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PAIN MANAGEMENT

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Pain is a widely recognized accompaniment to numerous disease conditions and influences on a victim’s quality of life. Despite the fact that advanced knowledge, as well as technological resources, have been determined for pain management, different investigators assert that many hospitalized patients still experience pain. For instance, a study conducted by Pasero et al. (2016, p.170), indicates that an estimate of three-quarters of victims hospitalized with medical disorders reports pain where 32 percent of these individuals in adverse pain-related distress, in spite having prescribed analgesia. With that said, various researchers maintain that nurses take an integral part in not only assessment but also the management of patients’ pain. Nevertheless, it is unfortunate that studies performed in clinical settings depict that nurses underestimate patients’ pain (Pasero et al. 2016, p.174). In turn, nurses under-medicate pain victims by underprescribing pain relief. As a matter of fact, nurses compound the mismanagement of pain by continuing to utilize analgesia at the lower end of an array of potential doses even when a person’s pain is not relieved by these doses.

            A point in case is that of my uncle who was attended to a nurse at one of the hospitals in California, it was evident that the nurse aspired to mitigate his pain instead of relieving it completely. In particular, this is enough evidence to demonstrate that nurses do not pay adequate attention as far as pain management is concerned. What is more, Pasero et al. (2016, p.177), show that nurses appear to link particular kinds of surgery or even medical situations with certain expectations concerning the severity of pain and the effective time of analgesic therapy with narcotics. Different studies indicate that approximately 50 percent of the nurses administer narcotic analgesia to trauma or post-operative victims for a maximum of 72 hours. On the other hand, research has determined that a considerable portion of nurses do not have adequate working knowledge of the features and responses of narcotic analgesia as well as do not comprehend the precept of scheduled analgesic administration.

            It is evident that pain assessment and management has been focused globally in numerous scientific sectors. Nevertheless, research indicates that pain evaluation in non-communicating disabled individuals is limited. Nurses experience difficulties in interpreting patients’ behaviors, as well as pain among the victims, remain unidentified. According to Voshall et al. (2013, p. 227), pain examination in disabled human beings is hard due to insufficient assessment approaches and inadequate skills and knowledge of nurses. It is unfortunate that intellectually disabled individuals suffer from adverse pain on a daily basis; however, their pain not well controlled. Nurses need to assess pain in non-communicating human beings by adhering to physiological changes such as skin color, breathing, blood pressure, heart rate, and sweating, to mention but a few. Accordingly, nurses require observing behavioral alterations such as facial expressions to assess pain.

            Nurses lack appropriate skills and knowledge that enable them to utilize various types of pain assessment equipment. Specifically, this makes it hard for the non-communicating disabled individuals, as they are unable to employ any self-rating scales. In the modern world, documentation of pain evaluation and its efficiency is crucial grounded on the systematic application of a validated pain examination tool. Studies indicate that nurses do not practice what is supposed to be performed during a patient’s pain assessment process (Hunnicutt et al. 2017, p.232). For example, it is recommended pain re-assessment should be done 30 minutes after the usage of analgesia. What is more, nurses require utilizing pain management tools as well as examining the efficiency of an approach used in pain control.

            A study carried out by Fishman et al (2013, p.971) indicates that approximately 8 percent of the nurses do not go through an additional training for pain management; however, they have a significant experience working with people with intellectual impairment. The authors of the article in question suggest that nurses need to pay more attention to their education in pain examination, as they should possess excellent skills to identify pain. It is important to note that nurses do not take their time to assess pain in patients with intellectual disabilities in an effective manner (Fishman et al 2013, p.974). In this regard, there is the need for professional organizations to arrange adequate education for nurses is mandatory. Additionally, pain examination and the application of various equipment should be included in fundamental education programs of nurses.

            Different scholars argue that many individuals suffer from pain in numerous ways. For example, patients become anxious or even depressed and want to kill themselves. As a matter of fact, people with pain are unable to perform their daily duties, which they used to do without pain. Therefore, this state of living in pain adversely influences their correlations with other individuals and sometimes their capability to assert employment. Ersek et al. (2016, p.348), demonstrate that inappropriate control of pain can contribute to negative psychological and physical consequences for individuals as well as their families. People need to understand that continued unrelieved pain initiates the pituitary-adrenal axis, which suppresses the immune system. Nowadays, ineffective pain management puts nurses at risk for legal actions. The reason is that contemporary standards for pain control need that pain be efficiently addressed and controlled (Duke et al. 2013, p.12). On the same note, hospitals and all health centers stand to lose their public image and revenues if pain is managed inappropriately. Current evidence depicts that high degree of depression and pain are connected to poor satisfaction with care in ambulatory settings.

             According to Coyle (2016, p.318), lack of pain evaluation by nurses is a major problematic obstacle to obtaining excellent pain management. Despite the fact that many recommendations and standards are prevalent for what consists an appropriate pain evaluation, nurses do not put the recommendations into practice as far as pain management is concerned. Practitioners working with acute pain are required to choose adequate elements of examination for the existing clinical situation. Similarly, both patients and nurses need to comprehend that an appropriate pain evaluation is performed on a regular basis utilizing a standard format (Achterberg et al. 2013, p. 147). In particular, assessment guidelines should be directed to the hospital or even unit regulations as well as excellent procedures. In this case, to achieve the victims’ wants, pain re-assessment should be carried out after every intervention to examine the impact and find out whether the modification is required.

            DeVore et al. argue that healthcare institutions are working hard to monitor patient experience to assess and enhance the quality of care provided by professional practitioners. (2017, p.18). The reason is that nurses spend a significant amount of time with patients; hence, having a key influence on their experiences. The writers of the article in question maintain that nurses require understanding important aspects within the nursing work environment as far as pain management is concerned. Duke et al. allude to the fact that a variety of factors influence patient experiences of the quality of nursing offered to them (2013, p.15). Therefore, the investigators believe that nurses feel pressured to heighten productivity as well as report high administrative work, which is the reason why they undertreat patients with pain. The scholars conclude that nurses need to work within healthcare standards and reconcile cost-efficiency and accountability within their urge to offer adequate nursing care, which is grounded on patient needs as well as preferences.

            Addressing inadequate pain management problem requires profound transformations in how health schemes are developed. In this case, nurses are supposed to be adequately prepared to take on the task of pain management in an appropriate manner. What is more, patient safety and quality initiatives are important factors guiding nurses to practice from a professionalism framework (Duke et al, 2013, p.17). A current model for nursing administrative practice requires a restructuring of different roles, obligations, and functions of a nurse administrator. An excellent environmental supporting expert practice should be developed to ensure that nurses provide professional and safe services to pain victims. Additionally, need to comprehend that patient-centered care is key for adequate pain management process. As a matter of fact, nurses are advised to embrace holistic communication where they let go of judgments and learn to appreciate a patient’s point of view.    

            In spite of the preceding facts that nurses play a significant role in the failure of pain management, it is time for health authorities, governments, non-governmental organizations, and all stakeholders to look for ways to not only inform but also empower patients to agree on proper objectives and appropriate strategies to achieve effective patients’ pain management. What is more, there is the need for a robust organization of knowledge to develop approaches for strengthening patient engagement. It is noteworthy that differences in cultural barriers, social inequalities, and morbidity patterns must be considered when planning techniques to enhance significant patient engagement. In case the preceding obstacles are overcome, the consequences are positive, as individuals who are informed as well as engaged tend to apply few health care resources and make adequate selections, which contribute to excellent health results (Twycross 2013,p.e 166). Additionally, to obtain considerable efficiencies in resource use, promoting victims to take control when ill prove to be appropriate equipment for enhancing public health, especially pain management. 

Conclusion

            Overall, it is the time people to understand that appropriate pain evaluation needs an interdisciplinary method. Here, documentation of pain examination, as well as the influence of interventions, is paramount to enable communication among nurses concerning the prevalent status of the victim’s pain and actions to the plan of care. Despite the fact that all blame is directed to nurses, the truth of the matter is that developing and asserting an institutional pain performance enhancement plan is a joint commission need. Different institutions and government agencies should come up with interdisciplinary methods to acute pain control with clear lines of obligation for obtaining excellent acute pain management. In addition, documentation of pain evaluation is vital as a mode of monitoring the quality of pain control with a health facility.  For the long term aspirations of the medical sector with specific regards to pain management, it becomes imperative to realize that optimal patient care would entail the acquisition of requisite knowledge, skills and the right attitude towards pain and understanding the concepts of management. Knowledge acquisition and practice of diligent care towards pain management will need to be based on the availability of evidence to prevent patients from suffering the consequences of harm arising from medical negligence as far as patient pain is concerned. Currently, there is an inherent need for nurses to spearhead and advance pain management care for all clients under their care. Pain related promotional campaigns are now being supported by several medical institutions through preventative and rehabilitative incentives aimed at enhancing quality patient care through pain management.      

          Professionalism and quality assurance in nursing practice can be improved by implementing a raft of measures at various levels of regulation of the clinical practice. National regulators should review the barriers that limit nurses’ scope of professional duties and responsibilities. Currently, in Louisiana, nurses do not have authority to perform some key essential functions in pain management such as giving prescriptions for analgesic drugs. It is therefore only recommendable that such state regulations are reviewed and amended to expand the scope of clinical practice skills of nurses. In addition to being allowed to administer the analgesic drugs, nurses also ought to be allowed to acquire and practice the skill to accurately prescribe pain-relieving drugs. We should also train our nurses to perform the invaluable emergency theater skill of performing epidural induction of surgical anesthesia. Currently, the skill is only a preserve of anesthetists. In the case of mass surgical emergencies, nurses with such skills would therefore greatly relieve anesthetists of heavy workload hence improving quality and efficiency of the surgical unit. Improving pro-activeness among nurses is also recommended. Hospital management can capacitate and empower them by including them in key decision-making organs of the facilities. When accorded this level of trust the productivity and clinical self-esteem of the nurses are likely to improve, making them confident enough to undertake more perceived complex tasks in patients’ pain control. Finally, hospitals should invest in life-long training for all the health care workers to promote personal professional development among health workers in general. If implemented meticulously, these measures would greatly improve standards of pain management in nursing practice.

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