The Role Of The Nurse In Pain Management Essay

This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.The Role Of The Nurse In Pain Management Essay
Pain, which is defined in its widest sense as an emotion which is the opposite of pleasure (White, 2004, p.455), is one of the major symptoms of cancer, affecting a majority of sufferers at some point during their condition (De Conno & Caraceni, 1996, p.8). The World Health Organization (WHO, 2009, online) suggests that relief from pain may be achieved in more than 90 percent of patients

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De Wit et al (2001) state that the cognitive dimension of cancer pain deals with what patients pain means to them and how they think of it in terms of beliefs, attitudes and thoughts. This is to do with their personality. A patient’s beliefs effect how they cope with pain. They can initiate coping strategies and their level of adjustment to pain. Sofaer (1992) notes that pain causes anxiety and in turn anxiety can heighten pain. Guidelines for Treatment Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80). Aside from determining the type of pain suffered, the other major consideration in treating pain for cancer patients is to determine the level of pain. A significant proportion of patients experiencing pain would grade this as moderate to severe, but some may have only mild to moderate pain which may respond to lower risk treatment options (van den Beuken-van Everdingen et al., 2007, p.1437). Drug therapy is described by Fitzgibbon and Loeser (2010, p.190) as the cornerstone of treating cancer pain. There is currently no specific NICE guidance on pain management on cancer. The Role Of The Nurse In Pain Management Essay

The role of the nurse in managing pain by psychological approaches essay
Pain management is one of the core competencies of a nurse (Devinder & Upton, 2013). A licensed nurse should ensure that the patient receives appropriate care and provide an efficient intervention aimed at treating the patient’s pain and consistent with the recognized standards of nursing care. Nurses should possess knowledge about different methods of managing pain, should be able to distinguish between different categories of pain and sources of pain, and should be skilled in pharmacological, physiological and psychological techniques of pain management.

The patients ask for nursing help when they experience pain, especially acute pain, so the nurses should be able to address the patients’ needs and combine various approaches to managing pain in order to relieve suffering and enhance the process of healing for the patient. It is essential for any nurse to possess skills of managing pain using psychological approaches. These approaches are efficient when the patient on some reasons cannot use pharmacotherapy; psychological approaches of managing pain are invaluable for treating acute pain and stabilizing the patient’s psychological condition (Devinder & Upton, 2013). Furthermore, nurses should be able to develop programs of pain management for patients with chronic pain. Therefore, nurses play a key role in managing pain with the help of psychological approaches.The Role Of The Nurse In Pain Management Essay

What is pain? If you ask someone to tell you the definition of pain they will typically state something that hurts. Registered nurses should know the definition of pain and how it can be identified on their patients. However, Abdalrahim, Majali, Stomberg, and Bergbom (2010) propose that nurses did not receive adequate education in pain management and suggest the lack of knowledge hinders their ability to adequately control their patients’ pain. Therefore, the unethical treatment of pain can be traced back to nurses.
The author Abdalrahim et al. (2010) stated that nurses are not being properly educated in pain and pain management; in an effort to better form an opinion on this theory, it is imperative that we have an accurate and consistent definition of pain. According to Engebretson, Monsivais, & Mahoney (2006), “Pain results from somatosensory, cognitive and emotional events, and, in the case of chronic pain, neuroplastic changes that alter the physiology and change nervous system responses to various stimuli”. There are two distinct types of pain, acute and chronic. Ferrell (2005) suggest that acute pain can be manifested by different types of trauma (sprained ankle, broken leg, stubbed toe, pulled muscle, etc.), surgical incisions or body parts manipulated during surgery, and even the effects of a cold. Chronic pain can be portrayed as many medical conditions, some examples are: migraine headaches, arthritis, clinical depression, fibromyalgia, and spinal stenosis (Ferrell, 2005). The best definition of pain for nurses to adhere to was stated by Margo McCaffrey (1968), “Pain is whatever the experiencing person says it is, existing whenever the experiencing person says it does”.The Role Of The Nurse In Pain Management Essay

The management of acute pain is essential for nurses within clinical practice, particularly when
dealing with post-mastectomy patients. Post-mastectomy pain is associated with the physical
removal and subsequent damage of tissue, psychological distress, and inadequate or nonadherence of pain management. Acute pain referred to in the following essay represents the
perception of pain three or less months in duration caused by a mastectomy surgery. An
examination of pain definitions and theories,together with the use of a post-mastectomy case
study, allowed for a broad understanding of acute pain. Pain management strategies are guided by
pain pathway concepts, however, the emotional and psychological aspects of pain suggest that
post-mastectomy pain is a multidimensional, unique experience. Before treating pain, it is
important to understand how pain is experienced by undertaking a pain assessment, either verbal
or non-verbal in nature. However, some assessment techniques lack specific descriptive
information, which can lead nurses to underestimate the patient’s pain. Acute pain can worsen or
persist if the nurseonly focuses on the physical aspects of pain, disregarding the psycho-social
influences (Mohamed & Abdel-Ghaffar, 2013; Schug, et al., 2015). A holistic assessment is required
to comprehensively evaluate post-mastectomy pain. Post-mastectomy pain is complex, requiring
several analgesics targeting different pain receptors (Gregory, 2014). Non-pharmaceutical
interventions can work in collaboration with medication to control and manage post-mastectomy The Role Of The Nurse In Pain Management Essay
pain, without further side-effects. Some effective post-mastectomy pain interventions include: hot
or cold therapy, patient support, transcutaneous electrical neural stimulation and music therapy.
These holistic pain management strategies have been shown to improve patient outcomes, making
the nurse instrumental in preventing the persistence of acute pain. Central to holistic pain
management is tailored patient care, addressing individualised aspects of pain to prevent postmastectomy pain developing into chronic pain.
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Acute pain management is a vital component of nursing care within the clinical setting. Patients are
known to experience high levels of pain after mastectomy procedures (Hovind, Bredal, & Dihle,
2013). A mastectomy is a surgical procedure to remove tissue in the hopes of preventing or treating
breast cancer (Li, et al., 2011). This treatment could result in acute post-mastectomy pain, which
have the potentialto develop into chronic pain if left untreated. Through an analysis ofthe definition
and theories regarding acute pain, a case study of a forty-year-old experiencing acute postmastectomy pain is better understood. Before treating pain, it is important to understand how the
patient experiences their pain. Several suitable assessment techniques can be used as part of this
process such as verbal and non-verbal tools. However, because pain is multidimensional it means
assessment tools focusing on the whole person are just as important. These assessments are used
to frame possible post-mastectomy pain management. Acute post-mastectomy pain may require
pharmaceutical interventions, although non-pharmacological therapies can be used in conjunction
to offer the best possible chance of recovery for the patient. Tailoring the pain management to the
individual allows the case study patient [CSP] the best possible chance of a full recovery by
considering their post-mastectomy pain as a unique experience.

Formulating a definition of acute pain is fundamental in analysing aspects of a post-mastectomy case
study. Appropriate treatment is provided based on how pain is classified (Zeleníková, Žiaková, Čáp,
& Jarošová, 2014). Without the use of pain definitions, nurses are at risk of providing inappropriate
and unsatisfactory pain management to their patients (Zeleníková, Žiaková, Čáp, & Jarošová, 2014).The Role Of The Nurse In Pain Management Essay
Pain can be described as an unpleasant sensation, physical or emotional in nature, related to possible
or genuine tissue damage (Schug, Palmer, Scott, Halliwell, & Trinca, 2015). Liet al. (2011)supported
this notion, although inserted a multidimensional element. Acute pain refers to a sharp pain shorter
in duration, while chronic pain is more associated with a dull pain longer in length (Taylor, Lillis,
Lemone, & Lynn, 2011; Schreiber, et al., 2013). Acute pain has also been defined as quick in onset,
short in duration and protective in nature (Taylor, et al., 2011). Farrell and Dempsey’s (2014)
definition of acute pain has several similarities to Taylor et al.’s (2011) definition, although they
stipulated a duration of up to six months. In contrast, Fishbain et al. (2014) and Riskowski (2014)
defined acute pain to occur for three months or less due to a procedure or incident. Even though
pain definitions found in literature incorporate similar aspects, an absence of an overall consensus
still remains. As such, this essay refers to acute pain three or less months in duration, caused by a
surgical procedure such as a mastectomy. This definition will be used in assessing the case study of
a forty-year-old female experiencing acute post-mastectomy pain.
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A mastectomy procedure involves the removal of breast and/or lymph tissue which could result in
possible nerve, muscle or tissue damage (Li, et al., 2011; Belfer, et al., 2013). Even though a
mastectomy can occur prophylactically to prevent the development of breast cancer, Ye, Yan,
Christos, Nori and Ravi (2015)suggested that females in their forties were more likely to under-go a
mastectomy due to a breast cancer diagnosis. Schreiber et al. (2013) outlined that the majority of
mastectomy patients ratetheir pain as the most distressing symptom, often leading to psychological
anguish, physical disability and impediments in their pain management. Holistic nursing care
considers and addresses all aspects of health impacted by a mastectomy procedure. A forty-yearold female case study patient is used to assist in understanding the nursing management of acute
pain post-mastectomy. To fully appreciate post-mastectomy pain, one needs to consider theoretical
models of pain.
The post-mastectomy case study’s pain can be better understood by considering theories around
pain perception (Moayedi & Davis, 2013). The Specificity Theory [TST] by Charles Bell formulated a
concept of specificity, where each neuron responds to a distinct stimulus (Chen, 2011; Moayedi &
Davis, 2013; Perl, 2011). The Role Of The Nurse In Pain Management Essay  Central to TST is the idea that pain travels along a pathway from the
periphery through the spinal cord to the brain (Moayedi & Davis, 2013). The Gate Control Theory of
Pain [GCTP] by Melzack and Wall use thisidea of a pain pathway to theorise that the pain signal can
be inhibited through sensory stimulation (Chen, 2011). These theories can be applied to the postmastectomy case study through careful selection of pain management techniques. However, TST
and GCTP does not explain the complexities of pain experienced by post-mastectomy patients
(Gregory, 2014; Perl, 2007). Vilkolm, Cold, Rasmussen and Sindrup (2009)suggested that this could
be due to both nociceptive and neuropathic involvement in post-mastectomy pain sensation. The
majority of pain theories overlook the situational, physical and psychological aspects of pain, which
is central to the Theory of Unpleasant Symptoms by Lenz et al. (Matthie & McMillan, 2014). This
theory raises the idea that pain, including post-mastectomy pain, is multidimensional, not only
supporting Li et al.’s (2011) definition of pain but also supporting a holistic view of pain (Hayes &
Hodson, 2011; Matthie & McMillan, 2014). Furthermore, Khan, Raza and Khan (2015) argued that
pain is a unique experience which cannot be shared or measured, suggesting perhaps that instead
of using a pain theory to understand the case study, it should be assessed and valued as a distinct
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The concept that pain is an idiosyncratic experience is reinforced by assessing how the CSP
experiences their pain. Pain can be assessed verbally, through observations or by using holistic
patient assessment methods. The first type of assessments to be discussed refer to verbal pain
assessment tools [VPAT]. A VPAT used in the clinical environment is the numeric rating scale [NRS]
(Ledowski, et al., 2013; Pudas-Tähkä, Axelin, Aantaa, Lund, & Salanterä, 2009). The NRS requires the
CSP to assign a number between zero and ten, based on their current pain (Bertagnolli, 2004).The Role Of The Nurse In Pain Management Essay
Eriksson, Wikström, Arestedt, Fridlund, and Broström (2014) argued that the NRS is open to
interpretation, as the post-mastectomy patient and nursemay have opposing understandings ofthe
same pain score (Alemdar & Aktas, 2014). Regardless of the criticism, NRS is a valuable tool which
can help to formulate a common language between the nurse and CSP, allowing to track how pain
may change (Wikström, Eriksson, Årestedt, Fridlund, & Broström, 2014). If the post-mastectomy
patient finds it difficult to assign numerical values to their pain, they can instead choose to describe
it (Eriksson, et al., 2014). Pain descriptive tools such as the verbal descriptor scale [VDS] and
COLDSPA can be used to assess the case study’s pain (Gregory, 2014; Montgomery & Mitty, 2008).
The VDS is similar to the NRS, but instead of using a numerical scale it uses descriptive phrases such
as ‘intense’, ‘mild’ or ‘no pain’ (Gregory, 2014). Even though it is descriptive in nature, it does lack
specificity (Gregory, 2014). In contrast, COLDSPA is a comprehensive mnemonic able to assess the
character, onset, location, duration, severity, pattern and associated patterns of pain (Düzel, Aytaç,
& Öztunç, 2013; Montgomery & Mitty, 2008). If the patient in the case study acknowledges they
have pain, COLDSPA can be used to better understand how they experience their pain. Acute pain is
often undetected or inadequately treated, which have led some to suggest that pain assessment
should be considered to be the fifth vital sign (Bertagnolli, 2004; Lorenz, et al., 2009).
Pain assessment is just as important for those patients unable to communicate their pain (PudasTähkä, et al., 2009). Immediately post-surgery the CSP may be drowsy or sedated, therefore
highlighting the need for non-verbal pain assessment tools such as the behavioural pain scale [BPS]The Role Of The Nurse In Pain Management Essay
and non-verbal adult pain assessment scale (NVAPAS) (Pudas-Tähkä, et al., 2009). Arbour and
Gélinas (2010)stated that vital signs are not an adequate predictor of pain, hence why BPS and
NVAPAS use a combination of vital sign results, behavioural, and physiological observations to assess
the patient’s pain level (Pudas-Tähkä, et al., 2009). Acute pain can lead to physiological and
behavioural changes such as; increased blood pressure; higher respiration rate; rise in heart rate;
flushed skin appearance; pupillary dilation; decreased body movements; and facial grimacing
(Pudas-Tähkä, et al., 2009). Even though Pudas-Tähkä et al. (2009) found BPS to be the most valid
and reliable indicator of acute pain, its applicability in assessing post-mastectomy pain is yet to be
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determined. Acute pain experienced by the CSP could be due to the mastectomy procedure itself,
alternatively it could be indicative of a potential post-surgery complication (Mancaux, et al., 2015).
Adequate assessment of the wound site could assist the nurse to attribute the patient’s pain to an
infection instead of assuming that it is connected to the surgical procedure (Mancaux, et al., 2015).
Furthmore, it may be suitable to assess the patient’s circulation, neurological function and
respiration as these can impact post-mastectomy pain and complications (Pereira, et al., 2015). Nonverbal pain assessment tools are at risk of the nurse underestimating the patient’s pain (PudasTähkä, et al., 2009). However, this could be due to the assessment focusing on the physical aspects
of pain and disregarding the biopsychosocial components of pain (Schreiber, et al., 2013).The Role Of The Nurse In Pain Management Essay
Pain has been described as being multidimensional in nature, highlighting the need for a holistic pain
assessment (Newson, 2008). Schreiber et al.’s (2013)research showed a strong correlation between
psycho-social aspects and the development of persistent post-mastectomy pain. They observed that
acute pain is particularly associated with psychological anguish, anxiety, depression, disturbed sleep
and dysfunctional coping strategies, findings supported by Fishbain et al. (2014). It is theorised that
the emotional and sensory neurological pathways appear to actindependentlywhile simultaneously
functioning in parallel, giving rise to a strong association between the emotional and physical feeling
of pain (Fishbain, et al., 2014). This could explain why some post-mastectomy patients often describe
both the physical and psychological elements of pain (Matthie & McMillan, 2014). The CSP may
report intensified feelings of pain due to psychological and social distress related to an altered body
image, separation from family or coping with a breast cancer diagnosis (Jia-Rong & Mei-Ling, 2014).
If pain is assessed purely from a physical standpoint it is possible that the post-mastectomy pain
could worsen or persist (Mohamed & Abdel-Ghaffar, 2013; Schug, et al., 2015). Jia-Rong and MeiLing (2014)illustrated that pain assessment toolsincorporating coping strategies can empower postmastectomy patients, thereby improving their pain (Slatyer, Williams, & Michael, 2015). The wholeperson assessment [WPA] is such a tool, although it also covers physical, emotional, environmental,
spiritual and social aspects of health (Hayes & Hodson, 2011). By treating the patient holistically, the
nurse is able to address each component of the patient’s health (Durie, 1998). Kress et al. (2015)The Role Of The Nurse In Pain Management Essay
showed that holistic nursing care is able to improve the patient’s emotional anguish, quality of life,
and overall recovery. As such, by considering health in its entirety, nurses are ideally placed to
provide care which can vastly improve the overall health outcome of patients. The role of the nurse
in psychological, emotional and physical assessment is vital, as only nurses consider all these health
aspects as one(Andión, Cañellas, & Baños, 2013). Even though the WPA was redesigned to address
chronic pain, Hayes and Hodson (2011) advised it can be used to address acute post-surgery pain.
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The CSP underwent a surgical procedure, further emphasising the suitability of WPA as an
assessment tool. Even though the WPA can be time consuming to complete, Newson (2008)stressed
its importance as cultural and spiritual elements could influence how the CSP express their pain. The
use of suitable pain assessment can ensure appropriate nursing management strategies are put in
Invaluable information obtained through pain assessment can assist to formulate appropriate pain
management for the case study. Applicable pain management techniques can include
pharmacological and non-pharmaceutical interventions that are continuously monitored and
tailored to the individual. The first management approach to be discussed dealswith pharmaceutical
interventions. Opioid analgesics work by binding to receptors in the central nervous system to
interrupt the pain signal (Dubin & Patapoutian, 2010). According to Amaya et al. (2015), most
analgesics can suppress acute post-operative pain, however Gregory (2014)pointed out that postmastectomy pain may require several analgesics to target both nociceptive and neuropathic
receptors. The analgesia ladder is a useful paradigm in addressing pain in the CSP by using nonsteroidal anti-inflammatory drugs, paracetamol and adjuvant medication in conjunction with opioid
analgesics (Gregory, 2014). The Role Of The Nurse In Pain Management Essay Legeby, Sandelin, Wickman and Olofsson (2005) showed that
administering several different analgesic medications can significantly reduce post-mastectomy
pain. Using a combination of medication to treat acute pain allows for effective pain relief but at a
reduced dose (Gregory, 2014). A lesser dose can also decrease the analgesic side-effects such as
nausea and vomiting, felt by some post-mastectomy patients (Montgomery, et al., 2007).
Nausea and pain should be considered in unison, as both can have the same physiological
consequences. Montgomery, Schnur, Erblich, Diefenbach and Bovbjerg (2010)suggested that pain
and nausea is particularly unfavourable for post-mastectomy patients as it can significantly prolong
patient recovery, delay hospital discharge or lead to unforeseeable readmission. The adverse health
effects of nausea can be worsened by the presence of emesis (Singh, Yoon, & Kuo, 2016). Vomiting
can impact the patient’s overall health as it can lead to dehydration,reduced nutritional intake and
pulmonary complications (Duncan, et al., 2014). Amaya et al. (2015) argued that the inclusion of
antiemetic medication into post-mastectomy recovery treatment is therefore just as important as
analgesia. The nursing role in pharmaceutical pain management relates to the administration of
medication, monitoring of side effects and providing patient education (Alemdar & Aktas, 2014).
Timmerman, Stellema, Stronks, Groeneweg and Huygen (2014)showed that patients are more likely
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to adhere to treatment regimens if they are provided education, specifically related to the
medication and associated side effects. Some medications are prescribed on an as need basis, which
require the nurse to use their assessment skills to analyse suitable pharmaceutical interventions The Role Of The Nurse In Pain Management Essay
(Gordon, Pellino, Higgins, Pasero, & Murphy-Ende, 2008). Alternatively, the nurse can administer
medication strategically to assist the CSP with mobilisation, hygiene cares or nutritional intake
(Legeby, et al., 2005). Pharmacological strategies can be used in conjunction with nonpharmaceutical interventions to help manage acute pain post-mastectomy.
As nurses provide holistic patient care, it is important to consider non-pharmacological interventions
to help manage post-mastectomy pain. Vilkhom et al.’s (2009) research found that patients
experiencing pain have intensified cold and warm detection thresholds supported by Kaunisto et
al.’s (2013)findings in post-mastectomy patients. As such, Kaunisto et al. (2013)suggested that hot
or cold therapy can be used to treat post-mastectomy pain. Silva et al. (2014) on the other hand
found that transcutaneous electrical neural stimulation [TENS] have a similar analgesic effect,
particularly for intercostal pain in post-mastectomy patients. Both hot or cold therapy and TENS
support the GCTP by using a non-noxious stimulus to disrupt the pain signal (Perl E. R., 2011;
Mendell, 2014). Other non-pharmaceutical therapies have a psychological focus. Clarke et al. (2015)
showed that post-mastectomy patients experience increased feelings of depression and anxiety.
After receiving emotional supportthese patients reported lower levels of pain (Clarke, et al., 2015).
This could be due to actual decreases in pain, better coping skills, or distraction (Li, et al., 2011).
Regardless of the pain relief action, addressing a patient’s emotional and psychological health plays
an integral part in post-mastectomy pain management (Clarke, et al., 2015). Hovind et al. (2013)
found that post-mastectomy patients reported a need to discuss the recovery process, therapy
options and risk of developing ongoing chronic pain. The nurse can address the CSP’s psychological
health by creating instances to communicate these concerns, which could lead to further
educational opportunities (Cho, et al., 2012). Hayes and Hodson (2011) showed that postmastectomy patients provided with adequate information are able to cope better with their acute
pain while Cho et al. (2012)showed that it could lead to better health outcomes. Another useful
pain treatment option addressing psychological aspects of pain in the post-mastectomy case study
is music therapy (Li, et al., 2011). Music therapy is effective yet non-invasive with no added sideeffects, and can also be used to treat depression, anxiety, nausea, and vomiting (Li, et al., 2011).
Even though some of these non-pharmaceutical therapies may be useful, each individual has a
unique response to treatment.
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To provide suitable holistic patient care, nursing interventions must be individualised. Pain
management has been shown to be more effective if it is tailored to the individual patient (Gupta,
et al., 2010). Pain is a subjective experience and should be recorded and treated as it is described by
the patient (Ledowski, et al., 2013). Two studies found a difference in pain threshold between
various ethnicities (Belfer, et al., 2013; Riskowski, 2014). This was attributed to potential socioeconomic influences, discrimination or physiological differences, which may be applicable to the
case study depending on their ethnicity or situation (Riskowski, 2014). Nurses are ethically
responsible for pain management, as such the CSP’s pain should be managed regardless of their
socio-economic status, culture, ethnicity, sex or history (Düzel, et al., 2013). Newson (2008)The Role Of The Nurse In Pain Management Essay
suggested that acute post-mastectomy pain can lead to chronic pain due to cultural attitudes
forming barriers to pain management (Mularski, et al., 2006). In some cultures, it is considered
inappropriate to show a weakness such as pain (Chiauzzi, et al., 2011). This could influence pain
management, thereby prolonging the CSP’s recovery. Another influencing element on postmastectomy pain is identity. As a forty-year-old, the CSP must overcome Erikson’s crisis stage of
generativity versus stagnation (Slater, 2003). Developing resiliency, a coping mechanism in itself, can
lead the CSP to experience improvements in acute post-mastectomy pain (Fishbain, et al., 2014;
Svetina, 2014). At this stage there is already a heightened sense of self-awareness, which is further
compounded by the loss of breast tissue (Satinder & Hemant, 2015; Slater, 2003). As a relatively
young women under-going a mastectomy procedure, there is a high risk of developing body image
concerns. This highlights the importance for nurses to assess and provide holistic care, tailored to
each individual’s co-morbidity that may arise (Kress, et al., 2015). As breasts are associated with
motherhood, femininity and sexuality, the removal of them could adversely impact the individual’s
body image (Lewis-Smith, 2015). Schreiber et al. (2013)noted that an altered body image could lead
to feelings of anxiety, stress and depression which can worsen their post-mastectomy pain (Clarke,
et al., 2015; Schreiber, et al., 2013). Pre and post-operative counselling or breast reconstructive
surgery cannot only help mastectomy patients to feel more attractive, but can improve their pain
and overall well-being (Lewis-Smith, 2015; Satinder & Hemant, 2015). Addressing acute postmastectomy pain prevents the risk of it developing into chronic pain.The Role Of The Nurse In Pain Management Essay


Knowledge and Attitudes of Nurses and Pain Management

Among the most fearsome symptoms many people do fear is pain, and untreated pain has many negative consequences. The World Health Organization (WHO) postulates that people with little or no access to pain management end up dying. Pain causes physical, social, financial and psychological well being of a person. According to Argoff (2007), unrelieved pain causes discomfort depriving individuals of sleep, causes depression, increases anxiety, leads to morbidity and eventually death. Long & Morgan (2008) argues that some people may think that pain is a punishment for past misdeeds. This basically implies that pain is a deeply personal experience and a sensitive issue that need to be discussed in-depth by healthcare professionals. It is evident that poorly managed pain may have adverse effects like loss of energy, decreased quality of life, loss of concentration, and inability to live a normal life.The Role Of The Nurse In Pain Management Essay

Effective pain management is important from people suffering from either acute or chronic pain irrespective of their gender, race or age. The main reason for this study is because of lack of sufficient knowledge as well as attitude from the nurses as shown from previous studies. It has been documented and is a well known fact that ineffective pain management does affect thousands and perhaps millions of people negatively in many different ways. As compares to other professionals, nurses are in a better position to manage pain effectively. This is because of their close relationship with the affected patients. Positive attitudes and knowledge of pain is the key to successful and effective pain management.  Nurses play a main role in the management of pain in patients. This necessitates the fact that the nurses should portray excellence in every sector of management of pain hence enabling effective and appropriate patient’s pain management. In the contemporary times, it seen that unrelieved acute postoperative pain is a central health-care problem. Furthermore, the nurses play a particularly significant role in the patient’s pain management; say for example after surgery undertaking, taking care of the involved patients under a 24- hour care. The findings from the researches will help understand the role of nurses in pain management. Therefore, the results from these researches are of so much assistance as it helps the nurses know how to provide the appropriate patient health care and appropriate postoperative pain management.The Role Of The Nurse In Pain Management Essay

Practical placements do expose nursing students during the course of their career to an array of experiences that have an effect on the quality of life of their patients in different ways. The researcher took an initiative that aimed to establish the definite cause of the problem after it was exposed that patients were suffering due to untreated pain during practical placements.  The most common entity under pain in relation to nurses is the excessive pain following a surgery. However, even after 40 years, there seems to be little improvement to relieving pain as a small percentage of patients were satisfied with their pain as having been relieved. The multifarious nature of pain is physiological and has undergone an exponential growth while understanding it. This has paralleled the very important advancements in science the management of pain interventional. Even with the efforts pain after a surgery is conducted. The morbidity and mortality of patients is contributed to highly by the unalleviated pain that is experienced by the patient after undergoing a surgery. The effects of pain on the patients can either be long term or short term, and they are massive. The types of pain experienced by the patients also include chronic and acute pain, and there is evidence that acute pain can progress to chronic pain with time (Hollen, 1998). There is also documented evidence in literature that after a surgery has been carried out it is then followed by chronic pain. A very key role is played by the nurses in the management of pain; therefore it is of the essence to ensure highly high and quality standards of the management of pain.The Role Of The Nurse In Pain Management Essay

Pain is highly subjective and yet objective and it embraces the fact that pain includes both emotions and sensation as well. Charlton (2005) underestimated the importance of pain being recognized as a bio psychosocial experience with extremely crucial sensory, cognitive, behavioral and affective constituents. In the 1970’s, the bio psychosocial model was invented, and this contested the traditional biomedical model of illness. This was based on biological indices, as the only determinant of defining a disease or a particular illness. The bio psychosocial model has a central component that the biological factors are not explained by the outcomes of health, rather, the factors as well as the social and psychological factors are considered as interconnected entity. In the determination of pain, the bio psychosocial model suggests that biologic aspects as well as social, psychological variables and behavioral, thus should be considered in pain determination. Pain is broadly classified into two classes which include; acute and chronic pain. There is such a distinctive difference between acute and chronic pain.  After a surgical intervention then the pain is associated to trauma or injury from a tissue. Acute pain serves as unpleasant, and its aim is to alert the potential or actual body tissue injury that is imperative of survival. On the other end chronic differs from acute pain as it as it serves no biological response.The Role Of The Nurse In Pain Management Essay

Chronic pain is or may be caused by an illness or a disease but can be likely perpetuated by factors that are physically and pathologically remote from the originating cause. Extends for more than 3 months which often has low levels of underlying pathology that is facilitated by malignant or non-malignant causes, these are the characteristics of chronic pain. As research has been carried out, it shows that chronic pain can cause the epidemiological problems. This is based on a study that was carried out in Ireland. The study was meant to show the effect that chronic pain had on the community. Thus from the report it was deduced that chronic pain is a significant cause of healthcare problem. The Role Of The Nurse In Pain Management Essay  To add to the findings it was found out that the analysis indicated that chronic pain was associated with psychological and functional disabilities (Marie, 2002). There are various initiators of chronic pain, they include a malignant condition, non-life threatening conditions for example(facial pain, vascular pain and headache and injuries might initiate or result to a chronic pain (e.g. trauma, surgical intervention), non-life-threatening conditions, and malignant conditions (e.g. musculoskeletal, peripheral nerve pain, vascular pain, facial pain, and headaches) there is no adaptive or functional purpose that is served by chronic pain unlike with acute pain, Various physiological interactions that are complex and the processes always instigate chronic pain. Moreover, the unified factors, including, environmental, cognitive, and psychological factors will always interact with sensitized nervous system contributing to persistence and continuation of the pain in psychological factors that play an integral role in the perception of pain mostly in the chronic pain asserts. Excruciating pain can be triggered by non-noxious stimulus and pain can occur without any apparent stimulus. There are pain theories that are involved. The theories being specificity theory which is the traditional pain theory mainly states that, pain is transmitted through an independent pathway (Eliopoulos, 2010). Thus, pain is carried from the designated pain receptors from the periphery (skin) to a pain centre in the brain. The evidence of conditions such as neuralgia, causalgia and a phantom limb has given a good refutation of the pain concept as a direct specific-line nervous system.The Role Of The Nurse In Pain Management Essay

The main objective of this thesis is to describe the attitudes and level of knowledge regarding the nurses working in the healthcare sector and who are in charge of patients going through pain. Therefore, this paper will find out the registered nurses’ level of education and their attitudes towards management of pain. The paper will also highlight the factors that may affect nurses’ decision making process regarding management of pain. It is our hope that the results of this study will benefit not only the nurses and their patients but also other healthcare professionals in the industry and all stakeholders.  The Role Of The Nurse In Pain Management Essay

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