Pain Assessment and Management
Definition of Pain
In 1968, Margo McCaffery defined pain as “whatever the experiencing person says it is, existing whenever the experiencing persons says it does.” This definition focuses the caregiver to listen to and believe the patient’s report of pain. Our first professional responsibility to the patient in pain is to acknowledge and believe the patient’s report. Pain is subjective and requires us to put aside our own opinions and believe the patient’s report.
Unrecognized Pain
Sometimes, we expect a patient in pain to act in a particular way. As healthcare providers, we have been taught to look for indicators for pain such as grimacing, moaning and groaning. Many of our older patients may develop impaired cognition, and the demonstration of pain may look somewhat different. We need to consider behaviors such as aggression, biting, hitting, resisting care, yelling, and fighting as possible and potential indicators of pain. Patients may not always act as we think they should. In older patients who are cognitively impaired, we will need to first consider their diagnoses as possible indicators for pain.
Un-Relieved Pain
It is important to treat the right type of pain with the right medication. When we don’t interpret each type of pain that the patient may be experiencing, we often have the potential to only manage one type of pain and may miss another type of pain. This may lead to poor pain management and result in increasing medications that may not be necessary. Very often our older patients experience combinations of pain and require multiple or combinations of medications.
Under-Treated Pain
Sometimes pain is not appropriately treated because of concerns about dosages of medications. It is always appropriate to treat patients with the smallest number of medications and the least dosage possible. Often when patients have chronic pain issues and have been on medications for long periods of time, they will develop a tolerance to either the medication or the dose. When patients continue to need larger doses of medication to appropriately treat their pain, this is often misinterpreted and the patient may be under-treated.
If you would like to read more information, please click here.
This is a PDF File and Adobe Acrobat Reader is required to read it, to download it click here.