Nancy Politarhos, RN, MSN, Assistant Vice President, Patient Services, Taylor Hospital
As nurses, we are responsible for assessing, treating and monitoring pain (referred to as the fifth vital sign); educating patients about their pain medications; ensuring safety during pain medication administration; and advocating for patients with unrelieved pain.
The first three provisions of our code of ethics ensures that “(1) in all professional relationships, nurses practice with compassion and respect . . . (2) the nurse's primary commitment is to the patient . . . and (3) the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient.” This includes the right to effective pain relief.
Often we are the patients’ voices, ensuring that they are being heard and seeking alternatives for ineffective pain management on their behalf. There is an arsenal of treatments to effectively manage both acute and chronic pain conditions, and it is our duty to make sure that each patient receives optimal treatment to meet his or her individual needs.
It is very important to know and recognize the patient’s physiological, psychological and emotional responses to pain. Without addressing these important issues, it is often difficult to develop an adequate pain treatment plan. In addition to collaborating with physicians, we need to partner with our patients and engage them in their pain management plan.
Always ask -- and believe -- the patient’s assessment of his or her own pain. Don’t trust that patients aren’t having pain because they "look comfortable." Some patients with pain, even severe pain, can be distracted from thinking about their pain, and may even be able to sleep. Remember that changes in vital signs do not occur with all patients who are experiencing severe pain, so don’t rely on vital signs to determine the severity of a patient’s pain.
Pain can affect patients in many ways; it can decrease mobility, interfere with rest, decrease appetite and limit socialization. Our patients have the right to expect a rapid and effective response to a complaint of pain. Evidence shows that good pain control results in fewer complications, faster healing and decreased hospital stays.
At Crozer-Keystone, we are proud of our nursing staff’s daily dedication to managing our patients’ pain. Hourly rounding on our patients ensures frequent assessments and rapid interventions. Our system wide pain committee continues to seek improvements to our current treatment protocols by exploring literature for best practices surrounding the management of pain.