Medical-Surgical Blog

This week, I encountered one particular patient named Lucille (pseudonym) a 69-years-old woman with diabetes who has had her left toes amputated for gangrene. As I approach her room, my feelings were mixed as I detected restlessness in her voice as she moaned. She stated that her shoulder and feet hurt. I felt crushed realising that no pain relief was given during the night.

I initially provided reassurance, use words that empathise and therapeutic touch as I commence on wound assessment and observe her manner of expressing pain. Studies suggest that a person’s having positive outlook and increase emotional coping mechanism influence the quality of pain they experience (Wood, 2010). Then, I asked her to describe the exact location, intensity and quality of pain.

Using numerical pain assessment that I have learnt from clinical laboratory at the university, Lucille rates her pain as 6 on a 1 to 10 scale. I also ensured that Lucille is comfortable by offering her a beverage and turned the television on as she requested which somehow brightens her mood unfortunately the level of pain remained the same. I have realised that the environmental distractions and interruptions helped lessen her attention to pain (Pediaditaki, Antigoni, & Dimitrios, 2010).

Afterwards, I immediately consulted with Nurse Sam (pseudonym) and mentioned my initial thoughts on pain management and whether my actions were correct. She supports my assessment and then we proceed to administered bolus dose of IV morphine. While waiting for the additional morphine to take effect, I suggested if we could implement some alternative therapies and relaxation techniques (Lewthwaite et al., 2011).

We applied a warm pack to her shoulder and near her feet then used gentle massage technique and practice some deep breathing exercise. As we continued to manage the pain with these additional measures, I was astounded to witness the positive effect on the patient as she became more relaxed, verbalised decrease in pain level and permit us to assist her to a sitting position in bed.

Overall, this experience has taught me that pain medication alone is not always 100% effective to ease the patient’s pain (Corazzini et al., 2013). Schoenwald (2011) stated that pain is multidimensional and complex so it’s better to formulate alternative solution to relief pain that a nurse could institute to avoid exacerbation of pain. I previously known that medications were the only remedy to all pain, this experience reinforced the need to treat the patient physical as well as psychological aspect in dealing with pain (Lewthwaite et al., 2011).

With this perspective I could now somewhat relate to what the patient’s must be experiencing. I also learned that the ability to listen among nurses and encouraged patient to self-reporting of pain are the key to pain relief (Pediaditaki et al., 2010).

Next time, I will be more confident in managing patient with pain. I will make sure that I will be able to increase my knowledge of pharmacology drugs for pain and teach preferred non-pharmacology approached for pain management to my patient.

This week, I encountered one particular patient named Lucille (pseudonym) a 69-years-old woman with diabetes who has had her left toes amputated for gangrene. As I approach her room, my feelings were mixed as I detected restlessness in her voice …

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