination and spread of the disease. There is medical equipment that do not require to be reused and thus are only used once. It is important to note that disposal is also an important aspect of safe usage of medical equipment. In order to reduce the spread of disease and contamination it is important dispose the equipment in a proper way (Seavey, 2013). Documentation of patient’s pain experience, assessment performed, interpretation and implementation of pain relief strategy.
Nursing documentation is an essential part of the good clinical communication. Legible and appropriate documentation provides an exact reflection of the nursing assessments. The documentation of the care also includes the provision of provider and the patient pertinent information and the support for the multidisciplinary team so that care can be delivered in a proper way. The various changes that the patients are undergoing are also within the scope of documentation (Rch.org.au, 2018). Documentation provides the evidence of the care and is also an important part of the medico-legal and professional requirement of the nursing practice. Documentation involves all the electronic and the written entries that are reflected in all the aspects of the patient care that are planned, communicated, recommended and provided to the patient. With respect to the documentation of the aspects of pain by the nurses, the implementation of the pain relief strategy, interpretation, pain assessment performed and the pain experience are all within the purview of documentation due to the valuable information it carries and then it helps in the further pain management strategies in future. Documentation also leads to proper management of the medical records (Blair & Smith, 2012).
Importance of Nursing Documentation in Pain Management
There are different types of ways through which the pain documentation is dealt. However, the best strategy is to reflect on the approach taken by the nurse and also on the health outcomes of the patient. Self-reflection is one of the best and appropriate way through which meaningful practice of nursing which allows the feelings of empowerment a satisfaction. The critical nursing practice has plenty of benefits and helps the nurses to gain an insight into the practice (Bulman, Lathlean & Gobbi, 2012). Reflection on the approach of the patient’s pain experience provides an understanding how the nurses feel about the pain experienced by the patient and what are the approaches taken by the nurse to deal with the pain of the patient. It is also important to reflect on the outcomes that are reported by the patient and the observation of the registered herself. The reflection upon the outcomes by the patient helps in taking into account the perspectives of the patient and the self-reflection also helps in proper observation of the patient and how the different strategies followed in the care delivery of the patient (Duke et al., 2013).
References
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