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What is new about pain management? Actually, the area of pain management has grown significantly in the past few years. However, practitioners continue to deliver care based on outdated information and personal beliefs. Most nurses received only a few hours of instruction on pain management in their nursing courses.1
Attitudes about pain and the management of pain have largely been influenced by our own experience and the experience of other health care providers. To understand pain and pain management, we need to look at the current research.
Pain is a very subjective experience. It is different for everyone. For health care providers who are used to dealing with objective data, the lack of objective measurements to evaluate pain has resulted in less than adequate pain relief for many people. Unrelieved pain causes needless suffering, increased hospital stays and increased surgical complications.2
If I asked nurses how well they control the pain of their clients, most would rate themselves fairly high. However, studies suggest
that a majority of clients experience poor or inadequate pain relief. The truth is, different nurses will treat pain very differently, based on their own beliefs, values and experiences.3
Pain is probably one of the most frequently used nursing diagnoses. If you look at all of the people who have surgery, injuries, burns, or cancer in the United States at any given rime, you can begin to recognize the enormity of the problem. As nurses, we try to provide comfort and caring interventions to all clients. However, lack of understanding, related to the phenomena of pain, has often prevented our success.
There are many definitions for pain. Pain can be described as an unpleasant sensation or a state of discomfort. However, since pain is a subjective experience, the only expert on pain is the person who is experiencing the pain. McCaffery's definition of pain is probably the most useful and realistic definition currently available. She defines pain as "whatever the experiencing person says it is, existing whenever he says it does."4
This belief, in the subjectiveness of pain, will be the starting point for this course. It is hoped that at the completion of this course you will have had a chance to explore your own beliefs and gain a better understanding of how these beliefs influence your nursing interactions with clients experiencing pain.
Before you begin this course take a few minutes to complete the Pain Knowledge Self-Test on the next page.