How Pain Refers To The Physical Suffering And Discomfort?
Pain refers to the physical suffering and discomfort that results from an injury or illness. There are various ways through which the health practitioner can identify that the patient is experiencing pain. Patients who can talk can volunteer information to the healthcare provider or can answer questions asked to enable the health provider to identify pain and its intensity. Drugs that are used for pain management include acetaminophen, corticosteroids, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs, naproxen and ibuprofen. (Gélinas et al. 2013, p160). However, the patients do not usually volunteer information on pain since some of the patients think that if they say they are experiencing pain, the doctor’s workload may increase, increase in medication and also increase in the hospital bill. Patients can make assumptions that pain is part of the recovery and management. The health practitioners may have misconceptions that newborn, the old or people with altered mental capacity have reduced sensitivity to pain (Flor & Turk, 2015 p10). The patient can either use the verbal method to tell the health professional about the presence of pain.
There are non-verbal prompts that the patient can use to indicate the presence of pain and the exact location of the pain (Gélinas et al. 2013, p160). These cues are mostly used by patients with altered mental capacity. Non-verbal signs include; various facial expressions, the physical change of positions, variations in relational responses, changes in action designs and alteration in conceptual status. The different facial signs that the patient may show to indicate pain include; twisting, unfair expressions, scowling and quick eye blinking. There are various changes in body movements for pain indication ranging from guarding, worried, rigid, and fiddling and also anxiety. There is a change in relations nature in which the patient shows anger towards people, fighting healthcare attention as well as withdrawal. The patient experiencing pain exhibits variations in action design. Pain can make the patient have changes in mental capacity which lead to grief, bad temper, misperception as well as crying. There are also physiological signs that can be used to determine the presence of pain. When the patient is experiencing pain, there develops tachycardia and increased breathing rates. The patient can also show signs of increased blood pressure. Finally, a patient experiencing pain can have diaphoresis and dilated pupils (Hasenbring et al. 2014 p367).
Patient’s understanding of pain is crucial since pain is best assessed by gathering various information from the patients themselves since pain is regarded as a personal encounter. Therefore, the health care provider usually believes on the report given to the patient regarding their pain situation. This can be through verbal or non-verbal methods. The procedure of the pain assessment process relies on the mutual interactions between the patient and the care provider. Trust is created, and the patient is encouraged to give the report voluntarily without any biases. Determining pain is a vital element in the physical assessment. Pain has been described as the fifth vital sign which represents a five-step evaluation of pain. This evaluation starts from the point of no pain (Flor & Turk, 2015 p16). The second stage is a little pain, then more pain, a lot of pain and finally the fifth stage is the unbearable pain. As seen above, pain assessment is considered as a continuous activity and not a single occasion. A detailed and more comprehensive evaluation of pain is advocated in situations where the pain drastically varies since abrupt changes usually represent an underlying pathological condition (Ballantyne, 1523). Pain is assessed at the start of physical examination to enable the clinician to know the comfort range of the patient to develop any measures needed to reduce pain.
According to the nursing standards, nurses should possess certain values including ability to solve problems. Getting information on pain from the patient is not an easy task since various obstacles face the pain assessment process. These can be either patient or nurse related factors. The patient may not give the required information on pain due to fear of being seen weak, cultural beliefs, privacy issues, fear of increased medication which could lead to the rise of the medical bill. Therefore, the nurse should develop various abilities related to problem-solving (Yoo & Park, 2014, p47). Privacy of the patient during evaluation of pain is paramount since it reduces distractions and enables the patient to give information that he may regard shameful for example pain in the reproductive organs. The nurse should have extensive information the cultural beliefs of the patient to carry out pain evaluation procedure according to the culture of the people. For instance, the female nurse should know the restrictions in some cultures that does not allow men to undress in front of the women. Therefore, the female nurse should be able to ask for help from their male counterparts. The nurse should be able to explain to the patient the benefits of medication that are used in pain management for example analgesics. The nurse should be able to convince the patient that though the drug bulk and hospital bill might increase, the medication for relieving pain are important hence help on pain should be sought as soon as symptoms arise (Yoo & Park, 2014, p51).
There are few tools and devices in use for the pain assessment procedure. These devices need prior collection, gathering, assembly and set up to reduce wastage of time since pain evaluation process should be as short as possible since the patient is in pain and needs urgent medical attention. Gathering equipment is helpful in managing time so that the patient is put out of misery as soon as possible (Bourne et al. 2016, p73). In assessing pain, tools required are minimal. The most important assessment tool is the nurse’s understanding of the pain, how the nurse perceives pain and the nurse’s attitude towards suffering. It is key that the nurse understands pain structures, pain theories, perceptions of pain and the psychology surrounding pain. Most of these concepts are discussed in medical books. Tools used in pain assessment range from simple scales to more complex ones. Simple levels include Visual Analogue Scales (VAS), while the more complex ones are color scales and logarithmic scales that are used in analyzing different pain facets (Bourne et al. 2016, p73). The choice of the tools or scale used depends on the type of pain experienced. The McCaffery-Beebe, the Melzack, and the VAS are adequate in assessing pain. A thermometer and a stethoscope can be used to assess the physical effects and the impact on body organs. These two equipment are straightforward and familiar but necessary in all clinical procedures (Bourne et al. 2016, p77).
Pain assessment needs to be conducted in a systematic way. The pain evaluation procedure should always start with the patient rating the pain on a scale of 0 to 10 whereby 10 represents the most severe pain while 0 means that there is no pain at all (Perry et al. 2013, p15). The nurse or other healthcare personnel should ask on the history of the present pain which requires the patient to answer questions on when the pain started and the duration the pain has been there. The patient should be able to explain what they think started the pain and whether the pain is being referred to any other place. The location of the pain refers to the region where the patient is feeling the pain. The location is the structural dissemination of pain. The quality and character of pain can either be burning, stab, lancinating or even aggravate. The intensity pf pain can be described as either mild, moderate or severe based on various scales. The aggravating pain factors refer to what makes the pain worsen. The alleviating or relieving factors refers to what makes the pain lessen. These alleviating factors may include medications and other remedies taken.
The tool to be used in the evaluation of pain must be dependable. This tool should have constant outcomes when used in similar situations. The tool should also be valid such that it can measure pain and no other quantity which may include anxiety. The tool should also be precise and not burdensome since patients tend to give up if tired or in pain. Most of the time pain is assessed while the patient is making movements and taking deep breaths. The important method of pain assessment is through verbal communications as the patient narrates his encounter with pain to the nurse (Hadjistavropoulos et al. 2014, 1218). Various pain evaluating programs produce arithmetic data in a continuous or interval measure.
Mechanisms of pain evaluation include oral and arithmetic self-rating measures, behavioral surveillance techniques and physiological reactions. The patient offers the most efficient measure of the experience since pain is subjective. The Visual Analogue Scale together with McGill Pain Questionnaire are the most used approaches for the evaluation of pain in the general medical practice and research (Lucas et al. 2016). The McGill is usually used in cases of complex pain situations since it requires a lot of time. The assessment tool should be very sensitive and not biased providing instant data with precision and dependability. The tool should distinguish between pain, emotions, and unpleasantness (Bourne et al. 2016, p73).The tool that is applicable in both clinical and experimental settings is preferred. The favorable device should be absolute and not relative scales.
Hospitals are environments in which many infections can be acquired. Therefore, healthcare cleanliness is significant for patient’s prevention of infection, and well-being. Cleanness entails both personal hygiene and environmental purity. The health practitioner should ensure hand hygiene when dealing with the patients to reduce possibilities of infection. Patients should always handled with clean hands and gloves on all the time to reduce spread of infections. Cleaning of material is crucial in ensuring that time is saved, the patient is safe and promotes hygiene within a unit (Whitehouse et al. 2014). This prevents reinfection or spreading of infections and diseases. It is also important as given in different ethical setups to return equipment as a matter of colleague courtesy. Proper disposal of used tools ensures reduced environmental pollution. When the used dangerous tools and equipment, for example, the needles used to inject analgesics, it serves as a safety mechanism since these harmful instruments are out of reach to the population. The containers that have medicine used for pain management and other waste products of this process can be a significant environmental risk of pollution since most of them are not biodegradable. Therefore, proper waste management and disposal methods should be employed (Hueil et al. 2014). Various policies provide the guidelines on the measures to be undertaken to enable a clean environment. The nurse should be able to clean the instruments that can be reused and properly dispose of other used equipment. The tools that are needed for the pain assessment procedure of the next patient should be replaced instantly to avoid inconvenience and delays in service delivery. The standards for the clean policy are outlined by the Center for Disease Control (CDC) which every health professional should follow (Whitehouse et al. 2014).
Documentation is an important tool in the delivery of medical care. The healthcare provider needs to document and record each and every detail that the patient narrates. Various documents and reports are usually prepared and contains valuable information that helps the healthcare provider to offer adequate health care services. In pain assessment, documentation is paramount since the evaluation is based on the narration of the patient (Kozlowski et al 2014, p23). Documentation warrants the continuity of healthcare as it is used as a communication device amongst clinicians. The documents help in planning and evaluation of patient’s treatment since it creates a long lasting record for future patient care needs. The records also help in the assessment of the effectiveness of the treatment. For example, on arrival, the patients report that he feels chest pains, during discharge the clinician should refer to the documents and ask if the pain is still there or gone. This help assesses if the offered services were helpful. Records acquired in pain assessment is also used in research to help come up with better pain management plans and methods (Kozlowski et al 2014, p34). The records are used to substantiate billing as well as their use to recollect a memory. Every care provider should know the importance of documentation during various medical processes including pain assessment.
Theory is acquired from the nursing schools, conferences, books, online and from other many clinical materials. A nurse should be able to connect theory and practice while carrying out their pain assessment procedure on patients (Baillie, 2014). Proper synthesis and understanding of literature, documentation, and interpretation of various methods related to pain evaluation help the clinician accurately understand and implement the pain assessment procedure. The nurse should have vast knowledge on all the aspects of pain evaluation and an explicit integration of all this information to enable exceptional performance in the pain assessment process. Since the nurse is aware of the various adverse effects that can be caused by untreated pain, he or she will act according to the urgency of the situation to avoid the physical and psychological effects resulting from constant pain. The health professional should have the necessary knowledge and skills required to operate pain assessment tools correctly so as to ensure ultimate patient satisfaction (Day et al. 2014, p.691). The learned theory about the guidelines of the pain assessment tool should be put into practice through following the set instruction to ensure better results and safety of the patient. The nurse should have an open mind to offer individualized services since pain evaluation process is patient based. The nurse should employ pharmacology knowledge and physiological of pain to come up with a medical prescription that meets all the needs of the patient (Day et al. 2014, p.703).
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