Pain is a common and expected problem after any surgery, but it is often unrelieved for many patients. Even with the use of opioids, the incidences of pain postoperatively remain persistent. Postoperative pain can be very destructive, causing stress response, diminished reflexes, protein breakdown, aggravated platelets, nausea, ileus, and suppressed immune system. Inadequately managed pain can lead to adverse physical and psychological patient outcomes for patients and their families (Hinkle & Cheever, 2018). Unrelieved pain may lead to immobility which can cause deep vein thrombosis, pulmonary embolus, and pneumonia. Postoperative pain that is not managed can negatively affect a patient’s well-being and lead to anxiety and depression. Pain causes stress, and postoperative stress can cause hypercoagulation, increased heart rate, blood pressure, cardiac workload, and oxygen demand (Hinkle & Cheever, 2018). The nurse’s role is to appropriately assess and manage pain for patients to have the most significant outcome.
When we are administering medication in my unit, vital signs must be taken before giving the medicine. Therefore, there was no need to reevaluate the vital sign of the patient after given narcotics. As indicated in research from Roth-Carter et al. (2018), to meet the patients’ needs, pain should be reassessed after each intervention to evaluate the effect and determine whether a modification is needed. The time frame for reassessment also should be directed by hospital or unit policies and procedures. The patient’s lack of reassessment after given pain medication may cause the death of a young adult who received multiple-dose of opioids and did not have a proper reassessment. They decided to change the policies and implement safe practices to ensure the patient’s safety. They introduce the “sandwich vital signs’ which means you check the vital sign before and after any pain medication administration. So far, it has been in practice in the hospital, especially in my unit.
According to the new research, frequent and vast changes in acute care hospitals can take a toll on nurses and cause change fatigue, which has been largely overlooked and under‐researched (Brown et al., 2018). At the beginning of the change, nurses complained about the amount of work they would do. They applied the decision-making process by analyzing the problem, which is the lack of reassessment leading to death. They implement the alternatives, which means to emphasize the nurse’s return to reassess the patient. They presented the new evidence-based research showing the importance of reassessment. They finalize it by introducing a new policy that will eventually improve patient outcomes and prevent sentinel events.
In nursing, the care of the patient depends on us. The decision‐making research in acute care nursing is prevalent; errors in decision‐making continue to lead to poor patient outcomes (Nibbelink & Brewer, 2018). We are the advocate while trying to encourage and reinforce their decision respectfully. Every day in the healthcare system, the nurse must make decision-making to improve the patient’s outcome, and it is all on evidence-based practice. Evidence‐based practice involves integrating best results in research with clinical experience, which will enable us to provide a higher quality of care and optimize the care given (Bennasar‐Veny et al., 2016). The decision to change the policy was initially not welcomed, but nurses started to understand the rationale and begin accepting the change. From the time they have changed the policy, no sentinel event happened.
Nursing is about protecting, advocating for their patients, and providing them with the adequate treatment they deserve. Surgeons will be the ones to prescribe medications, but it is the nurse’s role to maintain a safe environment for the patient and ensure no further harm comes to them. Lack of proficient pain assessment is a barrier to achieving adequate pain management. Measuring and treating pain may differ for each patient, so it is the nurse’s role to help assess and characterize their pain to treat it accordingly. Pain assessments done by nurses can help prevent lapses in the administration of pain medication, leading to further complications like stress, leading to an array of complications. There are many different types of pain management treatments, and since the nurse will be with the patient during post-op, the nurse can help recommend other forms of treatment. Nurses should know different pain management treatments: patient-controlled analgesia (PCA), opioids, non-opioid analgesics, NSAIDs, and alternative measures. The nurse should help with guided imagery, music therapy, heat and cold therapy, and relaxation techniques. Pain is never an easy task to conquer, and every patient will experience different types of pain, and pain management will be different for every patient. It is up to the nurse to be open-minded, patient, and empathetic. All a nurse can do is provide the best care possible.
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