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Post by Christina on Jun 28, 2015 15:33:59 GMT
Do we assess level of pain before and after wound care?
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Post by Admin on Jun 28, 2015 16:28:36 GMT
A good prudent nurse would always assess level of pain before and after to avoid emotional jeopardy (plus you also need to chart on how the patient tolerated wound management). But when you are stressed, like when you are being followed closely by the Clinical Examiner... logic evades you!
Is it required as critical elements of wound management? No... that that doesn't mean it's not a part of another (emotional jeopardy from inadequate pain control)!
There is relief however, you would have already taken care of the pain no matter what the situation is... within the first few minutes of the PCS whether or not you are assigned pain management or not. If you follow the HIPPI COW PTSD... then do a few quick things (See sample Grid and watch 20-Min 1-5 videos). What are you really shooting for??? Your aim is to get a cooperative patient who is comfortable enough to withstand a student nurse for an hour!! Even all it means is telling the assigned nurse to medicate the patient for pain.
This becomes especially important when you are assigned not only wound management but also abdominal assessment, respiratory management, mobility etc... anything that requires exertion on the part of the patient. You'll be testing on a med-surg floor. Most patients, even if they have established a pain management plan with their RN upon admission, they are rarely following it or demanding that the RN follow it. Only one patient I have seen so far with the best pain management plan... I went to see her my past manager/mentor after her major orthopedic surgery and I couldn't even tell that she had any surgery!! She had made her own pain management plan when she was admitted that included a strict regimen of her narcotic pain medication... even how she wants to be tapered off... pain med X Q3 hrs day 1 and 2, Pain med Y Q6 hrs day 1 & 2.. tapering down to Q4 hrs and so on.. That does not surprise me at all because She has been always on point and one of the best bosses I ever had.
But do we expect that from a patient who may not be as informed? So we have to be their advocate and provide them adequate pain control!!
With my workshop, what I'm trying to do is create a culture of performance!! I want to make sure that those who come in contact with me, not only get inspired to pass the CPNE and get their RN License in their hands, but to cherish that license for the rest of their nursing careers!
Tina
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