There are various misconception that affect patients ability to communicate their pain levels with the nurse.The primary reasons for using guidelines in pain assessment is to prevent biases and remove guesswork. It is very important to understand when patient is experiencing pain and to use pain assessment guides for each individual such as:
1.Pain location.That is where is your pain?.For example head,abdomen, back,leg. Is it internal or external pain ?.
2.What is the intensity of the pain?.On a scaleof 0 to 10 how will you rate your pain?.10 is worst pain ever and zero is no pain.
3.What is the quality of the pain?.What is the exact word that you will use to describe your pain .For example dull,sharp,shallow ,aching, stabbing,throbbing.How long does the pain last?.
4.What is the duration of the pain?.How long does your pain last?.
5.What aggravates the pain?.What makes the pain to get worse. And what alleviates the pain?.That is what makes the pain to go away or disappear or get worse?.
6.What is the chronology of the pain?.How does the pain develop and how does it progress. Since the pain started is there any change?.What methods of pain relief have you tried since the pain started?.
7.What is the indication of the pain physiologically. That is,are there signs of sympathetic or parasympathetic simulation that occur with the pain?.
8.How does patient emotionally response to pain?.( Behavioral response- movements, gross motor activities)
9.What are the subjective and Objective findings?.Decreased blood pressure and pulse,pupil constricted, crying, rapid and irregular Respiration, muscle tension, nausea and vomiting, signs and evidence of anxiety,moaning, grunting.
10. How does pain affect patient daily activities?.Accurate assessment of pain and effective management of pain.
Some clinics will give patient the McGill-Melzack pain Questionaire in which patient/client/individual will pick up words that match or describes their pain experience. The general misconception is that only the health care professionals has authority about the existence of pain, and the nature of patient pain.
That is totally wrong because patient has the pain and knows exactly about the pain and not the health care professionals.He who wears the shoes knows where it hurts. I have witnessed so many instances where patient suppressed their pain or used alternative means to alleviate their pain.I can recall a young man that had surgery. I frequently visited his room to ask him about his pain level. He denied pain.I knew that the spinal block is suppose to last for few hours in this case study but he kept denying pain for days. I monitored patient closely only to find out that his friend brought him pain medication from outside.I reported it and questioned him he told me that in his previous surgery he went through difficult times with nurses because they believed that he was a “pain seeker”. So he decided not to go through that again.His primary care physician came and reevaluate patient level of pain and included Ativan 1mg po Q8hours to reduce anxiety.
Some patients can be emotional about pain but that does not mean that the pain did not exist.If pain is adequately treated following the guidelines patients will not be afraid to communicate their pain levels to the nurses or doctors.
QUESTIONS AND ANSWERS.
1. Mr Robert Mxy during postoperative care is on controlled analgesia pump. This allows patient to:
A.Admister his own analgesia.
B.Happy and free from pain.
C.Patient take as much pain medication as possible.
D.Freedom of selection of pain.
Correct answer is A.Patient controlled analgesia pump does allow the patient to administer his own medication.
2.Mr Robert complain of gas pains which is common postoperative discomfort.What will be the best nursing actions?.
A. Encourage frequent ambulation.
B.Vital signs every four hours.
C.Deep and coughing immediately.
D.NPO x ice chips for 48hours.
Nurses You Move Me 