Pain - Critical Analysis
Pain is a multidimensional phenomenon that varies with each individual and each painful experience (Watson, Garfinkel, Gallop, Stevens, & Strenier, 2000). Within the past 20 years there have been dramatic advances in pain control (Carr, 1997). However, under treatment of pain continues to be a major public health problem (Berry & Dahl, 2000). McCaffery and Pasero (1999) noted that barriers to pain management are numerous and complex. The aim of this critical analysis is to explore some barriers to pain management, and the implications these issues have on nursing practice.
Nurses have a unique role in pain assessment and management given that, of all health professionals, they spend the most time with patients in pain (Musclow, Swhney, & Watson, 2002). Failure of nurses to assess pain is a critical factor leading to under treatment (Chuk, 2002). Despite the numerous research articles on the under treatment of pain barriers continue to exist (Shannon & Bucknell, 2003). Some identified health care barriers include: inadequate pain assessment and documentation by nurses, under treatment of pain with analgesics, inadequate knowledge of nurses regarding pain management and pain medications, nurses’ fear over sedating patients, which could produce respiratory suppression, and the perceptual differences of pain between patients and nurses (Holley, McMillian, Hagen, & Palacois, 2005), Bouvette, Bourbonnais, & Perreault, 2001, Clarke et al., 1996, McCaffery & Pasero, 1999).
Pain assessment is an essential part of the pain management process (Treadwall, Vichinsky, & Frank, 2002). Research has demonstrated that when routine standardized nursing pain assessment is implemented, patients receive improved analgesia, experienced less pain, and are more satisfied with care (Treadwall et al., 2002). There have been a variety of tools developed to assess pain (Bouvette et al., 2001); however, inaccurate assessment of pain continues to exist (Shannon & Bucknell, 2003) .
Nurses have a unique role in pain assessment and management given that, of all health professionals, they spend the most time with patients in pain (Musclow, Swhney, & Watson, 2002). Failure of nurses to assess pain is a critical factor leading to under treatment (Chuk, 2002). Despite the numerous research articles on the under treatment of pain barriers continue to exist (Shannon & Bucknell, 2003). Some identified health care barriers include: inadequate pain assessment and documentation by nurses, under treatment of pain with analgesics, inadequate knowledge of nurses regarding pain management and pain medications, nurses’ fear over sedating patients, which could produce respiratory suppression, and the perceptual differences of pain between patients and nurses (Holley, McMillian, Hagen, & Palacois, 2005), Bouvette, Bourbonnais, & Perreault, 2001, Clarke et al., 1996, McCaffery & Pasero, 1999).
Pain assessment is an essential part of the pain management process (Treadwall, Vichinsky, & Frank, 2002). Research has demonstrated that when routine standardized nursing pain assessment is implemented, patients receive improved analgesia, experienced less pain, and are more satisfied with care (Treadwall et al., 2002). There have been a variety of tools developed to assess pain (Bouvette et al., 2001); however, inaccurate assessment of pain continues to exist (Shannon & Bucknell, 2003) .
References: Berry, P., & Dahl, J. (2000). The new JCAHO pain standards: Implications for pain management nurses [Electronic Version]. Pain Management Nursing, 1(1), 3-12. Bouvette, M., Bourbonnais, F., & Perreault, A Carr, E. (1997). Evaluating the use of a pain assessment tool and care plan: A pilot study [Electronic Version]. Journal of Advanced Nursing, 26, 1073-1079. Chuk, P Edwards, H., Nash, R., Yates, P., Walsh, A., Fentiman, B., McDowell, J., et al. (2001). Improving pain management by nurses: A pilot peer intervention program [Electronic Version]. Nursing and Health Sciences, 3, 35-45. Fenwick, C Hawthorne, J., & Redmond, K. (1999). Pain: Causes and Management. London: Blackwell Science. Holley, S., McMillian, S., Hagen, S., & Palacois, P. (2005). Pain resource nurses: Believing the patients, believing in themselves [Electronic Version]. Oncology Nursing Forum, 32(4), 843-848. Mac Lellan, K Manias, E., Botti, M., & Bucknall, T. (2002). Observation of pain assessment and management - the complexities of clinical practice [Electronic Version]. Journal of Clinical Nursing, 11, 724-733. McCaffery, M., & Pasero, C McColl, P., Holden, J., & Bucschmann, M. (2001). Pain management: An assessment of surgical nurses ' knowledge [Electronic Version]. MedSurg Nursing, 10(4), 185-191. McNeil, J., Sherwood, G., & Starck, P Mrozek, J., & Werner, J. (2001). Nurses ' attitudes toward pain, pain assessment, and pain management practices in long term care facilities [Electronic Version]. Pain Management Nursing, 2(4), 154-162. Musclow, S., Swhney, M., & Watson, J Puntillo, K., Miaskowski, C., Kuhlman, U., & Mettang, T. (2002). Use of a pain assessment and intervention notation tool in critical care practices [Electronic Version]. Heart & Lung, 31, 303-314. Resnik, D., Rehm, M., & Minard, R Schafheutle, E., Cantrill, J., & Noyce, P. (2001). Why is pain management suboptimal on surgical wards? [Electronic Version]. Journal of advanced Nursing, 33(6), 728-737. Shannon, K., & Bucknell, T Simpson, K., Kautzman, L., & Dodd, S. (2002). The effect if a pain management education program on the knowledge of clinical staff [Electronic Version]. Pain Management Nursing, 3(3), 87-93. Treadwall, M., Vichinsky, E., & Frank, L Watson, J., Garfinkel, P., Gallop, R., Stevens, B., & Strenier, D. (2000). The impact of nurses ' empathic responses on patients ' pain management in acute care [Electronic Version]. Nursing Research, 49(4), 191-200. Young, J., Horton, F., & Davidhizar, R