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Pain Health Article

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Alternative treatment

Both physical and psychological aspects of pain can be dealt with through alternative treatment. Some of the most popular treatment options are acupressure and acupuncture, massage, chiropractic adjustments, and relaxation techniques such as yoga, hypnosis, and meditation. Herbal therapies are gaining increased recognition as viable options. For example, capsaicin, the component that makes cayenne peppers spicy, is used in ointments associated with arthritis; it serves as a counteractive or contradictory pain site—the mind focuses on it, rather than on the joint pain. Contrast hydrotherapy can also be very beneficial for pain relief.

Behavioral modification to incorporate a healthier diet and regular exercise may be of help. Aside from relieving stress, regular exercise has been shown to increase endorphins, pain alleviators that are naturally produced in the body.

Health care team roles

As members of the health care team, advanced practice nurses (A.P.N.s), registered nurses (R.N.s), and licensed practical nurses (L.P.N.s) are responsible for assessing the pain response that paints demonstrate, implementing proper pain-medication therapy, assessing the outcomes of pain therapy, documenting the patient's perception of pain severity using a pain scale, as well as describing other pain characteristics and teaching patients pain-management techniques.

Joint Commission on Accreditation of Healthcare Organizations standards

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which is the accreditating body for all health care facilities, is focusing on auditing health care organizations on their appropriate pain-assessment and pain-management techniques by way of newly published pain standards. Health care institutions are being held accountable for outcomes of pain management according to the standards, and A.P.N.s, R.N.s, and L.P.N.s must be aware of these standards in order to modify practices to meet the new regulations. The 2001 JCAHO standards are:

to acknowledge that every patient has a right to pain evaluation and pain management
to evaluate pain in every patient
to do a thorough examination when the presence of pain has been identified
to document the examination in a specific format that supports standard reexamination and review
to establish a customary protocol for observation and management of pain
to teach practitioners and guarantee health care team proficiency on pain-management standards
to create guidelines that incorporate adequate dispensing of appropriate medication for pain control
to create and implement educational materials for pain control to give to patients and families
to address pain-control measures upon the patient's release from the facility
to establish tools to evaluate the success of pain management

Assessing characteristics of pain

The health care team must be able to describe the characteristics of pain when identified by the patient. Subjective data should be collected. Information on the following eight variables is essential to get a clear picture of the patient's experience of pain:

Describe the pain (sharp, dull, aching, stabbing).
How often (constant or transient—comes and goes).
Where (point to the exact location, does the pain radiate, or spread)?
Intensity: Assign a number from 0 (no pain) to 10 (the worst pain you have ever had).
How long: all the time, or episodes of seconds, minutes, hours?
Does anything help to relieve the pain (a certain position, medication, ice, or warm compresses)?
Does anything make it worse (a certain position, exercise)?
Have you ever experienced this type of pain before?

Importance of pain reassessment

As the R.N. or L.P.N., assessing the outcomes of pain-management therapies is an important part of the health care role. Intravenous medications should provide relief within 10 minutes, intramuscular medications are active within 30 to 40 minutes, and oral medication takes effect within one hour or less. Pain reassessment takes these times into consideration. Reassessment in these time frames allows accurate outcomes evaluation for pain management.

Patient education

Teaching appropriate pain-medication administration as well as informing the patient of ancillary pain-management techniques are important in patient education. A person in pain should understand that various medications take time to be absorbed and start working. Also, teaching relaxation techniques, such as meditation, imagery, and aromatherapy, offers measures that complement pain-medication effectiveness and may even reduce the need for medication. Many patients are afraid to take some pain medications, for fear of becoming addicted. Explaining that the appropriate use of the medication, in the dose prescribed and in direct proportion to the level of pain, will avoid the potential for addiction. Health care team members are patient advocates, and they should not allow their patient to suffer.

Prognosis

Successful pain management is dependent on successful identification of the pain's cause. Acute pain will stop when an injury heals or when an underlying condition is treated successfully. Chronic pain is more difficult to treat, and it may take longer to achieve a successful outcome. Some pain is intractable and will require extreme measures for relief.

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