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Postoperative pain management - Essay Example

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Management of pain following a surgery employs oral or rectal analgesics, intramuscular opioid injections, systemic opioid analgesia, continuous subcutaneous infusion of analgesics, and patient-controlled analgesia (PCA)…
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Postoperative pain management
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Download file to see previous pages Management of pain following a surgery employs oral or rectal analgesics, intramuscular opioid injections, systemic opioid analgesia, continuous subcutaneous infusion of analgesics, and patient-controlled analgesia (PCA).Management of pain following a surgical procedure is one of the major challenges and source of concern for health care providers (Berge et al, 2004). However, surveys have revealed that hospital postoperative pain management, such as opioid intramuscular injections are frequently inefficient, resulting in unrelieved pain in approximately 50% of patients (Steinberg et al, 2002). Various studies have shown that postoperative pain has significant influence on the recovery of the patient, length of stay in the hospital, mobility, cost of hospitalization and also postoperative morbidity like cognitive dysfunction and pulmonary complications (Pain Management Guideline Panel., 1992). According to Sommer et al (2008), moderate to severe pain occurs in more than 50 percent of patients who undergo abdominal surgery It is crucial to control postoperative pain and currently in every hospital in the western world, control of post operative pain is given utmost importance. An understanding of pain management in the postoperative period can be enhanced through reflection. Reflection is evaluation and examination of thoughts and actions of oneself. For health practitioners, reflection means focusing on the interaction of oneself with colleagues and environment in a particular situation so that they are able to evaluate their own behavior. “Reflection gives scope for better understanding of oneself so that existing strengths can be used to build-up for future actions "(Somerville and Keeling, 2004). In order to be an effective practitioner, one must be able to identify one's strengths in approaching a problem, assess one's level of competency and improve on what one thinks are the weaknesses so that when the same problems arise in the future, the right approach can be adapted. Reflection is also an opportunity for professional growth and development to increase competence in the nursing practice (Alexander, Fawcett and Runciman, 2006). Reflective practice is very essential for nursing clinical practice because it helps the nurse to understand, assess and learn through the experiences during clinical practice (Burns and Grove, 2005). In the following assignment, I shall discuss about management of a patient with postoperative pain based on Gibbs (1988) Reflective Cycle. This is because, Gibbs Reflective Cycle is a straight forward and recognized framework for reflection wherein it enables clear description of the situation of the patient, the analysis of feelings, evaluation of the experience, analysis to make sense of the experience, conclusion where other points are considered and reflection upon experience to examine what you would do if situation arose again. Case description Mr. X was a 67 years old male patient, who I looked after in a Surgical High Dependency Unit (SHDU). He was transferred from theatre following Whipples, where a total pancreatectomy was performed along with the removal of Gall Bladder and Duodenum. Past medical history included hypertension and chemotherapy 2 years ago following the diagnosis of pancreatic cancer. He was also underweight. The patient was transferred to SHDU in a stable condition. On the 1st day post op, the Epidural Analgesia’s catheter was dislodged by accident and according to the protocol (NHS 2009), it could not be used anymore. Although, the patient had prescribed oral pain reliefs as required, Mr. X showed discomfort and pain, once resting and moving in bed. Because of the risk of post operative complications including pressure sores and chest infection, the issue was highlighted to Pain Management Nurse, who prescribed Patient Controlled Analgesia (PCA). The Pain Management Nurse provided short educational session for Mr. X, as he never used PCA before and appeared to be anxious about ...Download file to see next pagesRead More
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