Reflective Analysis of a Pain Management Incident in the Surgical Unit

Introduction

The study is a reflective account of a pain management incident that occurred in the surgical unit of my work placement. Gibb’s (1988) reflective cycle is to be used as it provides adequate structure to be followed in coherently examining an experience to determine its strength and weakness to be improved for future aspects (Adeani et al., 2020)

Description

In the surgical unit, a ward nurse administered antihypertensives along with osteoporosis pain control medication to a patient named K as she was suffering from high blood pressure as well as has osteoporosis. After the administration of osteoporosis medication, she expressed disapproval with the treatment and mentioned feeling discomfort out of pain with the mention of requiring usual immediate massage to relive her from the pain. The ward nurse immediately came over and explained her the importance as well as the mechanism of action of the medication provided for her health benefit. Moreover, health records of the patient were developed, and the ward nurse moved on to look after other patients while K reported on being ignored and dissatisfied with the services.

Feelings

The situation initially led me to feel confused and lack of confidence in continuing care for others with the ward nurse. This is because I felt the ward nurse is superficially caring for the patients and not meeting all their needs with satisfaction which is leading the patient to experience hindered emotional condition and disapproval with healthcare. According to NMC, the way to promote patient care include showing respect to understand the needs of the patients, enable effective care support for them, offer emotional support, coordinate care, involve patient advocate and others (NMC, 2018). In case of K, the ward nurse did not act to promote patient care as she did not respect and considered K’s decision of additional massage to support her get relived from the discomfort and pain caused by sudden medication administration for her osteoarthritis. Moreover, I felt that K was not effectively informed in detail with supportive evidence of the benefit of the pain medication for osteoarthritis by the ward due to which she expressed discomfort with the action. This is evident as I found the ward nurse to use medical jargons in explaining the medication mechanism to K who may not have understood the facts as he was unaware of such terms. The use of medical jargon is to be avoided in explaining care to the patients and the use of effective supportive evidence is to be implemented in simple terms to inform them regarding care. This is because the patients are not qualified enough to understand complex medical terms and information (Pitt and Hendrickson, 2020).

Evaluation

The thing that went well was that effective medication compliance and health reported of the patient was maintained by the ward nurse is treating patient K. This is evident as no medication error was reported for K and the correct medication was provided to K for treating her osteoporosis and high blood pressure along her health vitals are gathered. However, the thing that did not go well is compassionate care was not provided to the patient. This is evident as the patient though reported of pain and discomfort after the medication, the ward nurse instead of understanding her pain and taking time to clam her, went to deliver care to others and ignored the patient. The other thing which did not go well is effective pain management and SBAR was not implemented by the nurse which is part of their responsibility. SBAR (Situation, Background, Assessment, recommendation) is the technique used for facilitating prompt and effective communication (Shahid and Thomas, 2018). In the scenario, the ward nurse nor I was asked to perform SBAR for K so that her pain management could be improved. In addition, pain management include assessing the pain level of the patient and taking appropriate actions in limiting the pain (Park and Park, 2019). However, in K’s condition, the ward nurse avoided to assess her pain level and deliver the required support needed by her in limiting the pain and discomfort expressed after the medication.

Analysis

The effective medication delivery to patient occurred because the ward nurse has enhanced skills and knowledge regarding the specific medication and route of administration to the patient. The health record keeping of the patient by the ward nurse went well because she had effective understanding of the way and need of health vitals of the patients to be recorded. However, active pain management of the patient was not achieved because the nurse did not have adequate knowledge of the way pain expressed by patients are to be cared. This action compromised the action of delivery of care in the best interest of the patients and violated NMC Code (NMC, 2018). The response to medication delivery to the patient was not positive because effective permission before administering the medication was not taken from the ward nurse. The NMC Code mentions patients are to be included in deciding their care to ensure all their needs and demands are fulfilled (NMC, 2018). However, the decision regarding K’s care was not made by involving her, leading to hindered care delivery and patient promotion.

Conclusion

The experience leads to conclude that the ward nurse lack effective experience of providing cooperative care for pain management to patients by abiding with the NMC Code. The nurse also expressed hindered ability for pain management and administration of medication along with failure in using SBAR in making effective patient communication. I expressed effective compassion but faced lack of confidence in delivering care due to the hindered pain management for K.

Action Plan

In case of similar situation for making change in medication for patients, effective discussion with showcasing of proper evidence to understand the importance of the medication delivery to their health. the evidence is to be gathered through searching existing patient reports and proof of care. In making effective communication with the patients and health analysis, the nurses are to be trained in using SBAR as it is the key communication tool in making effective health judgement of the patient. In addition, the nurses are to be trained in respecting the patient needs and provide care by meeting their demands to ensure their satisfaction with care and health promotion out of effective competency in accepting care.

References

Adeani, I.S., Febriani, R.B. and Syafryadin, S., 2020. Using Gibbs’reflective Cycle In Making Reflections Of Literary Analysis. Indonesian EFL Journal, 6(2), pp.139-148.

NMC 2018, The Code, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 2 December 2021]

Park, C.S. and Park, E.J., 2019. Identification of knowledge structure of pain management nursing research applying text network analysis. Journal of Korean Academy of Nursing, 49(5), pp.538-549.

Pitt, M.B. and Hendrickson, M.A., 2020. Eradicating jargon-oblivion—A proposed classification system of medical jargon. Journal of general internal medicine, 35(6), pp.1861-1864.

Shahid, S. and Thomas, S., 2018. Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care–a narrative review. Safety in Health, 4(1), pp.1-9.

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