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Pain and Discussion about Chapters 1,2,5, and 8

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I was given the opportunity to provide care to two postoperative neck surgery patients. They both were first day post-operative and each patient had a different perspective of pain rating. My patient’s rating were drastically different. One patient was completely independent, hardly needed anything. When I asked her to rate her pain on a scale of 1-10. She would say “oh, give it a 1.” My second patient was completely dependent. I asked her the same question and it was “oh, 6 or 7.” This proves that pain is a subjective response and everyone perceives pain differently. Through learning about the importance of pain management in class, I did not realize how much pain can really effect a patient’s recovery. Through my clinical experience, I decided to research an article on the affect of pain management on a patient’s recovery time. The article showed that pain is important to control and it has an affect on the patient’s healing time and total length of recovery. It proved that pain control decrease length of stay, enhance functional recovery, and improve long term functional outcomes. Pain that is untreated is a major health care issue. Pain that is not under control leads to long-term functional impairment and extend recovery time. The article used the verbalize pain scale as mode of determining the patient’s level. The article helped me realize that pain is an important assessment throughout the patient’s recovery time in the hospital and at home.

Article: The impact of post-operative pain on outcomes following hip fractures
R. Sean Morrison, Jay Magaziner, Mary Ann McLaughlin, Gretchen Orosz, Stacey B. Silberzweig, Kenneth J Koval, Albert L Siu. May 2003

Everyday walking into clinical I have no idea what my day is going to consist of. The book, The Other End of the Stethoscope, gives insight of what the patient is thinking when getting care from nurses, doctors and other health care professionals. Chapter two is one of the chapters that stood out to me. Two simple words says it all. When I walk into a patient’s room and hear something terrible. All that comes to mind is “I’m sorry,” instead of what should come to my head is “I’m here.” The two words he wrote about makes much more sense because the patient needs to know that we are there for them no matter what it is. The words offer a sense of security. Now when I walk into a patient’s room, I will think twice about what words I use. Anger and frustration through screaming and cursing at nurses is a daily occurrence. The patients do not mean anything by it, but we as nurses need to not take it personal and grow some thick skin. We must take the screaming and quickly erase it from memory. I think this will be difficult to adapt to taking the screaming and yelling and not react back to them. It makes sense to lash out at health care professionals but it is how the health care professionals react to it is what matters. There is a time to say that you do not appreciate this behavior but there is other times that the behavior expressed is acceptable. Nursing is all about open ended questions to facilitate therapeutic communication. In summary, I would be cautious of the words I use to comfort the patient and understand if they scream at me, its not personal.

2 stethoscope... on Mon Nov 21, 2011 5:01 pm

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Not taking it personally is a hard pill to swallow for me. I have had patients yell and me, and one even hit me. My instinct was to yell and her and hit her back...obviously, I still have my job...so I didn't do that. I had to realize that her actions had nothing to do with me at all...it could have been anyone. I just happened to be standing near her at the time. So - it's not always about me, like I think it is. Wink

3 RE: Pain Control on Mon Nov 21, 2011 8:35 pm

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I am a firm believer in taking scheduled pain meds for controling pain. If the patient refuses their meds and pain gets unbearable, it's hard to get the pain back under control. Good job Meredith Very Happy

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