How Can Nurses Do Pain Management?

Nurses play an implicating role in critical care. They should provide the patient with explanations that give information about the procedures they will undergo and should also inform them about the sensory changes which they may experience.  These efforts would help decrease distress and anxiety, both of which are the known causatives of pain and discomfort.

Patients should be taught that the discomfort will be experienced by them for a short interval of time after their surgery and it will be similar to an achy feeling in their lower back. Nurses should inform them about the level of bed rest that will be required, which turns out to be a tiring effort. The nurse should explain & teach the patient with the coping skills, for this an assessment of how an individual copes with pain will be required. A pain relief strategy will be formed based on the coping capacity of the patient and strategies such as relaxation, book reading, listening to music, and / or using analgesics would be suggested to facilitate the pain management process. Giving the patient rubs, position change, imagery, provision of foam mattresses etc. would also help.

 Health Promotion & Prevention

The health promotion and prevention activities would include effective guidelines given to the patient during the discharge. After discharge, the patient has to be taught about how to take care of the site of intervention, how he should be able to recognize symptoms and signs of complications, and what lifestyle changes should be brought so that the risk factors are reduced.

Allied Health Team would be taken for assistance, the important members would be :

1. Dietician - to provide the patient with adequate health diet.
2. Physiotherapist- to instruct patient about the exercises required and to facilitate early recovery.
3. Counsellor – To counsel the patient, so as to keep him socially active and facilitate a speedy recovery. To educate the patient about his health, the complications he can face and the precautionary measures he has to take.
4. Other Staff members which indirectly assist in making the hospital a patient friendly place and ensure early recovery.

Patient Education is of vital importance so as to assist the patient and the family to get back to normalcy.

The education should involve the need for frequent assessment of vital signs, diagnostic tests, etc. Patient should report to the hospital if he finds any numbness or pain on the affected limb, or right/left lower quadrant pain. He should be emphasized that the affected limb should not be bent. Also the patient should lie in a straight position.

Instructions should be provided about all medications and their susceptive unfavorable effects. Also, before stopping the medications intake, the patient should be instructed to consult the doctor.

Pain management protocols to be instructed carefully, the dosages of analgesics should be limited to the drug dosage prescribed.

While being at the hospital and post discharge also, the patient and the family should be instructed to notify the signs and symptoms of toxicity like anorexia, nausea, depression, vertigo, blurred vision, etc.

For treatments of recurrent chest pains, the patient has to be instructed about the dosages of sublingual nitroglycerin.

Proper dietary instructions should be followed. The patient should restrict to a low-sodium, low-fat, or low-cholesterol diet; a list of foods to avoid has to be provided by the Dietician. The exercise program for cardiac rehabilitation has to be designed by the physiotherapist or the physiologist and then given to the patient explaining the level of exercise to be done.

Measures of coping with depression and stress should be instructed and if needed the patient should be subjected to support groups, in case a smoking cessation is required.

Ensuring that the patient follows all the protocols instructed is of necessity and to be taken care of by the family members.

It is of vital importance that the Nurses in the critical care areas of the hospital as well as elsewhere are a critical thinker, the nurses should be able to recognize the focus of care to be provided. The recognition of patient’s biophysical and psychosocial need enables an effective health management and recovery process for the individual. Nurses should understand their multidimensional and focused myriad roles, namely being an educator, counselor, helper, family member, friend, etc. so as to ensure that the patient can relate to the hospital care and facilities.

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