For this assignment, the pain management policy and procedures were evaluated. This policy enhances enlightenment to the registered nurses (RNs) on the appropriate guidelines after which they can act in a manner that is in accordance with the pain management requirements. Effective management of pain by the RN is enhanced through appropriate patients advocacy, assessment and intervention (Cousins, 2003).
How easy/difficult was it to find this procedure?
Utilizing my intranet facility to locate the HCHD pain management policy and procedure was an easy task. Therefore, there were no obstacles that were encountered.
Did the RNs know where to find this procedure?
Given that the RNs are usually supposed to assume the responsibility of examining and accessing the pain together with initiation of a care plan, it is possible for these RNs to use this responsibility in exploring for the information that is essential to meet the personal pain examination goal of the patient. In addition, the unit instruction and education extended to the RNs during the orientation process enhances them to easily locate the relevant information on the policy and procedures of pain management.
Is the policy evidence-based?
Yes, HCHD policy key is evidence-based-practiced. This policy details the guidelines that are essential to ensure that the pain assessment is successful coupled with HCHD patients’ reassessment. This HCHD policy evaluates the emergency center patients, ambulatory clinic patients, surgery patients together with the inpatients to enhance assessment of the pain that is fitting to the patient ability, condition and age together with the treatment, and care and services scope. As provided in the procedures and policy guidelines, it is important that the pain assessment be carried out by a qualified medical practitioner or RN. As provided in the guideline, the either of the parties is to ensure careful assessment of every patient for any evidence of pain. This is what is referred as the initial assessment phase (Cousins, 2003). Once the admission has been conducted, a comprehensive pain assessment is carried out for a patient requiring to be undergoing pain management procedures. In addition, the policy and procedure provides for the collection of assessment data coupled with viewing and verification by a registered nurse where appropriate (Goode, 2000).
Observe the RNs on the unit performing the identified procedure and describe what steps the nurses took and in what ways the nurses deviated from policy. What prompted the nurse to make those deviations?
Under a normal RN operation schedule, the call light went on prompting the nurse to respond within ten seconds. Under normal emergency situation, this duration is appropriate especially considering the fact that the RN has to assemble the appropriate equipment and medication before visiting the emergency area. Although this period hardly allows the RN to review the patient medical condition, it is reasonable to allow the RN gain an insight on the medication procedures required and the appropriate pain management compliance guidelines. Looking at the nurse to patient ratio and acuity levels, nurse was very much engaged at the exact time of immediate response to call light and reassessment of pain levels post medication administration.
Gebbie et al. (2000) insists that there are instances when the RN may be constrained or influenced by the personal factors. In such instances, the nurse may hardly be able to evaluate, access, and communicate the level of patient pain in a manner that is effective and objective. To compound this issue, there may be an instance whereby there is inadequate knowledge in the nurse when it comes to pain management. As a result, such RNs may hardly be able to recognize the urge of seeking out for additional facts to enhance effective implementation of the pain management in the patient (Gebbie et al., 2000). For example, Cousins (2003) explains a habit that is inherent in the RNs whereby they usually insist that the patients’ pain can simply be ‘known by having a look at the face of the patient’. This perception is dismissed by Cousins (2003) as a demonstration of insufficient knowledge base.
Consequences of not following safe institution
One of the consequences would be poor outcome in pain management which will hardly portray the nursing skills and experience in the specified healthcare field. In the medical practice, poor outcome as a result of negligence and inexperience of the medical practitioners is usually unwelcomed and in some instances results in criminal prosecution by the patient or family of the patient whose medical condition was neglected. This is a bad image to the RN that can easily ruin their career in nursing. Goode (2000) adds that in many occasions, there have been cases of equipments being damaged or misused as a result of implementing medical practices that are not procedural. The misuse can result in wrong conclusions and outcome that may not clearly reflect the medical condition of the patient.
What is the proper response when you, as a RN discover unsafe practice that deviates from standards, policies, or procedures?
As a RN that is fully committed for the patient welfare, it is appropriate to reassess the ethical nursing procedure in order to ensure that the unsafe practice that deviates from the required policies, procedures, and standards is managed. Gebbie et al. (2000) explains that it is primarily the role of the RNs to ensure that comfort and safety of the patient is ensured. Gebbie et al. (2000) at the same time recommends for knowledge, self-awareness, pain management, and awareness of the standard approach to pain care as a precautionary approach that should be adopted by the RNs. It is also important for the RNs to incorporate and refer to the existing standards of pain management and guidelines that are perceived to be evidence based (Goode, 2000).
Advocating for the patients welfare, Goode (2000) insists that the all the reasonable precautionary means should be taken by the RNs to ensure that the patients suffering and pain is alleviated. In addition, the nursing policies and procedures do not prevent the nurses from consulting and collaborating with the other experts that are specially trained in pain management such as the licensed nurses, pharmacists, physicians, acupuncturists, therapists together with other health care specialists. Through such consultations and collaboration, it will be possible to maintain effectiveness in the plan of interdisciplinary treatment that addresses the patient pain. Goode (2000) adds that in case of failure to address the needs of the patients, other means can be used such as referring to the organizational committee of practice, the committee in charge of ethics and the chain of commands for the organization.
Cousins, M. (2002). Evidence for persisting pain as a disease entity: clinical implications. Paper presented at Australian Pain Society Conference, Sydney.
Gebbie, K. et al. (2000) Nursing and Health Policy. Journal of Nursing Scholarship, Third Quarter. Pp 307-314.
Goode, J. (2000). “What Constitutes the Evidence in Evidence-Based Practice?” Applied Nursing Research. Vol. 13, No. 4, p. 222-225.