• Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month
  1. 1
  2. 2
  3. 3
  4. 4
  5. 5
  6. 6
  7. 7
  8. 8
  9. 9
  10. 10
  11. 11
  12. 12
  13. 13
  14. 14
  15. 15
  16. 16
  17. 17
  18. 18
  19. 19
  20. 20
  21. 21
  22. 22
  23. 23
  24. 24
  25. 25
  26. 26
  27. 27
  28. 28
  29. 29

Pain Assessment. The implementation and rationale for using pain assessment tools is focused on within this essay, with limitations of use being discussed and analysed.

Extracts from this document...


´╗┐Pain is a common experience for most people (Kingdon et al, 1998). McCaffery (1980) states ?pain is what the patients says it is and exists when the patient says it does?. This is one of the most widely used definitions of pain (Cunningham, 2001) however, if a patient does not say they are in pain how can a nurse identify their pain? Seers (1987) argues that patients do not always tell the nurse that pain has arisen and that they often expect the nurse to know. Therefore effective assessment of pain is a vital part of nursing care. Lawler (1997) maintains that good communication skills are vital in assessing pain in patients. The implementation and rationale for using pain assessment tools is focused on within this essay, with limitations of use being discussed and analysed. Pain management is optimised by increasing our understanding of the neurobiology of pain, combined alongside interactions with the patient, coupled with science and knowledge combined with empathy and humanity (Ducharme, 2000). Since the publication of Melzack & Walls (1965) gate control theory of pain, psychology has been accepted as an integral discipline in the study of pain (Skevington, 1995). The physiological and pharmacological aspects of acute pain, and its management are discussed and analysed within this essay. Acute pain management is more than a collection of interventions, it is a package of care which requires examination as a whole, as well as in its parts (McQuay & Moore, 1998). Holistic nursing care encompasses not only the physical aspects, but also the psychological, emotional and spiritual aspects of human nature. Anxiety can play a major role in an individuals pain experience (Kennerley, 1995). This is an area which is also explored within this essay, with specific focus on reducing anxiety levels by effective communication and development of a therapeutic relationship. Communication is a vital skill within the nursing process to enable accurate assessment, implementation and evaluation of interventions, this is another aspect which is explored and evaluated within this essay. ...read more.


C-fibres are unmyelinated, which are smaller and slower fibres, producing sensations of dull pain (Hawthorne & Redmond, 1998). Disease and injury often result in pain and hyperalgesia. These abnormal sensory events arise in part from the action of inflammatory mediators on the peripheral terminals of nocieptive neurons. Sensory nerves express a variety of receptors from inflammatory mediators. The expression pattern varies between individual mediators, but many of these receptors are found on the polymodal nociceptors. These receptors fall into three main classes: G-protein-coupled receptors, ligand-gated ion channels and the cytokine receptors or receptor tyrosine kinases. There is a considerable body of evidence that kinins contribute to the pathophysiological processes accompanying both acute and chronic inflammation. Bradykinin and the related peptide kallidin are formed from the kininogen precursor proteins following the activation of plasma or tissue kallikrien enzymes by path physiological stimuli such as inflammation, tissue damage or anoxia (Wall & Melzack, 2006). As previously noted the pain that Mrs Green was experiencing was categorised as acute pain. However, a factor which was taken into account when assessing Mrs Green?s pain was the impact of her anxious state, recognising that anxiety can lead to hyperalgesia, thus increasing her pain experience. Therefore the implementation of both adequate pain relief alongside the reduction of anxiety were main considerations when attempting to control Mrs Green?s pain. Pain management As pain can be a mutifactorial, there are a variety of approaches to treating pain. Choosing an appropriate treatment encompasses not only the clinical aspects but also the emotional, psychological and spiritual components that relate to the experience (Hawthorne & Redmond, 1998). The importance of recognising not only the physiology of pain that Mrs Green experienced but also the emotional and psychological impact was paramount to ensure that she received holistic care. The management of Mrs Green?s pain was complex and required the multi-disciplinary team to collaborate to provide effective holistic pain control. ...read more.


Kaufman. C.E. & P.A. McKee. 1996. Essentials of pathophysiology. Boston: Little, Brown and Company. Kenner. D.J. 1994. A total approach to pain management. Australian Family Physician. vol:23, p1267-1283. Kennerley. H. 1995. Managing Anxiety. Second Edition. Oxford: Oxford Medical Publications. Kingdon. R.T., K.J. Stanley & R.J. Kizior. 1998. Handbook for Pain Management. Philadelphia: W.B. Saunders Company. Lawler. K. 1997. Pain Assessment. Professional Nurse. Vol 13:1, 5-8. Lefkowitz. M. & A.H. Lebovits. 1996. A practical approach to pain management. New York: Little, Brown & Company. Livingstone. References Mackrodt K. & White M. (2001) Nurses? knowledge within the context of pain management. Journal of Orthopaedic Nursing 5, 15?21. Manias. E. 2003. Pain and anxiety management in the postoperative gastro-surgical setting. Journal of Advanced Nursing. Vol 41:6, 585-594. Martini F. H. 2007. Fundamentals of Anatomy and Physiology. Seventh McCaffery. M. 1980. Understanding your patients pain. Nursing 80:26. McCaffery. M. & C. Pasero. 1999. Pain Clinical Manual. Second Edition.. St Louis: Mosby Inc. McCaffery. M. & A. Beebe. 1994. Pain. Clinical manual for nursing practice. London: Mosby. McCaffery. M. 1965. Nursing Practice Theories Related to Cognition, Bodily Pain McCance. K.L. & S.E. Huether. 2002. Pathophysiology. The Biologic Basis for Disease in Adults & Children. Fourth Edition. St. Louis: Mosby Inc. McGuire D (1992) Comprehensive and multidimensional assessment and measurement of pain. Journal of Pain and Symptom Management. Vol 7:5, 312-319. McQuay. H. & A. Moore. 1998. An evidence-based resource for pain relief. Oxford: Oxford University Press. Melzack. R. & P.D. Wall. 1965. Pain mechanisms: a new theory. Science, 150: 971-979. Merskey. H. & N. Bogduk. 1994. Classification of chronic pain syndromes and definitions of pain terms. New York: Elsevier Limited. Miaskowski C., Nichols R., Brody R.& Synold T. (1994) Assessment of patient satisfaction utilizing the American Pain Society?s quality assurance standards on acute and cancer related pain. Journal of Pain and Symptom Management 9, 5?11. Montes-Sandoval. L. 1999. An analysis of the concept of pain. Journal of Advanced Nursing. Vol 29:4, 935-941. Naish. J. 1996. The route to effective nurse-patient communication. Nursing Times. Vol: 92, 27-28. NMC. 2002. Code of Professional Conduct. London: Nursing and Midwifery Council. ...read more.

The above preview is unformatted text

This student written piece of work is one of many that can be found in our University Degree Nursing section.

Found what you're looking for?

  • Start learning 29% faster today
  • 150,000+ documents available
  • Just £6.99 a month

Not the one? Search for your essay title...
  • Join over 1.2 million students every month
  • Accelerate your learning by 29%
  • Unlimited access from just £6.99 per month

See related essaysSee related essays

Related University Degree Nursing essays

  1. health needs assessment

    has been used to maintain confidentiality (Nursing and Midwifery Council NMC 2008). Evidence based research plays an enormous part in the way nurses practice and carry out tasks. It is ever changing so all research gathered and looked at has to be up to date and accurate.

  2. Law and Ethics in Nursing. The aim of this assignment is to reflect ...

    Covert administration refers to medication that is concealed, usually in food or drink, so that it is being provided to the patient unknowingly Griffith (2007). Although Mrs M's medication was not hidden from her in food, she was unknowingly taking the medications she had refused, with us informing Mrs M.

  1. The aim of this essay is to critically evaluate the bio-psycho-social perspectives and influences ...

    Individual health needs were not being met, due to clinician's perceptions of illness and lack of interest in patient's individual health (Engel, 1977). Due to these limitations in the biomedical approach a new model was proposed for explaining health and illness.

  2. The aim of this essay is to look at how infection control and the ...

    During orthopaedic operation, double gloving is recommended as any perforations will be highlighted and sterility will not be compromised. Surgical instrument and sterile equipment are prepared in the preparation room just before use, thus minimising the risk of contamination from airborne microbes.

  1. A 2000 word reflection on one specific conversation where personal communication and interpersonal skills ...

    My time with Frank enhanced my self-awareness as I have showed that I am able to show sensitivity and empathy towards others and has opened my eyes to medical conditions such as Frank's. It has also showed me the affect it has on their lives and how they must feel living with the condition.

  2. Community Profile

    rate as well as a higher risk of respiratory conditions like asthma and tuberculosis. Crime The Ward has an extremely high crime level within the city and has gained a reputation for being a hardened area. Appendix 5 shows the types of crime undertaken within the Ward between 2004 and 2010.

  1. My chosen skill is to assist the patients to feed and drink. I ...

    The Nursing & Midwifery Council (NMC) code of professional conduct (2004) established guidelines to inform nurses about their "professional accountability and practice". Nurses are professionally accountable for their actions and decisions involving patient care and safeguarding patient's interests independently of their "culture, ethnicity and religious beliefs" (NMC, 2004).

  2. Teamwork is an integral part of Accident and Emergency care and if it is ...

    Particularly in one recent study it was assessed that the way the questions are asked to the patient has a great bearing in which way the Chest Pain is going to be dealt with (Hofgren et al, 1994).. Over the past few years, analysis of verbal descriptions of MI has received increased attention.

  • Over 160,000 pieces
    of student written work
  • Annotated by
    experienced teachers
  • Ideas and feedback to
    improve your own work