handling a patient who constantly complains about pain?

  1. How would you handle a patient who constantly complains about pain?
    Using the E.A.R (event, action, result) interview method and your reflective skills
    provide a written (800 word) summary to this question.
    You are also required to refer to the criterion referenced rubric on page 13 of
    the unit outline. This rubric will also form the basis of your feedback for this assessment
    item

Industry Reflection
Introduction

Acute and chronic pain management are essential facets in the treatment process and
overall recovery process of the patient. If not properly assessed and handled, the physical,
psychological and emotional well-being of the patient can be negatively affected lowering the

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chances of complete, timely recovery. The benefits associated with pain management are
accrued not only by the patient but also by the caregivers since they can offer medication
quickly to the patient amongst other benefits (Dijk, FM, Vervoort, van Wijck, Kalkman, &
Schuurmans, 2016) .
Proper assessment of the patient in pain forms the cornerstone of optimal pain
management. The success of the assessment will not only depend on the quality of the
assessment tool, but also on the healthcare provider’s ability to focus the patient (Mcintyre et
al., 2014; Joshi et al., 2014). Listening and a strong understanding of the patient’s pain is
critical in knowing the cause of the problem and the best formula to handle the problem.
Following these guidelines firmly ensures that the patient is allowed access to the best level
of pain relief mechanisms available (Dougherty, Lister, & West-Osam, 2014) .
Event
Reporting
I have previously dealt with cases of patients in pain, with the most notable case
dealing with a middle aged man. Recently having undergone lung surgery, the patient was
experiencing a considerable amount of pain, with difficulties in breathing. The patient did not
report this and thus adequate treatment was not given. Proper clearance of the lungs was not
possible due to dry coughing associated with the severe pain. He thus developed pneumonia
over time.
Action
Responding
In treating postoperative pain, various analgesics (e.g. acetaminophen, anti-
inflammatory, non-steroidal and opioids) can be prescribed (Henderson et al., 2013; Schug et

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al., 2016)). The desired effect and the patient’s pain scores dictate the choice of medication,
as each drug has a differing mode of action. Improving pain control should not, in any case,
jeopardize the safety of the patient. Unnecessary administration of opioids and overdosing
should be avoided to reduce the possibilities potentially fatal respiratory depression, or
increasing the patient discomfort (Dijk, 2015) .
Reasoning
In the scenario mentioned above, I conversed with the patient with the aim of making
him feel at ease and open up to his problem. With sympathy, I listened as he explained how
the pain had started shortly after the surgery and grown steadily. Starting as the standard
after-surgery pain, the pain had increased to a sharp stab in the chest. Coughing was minimal
and easy in the first instance, but as the pain increased this had changed to a strained cough
due to chest pain. After some assessments, I detected some symptoms of pneumonia in the
patient. After the chat, I assured him I would do my best to intervene and help control the
developing condition and ease the associated pain (Twycross, 2013) .
After the patient was reassured of the best care, I duly notified the doctor of the
situation. Together with the doctor, we conducted an assessment of the patient to determine
the levels of discomfort he was experiencing. This also assisted in identifying the best
primary interventions that could be applied to alleviate the patient’s pain and discomfort.
Opioids were administered to reduce the pain levels of the patient while other more efficient
intervention methods took the course (Mettens, Goossens, Verbunt, Koke, & Smeets, 2013) .
Relating
This case is similar to the one I had encountered. Since I am equipped with the
excellent conversation skills and know-how of the medical field, my first action will be to

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identify the cause of the pain experienced by the patient. By being sympathetic and listening
keenly to the patient, I will be able to decipher the type of discomfort the patient is in and the
possible causes. Employing my knowledge in healthcare, I can be able to predict a treatment
course that can be most effective in the short run if necessary.
Since the doctor is the one with the ability to prescribe the right medication, I will
confer with the attending physician and notify them of the patient’s condition. In a follow-
up, I will then ensure that the patient’s pain is being managed in the right ways by the tasked
personnel. Finally, I will take on to reassure the patient that they have the best medical care,
and everything possible which can help their condition, is being done to ease their pain
(Abraham, 2014; Butow & Sharpe, 2013).
Result
Julian showed a great response to medication. After the intervention, the patient
showed slow progression and after a period of one week, he no longer complained of the
pain. I continued closely monitoring the patient to identify the possibility of further
complications, but the patient seemed okay. The treatment for pneumonia was also effective
in the condition easing ultimately. The relationship of Julian with the care providers also
improved and was no longer reluctant to express how he was fairing medically.

Reconstructing
Nurses are especially important in the health care setting as they provide the much
needed psychological care to the patient (Lrsson, Sahlsten, Segesten, & Plos, 2011) . Apart
from the medical service rendered to the patients, nurses also give verbal, and written advice
given to the patients help in the overall patient recovery (Ontario Hospital Association,

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2011) . This of great importance especially to patients that are newly diagnosed with terminal
ailments and need constant care and attention facilitate the control of symptoms and
progression of the disease (Caudill, 2016; Gifford, 2013). The close relation enables patients
to better understand the facts of the illness based on facts and not the anecdotes and
misinformation widely voiced by the public (Melanie, 2016) .

References

Abrahm, J. L. (2014). A Physician’s Guide to Pain and Symptom Management in Cancer
Patients (Vol. 3). Baltimore, Maryland.
Caudill, M. A. (2016). Managing Pain Before It Manages You (Vol. 4). New York, London:
The Guilford Press.
Dijk, J. V. (2015). Measuring Postoperative Pain. Utrecht: CPI Wohrmann.

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Dijk, V., FM, J., Vervoort, S., van Wijck, A. J., Kalkman, C. J., & Schuurmans, M. J. (2016).
Postoperative patients’ perspectives on rating pain: a qualitative study. International
journal of nursing studies, 53, 260-269.
Dougherty, L., Lister, S., & West-Osam, A. (2014, December 8). The Royal Maraden
Manual of Clinical Nursing Procedures, 9, 9-30.
Lrsson, I. E., Sahlsten, M. J., Segesten, K., & Plos, K. A. (2011, February 20). Patients’
perceptions of nurses’ behavior that influence patient participation in nursing care: A
critical incident study. Nursing Research and Practice,
Melanie, J. L. (2016). What is psychosocial care and how can nurses better provide it to adult
oncology patients. Australian Journal of Advanced Nursing, 28(3), 62-66.
Mettens, V.-C., Goossens, M. E., Verbunt, J. A., Koke, A. J., & Smeets, R. J. (2013). Effects
of nurse-led motivational interviewing of patients with chronic musculoskeletal pain
in preparation for rehabilitation treatment (PREPARE) on societal participation,
attendance level, and cost-effectiveness: study protocol for a randomized controll.
Trials Journal, 2-11.
Ontario Hospital Association. (2011). Leading Practices in Emergency Department Patient
Experience.
Twycross, A. (2013, April 23). Nurses’ aims when managing pediatric postoperative pain: Is
what they say the same as what they do? Pediatric Nursing, 19(1), 17-27.
Mcintyre, P. E., Schug, S. A., & Scott, D. A. (2014). Australian and New Zealand College of
Anaesthetists: 2010 Acute Pain Management: Scientific Evidence. Melbourne, Australia:
Australian and New Zealand College of Anaesthetists; 2010.
Joshi, G. P., Schug, S. A., & Kehlet, H. (2014). Procedure-specific pain management and
outcome strategies. Best Practice & Research Clinical Anaesthesiology, 28(2), 191-201.

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Hogg, M. N., Gibson, S., Helou, A., DeGabriele, J., & Farrell, M. J. (2012). Waiting in pain:
a systematic investigation into the provision of persistent pain services in Australia. Med J
Aust, 196(6), 386-90.
Joshi, G. P., Bonnet, F., & Kehlet, H. (2013). Evidence‐based postoperative pain
management after laparoscopic colorectal surgery. Colorectal Disease, 15(2), 146-155.
Gifford, L. (2013). Topical Issues in Pain 5. Author House.
Butow, P., & Sharpe, L. (2013). The impact of communication on adherence in pain
management. PAIN®, 154, S101-S107.
Henderson, J. V., Harrison, C. M., Britt, H. C., Bayram, C. F., & Miller, G. C. (2013).
Prevalence, causes, severity, impact, and management of chronic pain in Australian general
practice patients. Pain Medicine, 14(9), 1346-1361.
Schug, S. A., Palmer, G. M., Scott, D. A., Halliwell, R., & Trinca, J. (2016). Acute pain
management: scientific evidence, 2015. The Medical journal of Australia, 204(8), 315-317.

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