If you’ve been in nursing for more than five minutes, you’ve heard the phrase, “Pain is the fifth vital sign.” (OK, quick ,can you come up with the other four? Of course, you can. They are heart rate, respiration, temperature, blood pressure.) We certainly need to ask our patients if they have pain, but there is more to controlling a patient’s pain than that. Here are five crucial points nurses must know to effectively manage a patient’s pain.
1. Pain is very subjective.
Pain is what the patient says it is. Everyone experiences pain differently. We cannot judge according to our own pain threshold. Some patients may be stoic and deny pain. Others may experience pain at what we perceive as very low levels.
2. Before giving a pain medication, know where the pain is and the severity to evaluate if the analgesic is effective.
It is important to follow up to make sure the pain medication was effective in eliminating the pain or decreasing the pain to an acceptable level for the patient. If not and no other environmental measures help, consider calling the NP/doctor for more/different pain medication.
3. If the patient is using prn pain meds frequently, consider asking the NP/doctor for analgesics on a routine schedule to prevent the pain and a prn analgesic for breakthrough pain.
4. Encourage the patient to take pain medication before the pain gets so great that the pain medication may not be as effective.
5. Prevent/anticipate pain if possible.
Get to know the patient’s pain pattern. If a patient always has pain during physical therapy, give the analgesic in advance of the appointment so the pain is decreased enough for the patient to participate. If pain usually causes insomnia, consider giving the analgesic at bedtime or shortly after the patient goes to bed.
A patient in pain is an opportunity for you to put your nursing assessment skills to the test. Come up with a care plan that will address all of the above points, and you will have gone a long way to managing your patients’ pain.