ADVANCED PAIN MANAGEMENT & ACUTE CARE NURSING
Conventional post-operative pain management protocols and practices rely heavily on nurse-administered opioids, patient-controlled analgesia (PCA), and skin patches ("Pain relief," 1997, p. 4). Opioid analgesics include codeine, morphine, and other narcotics. PCA pumps allow a patient to administer her or his own medication. A portable, computerized pump containing medicine is attached to a small needle placed in a vein or under the skin. When a patient feels pain, the patient presses a button on the pump that delivers a preset, safe dose of medication. Skin patches release a steady dose of medication into the skin over days, with no need for frequent dosing. After applying the patch there is a lag time of about twelve hours before pain relief begins. Subsequent to that time, the level of medication in the bloodstream remains constant.
The obligation to manage pain and relieve a patient's suffering is an important part of a health professional's commitment. The importance of pain management is enhanced when other important benefits for the patient are realized in concert with the relief from pain. Such other benefits include earlier mobilization, shortened hospital stay, and reduced costs. Nevertheless, clinical surveys continue to find that conventional post-operative pain management protocols and practices result in unrelieved pain due to ineffective treatment in approximately 50 percent of the approximately 23 million post-operative patients in the United States each year (Owen, Fibuch, McQuillan, & Millington, 1997, p. 8). Unrelieved pain not only stalls the healing process but also impairs the immune system, keeps the patient from coughing as needed, increases the likelihood of pneumonia, and delays the return of normal stomach and bowel functions.
Nursing-Based Theoretical Perspective
A patient-centered approach to pain management couched within a theoretical p...