Are We Experiencing Pain - Essay Example

Concept Paper: Pain What do we mean when we say we are experiencing pain? Does the word ‘pain’ have aspecific meaning that is universally true for all? The problem with identifying what is meant when a person says he is experiencing pain is inherent in the fact that ‘pain’ is a symbolic word used to refer to an abstract idea or concept. Words such as health, hope, caring, grief, loneliness and pain are all examples of how language is used symbolically to refer to groups or classifications of thoughts, feelings and associations. The symbolic use of language is most easily understood in the context of a perception, in which the ideas being communicated can be expressed through concrete individual representations, such as a red apple or fire truck when considering the perception of ‘red.’ Concepts like pain are different from perceptions, though, in that they cannot easily be illustrated through concrete objects. One cannot just say the pain feels like a ripe banana and thereby give an impression of the color, texture and intensity of what is meant by ‘pain’. Concepts are the building blocks of theories and theories assist us in the effective treatment of patients of various walks of life. While the idea of pain may be considered a universal experience, understanding the ways in which conceptions of what is meant by ‘pain’ in different contexts can provide useful insight into a patient’s experience of pain and thus contribute to more effective pain management within the nursing setting. Generally speaking, the concept of pain is understood to refer to unpleasant feelings experienced within the body but can also be considered in terms of a subjective experience that is understood by the individual alone. While they can be called ‘sharp’ or ‘dull’, general or localized, these unpleasant physical sensations are described in direct relation to their location within the body in terms of volume and intensity. “According to this thread when we feel pain in parts of our bodies, we perceive something or some condition in those parts, and when we report them … we seem to make perceptual reports” (Aydede, 2005) of the ‘I see a yellow banana’ variety. Thus, this understanding of pain is understood in terms of adverse physical conditions within the body with an empirical cause and a solid relationship to concrete objects – ‘I feel sharp pain in my hand when I type’. This is partially related to our understanding of the biological reasons for why we must feel pain. “Pain can be helpful. Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment” (US National Library of Medicine, 2007). In addition, it is universally accepted that pain is associated with certain common activities – bringing the hammer down on your thumb causes a sharp, sudden pain followed by a longer lasting dull thudding pain for instance. This biological explanation for pain helps to create a concept that everyone can relate to, yet it remains unexplained because of the difficulty in describing the volume, texture and intensity of specific and generalized pain – the subjective aspects of pain. Moving beyond the physical realm, there is another way in which pain is generally conceived and this is based upon the subjective experience of it – i.e. the reporting of volume and intensity as it is understood within the subjective realm of the individual’s past experience. In the act of reporting pain, the realization that this is a subjective experience is integral to the language used in that it is always expressed as a part of a process of experiencing rather than as a physical location (Aydede, 2005). We realize that just because we have torn a muscle, we do not necessarily feel pain (i.e. if the nerve has been damaged or an anesthetic of some type has been used) just as we realize that the absence of physical injury does not necessarily indicate an absence of pain, as can be seen in the case of phantom limb pains. The fact that some individuals may report experiencing pain without experiencing tissue damage is further proof that pain is a subjective state only minimally related to actual physical condition. It indicates that the subjective nature of pain has become associated with psychological issues and conditions. In addition, because the concept of pain cannot be placed within a concrete perception, the reporting of it is always subjective, based entirely upon the experiences of pain an individual has had in their past. This is where differing concepts of pain intensity and volume complicate attempts at pain management. The subjective experience of pain was among those expressions artists of the modern art movement have attempted to explore. Artists such as Pablo Picasso did this by dropping many of the easily recognizable symbols of more traditional art and focused upon color and form to convey the emotion of their subjects. Picasso’s colors in “Woman Weeping” (1937) for example are predictably dark and muted, consisting primarily of dark earth tones suggesting the woman’s connection with the earth and universal suffering. Her eyes are the only white spaces not constrained in the center and spill out tears that paint a white and gray-blue handkerchief-shaped area out of the front of her face. However, because Picasso was interested in showing emotions, he made the handkerchief transparent for all but color, depicting the woman’s gnashing and gritted teeth as they open for weeping, move against each other in fear and gnash the edge of something in anger. Her tears are also diamond-shaped daggers digging into her fingers and her own fingernails as she attempts to hide her face behind her hands. The sharp angles and jagged edges of this central section reveal the stabbing sharpness of her sorrow while the more muted lines of the periphery denote the long-term suffering this present pain will become. Life observations also provide several examples of the physicality and subjectivity of pain. Upon breaking an arm, an individual generally expresses feeling a great deal of sudden pain. This is expressed through such actions as curling over the injured area, crying out, sudden tears in the eyes or facial expressions of injury. They may report feeling sharp pains within the arm itself, spreading through the back or chest or even feel pain in other, unconnected areas of the body. After the arm is set and immobilized, however, the person may no longer experience the sharp stabs of earlier experience, but instead experience a dull ache, occasionally interrupted by a sharp stab of pain. While the pain can be described and related to a variety of possible shared experiences, such as placing the pain of the broken arm on a rating scale in which one of the ratings is based on the pain of touching a hot burner for instance, the experience remains subjective. The description may sound something like: “Have you ever broken your finger? Imagine that times ten” or “You know how it feels when your arm falls asleep and then starts to wake up? Think of that only it lasts 3 times longer.” While these descriptions attempt to assign a specific degree of pain to the experience of breaking and healing, they are nevertheless outside of the comprehension of the listener. Within the hospital setting, pain management can be seen to play a large role in the treatment of emergency room patients. For example, upon a patient’s arrival at the hospital with a suspected heart attack, pain management is often one of the first symptoms to be addressed as managing the pain assists in helping the patient to recover or survive the incident. Although her experience of pain might be subjectively assessed, it is nearly universal to find that patients experiencing chest pain of any degree of severity can also cause emotional pain which can further deplete the body’s resources and increase the damage to tissues (Viney, 1996). Experiencing pain can reduce mobility, increase sympathetic physical activity such as increasing heart rate, respiratory rate and blood pressure at a time when the heart is already under extreme distress (Viney, 1996). While these reactions are expected in heart patients because of the physical connection between the body and pain, the degree to which each patient is affected by pain is variable because of the subjective nature of the concept. The only way to effectively manage pain within the hospital setting, then, is to include the patient in periodic assessments of pain directly from the patient as well as careful monitoring of patient body language and physical responses. It is important to remember the dual nature of pain within a nursing setting. The idea that pain is experienced and expressed in a variety of ways and to a variety of levels depending entirely upon the past experiences of the patient is easy to overlook. In a busy ward in which numerous patients are experiencing relatively similar physical conditions, average responses to pain scenarios may emerge that provide a nurse with a somewhat generic conception of the amount and type of pain treatment that should be expected for a given condition. Beyond this level, a nurse can quickly find him or herself becoming less willing to provide assistance as a result of a perception that the patient is being unusually difficult or is exaggerating their experience in some way for some reason. Understanding that pain is subjective, that a broken arm may barely affect one person’s experience of pain while it may redefine another’s, is not only beneficial to the patient in terms of providing them with appropriate and effective pain management strategies, but is also beneficial to the nurse in attempting to provide the quality care and compassion that they entered the profession to provide. References Aydede, Murat. (2005). “Pain.” Stanford Encyclopedia of Philosophy. Available June 26, 2007 from Picasso, Pablo. (1937). “Weeping Woman.” Oil on canvas. Online Picasso Project. Available June 26, 2007 from US National Library of Medicine. (2007). “Pain.” Medline Plus. Available June 26, 2007 from < http://www.nlm.nih.gov/medlineplus/pain.html> Viney, C. (1996). Nursing the Critically Ill. London: Bailiere Tindall. Read More