Freedom from Pain

Before anything else, pain assessment comes first. It is a very crucial stage because pain management will depend on the result of the assessment. The health care provider should be knowledgeable and skilled enough to assess the patient properly because pain is subjective. It varies from one person to another but the intensity of pain is the main focus of its management.

Pain develops when there is a stressor from a specific stimulus and being processed by our sensory senses through nociceptors.  This process is called nociception. The first thing to happen is the transduction wherein prostaglandin and substance P are produced. Ibuprofen is the best medical management. Transmission follows. There might be a sharp or dull pain depending on where the substance P affects the spinal cord. This time, opioid analgesics are given which can be codeine or morphine. Perception of the pain comes next and distraction would be best to divert the attention from pain. Last is the modulation. There is a natural release of endogenous opioid and serotonin in the central nervous system to decrease pain sensation and promote sleep.

The most common pain management is the Three Step Ladder Approach by the World Health Organization. It is divided into two categories which are the pharmacological and non pharmacological. In non pharmacological, different strategies are being used to reduce pain such as imagery or imagination of good things, contra lateral or stimulating the opposite, acupuncture, progressive relaxation which is an alternate tensing and relaxing of the muscle and yoga. 

Under pharmacological category, we have herbal medicines and drugs which are being classified into three. These are the adjuvant therapy, non opioid and the opioid medications. These medications are given in combinations according to the severity of pain starting from no pain, mild pain, moderate pain, severe pain, very severe pain and the worst pain.  The adult pain scale is actually scored from 1 to 10. Scores 1 to 3 needs for further assessment, scores 4 to 7 for relaxation technique and scores 8 to 10 for medicating the patient. The main goal of this therapy or treatment is to ease the pain and alleviate suffering. For children, Wong Baker pain scale is commonly used. There are 6 facial pictures with different facial expressions according to the intensity of pain being felt by the child. 

In the hospital setting, lots of patients especially the post operative patient complains of pain sensation more often due to the skin breakdown during the operation that triggers the release of pain receptors. The nurse, who usually wears urbane scrubs as uniforms, must be attentive and alert in attending the patient’s need for pain reliever and other concerns. Therefore, the health care providers who sometimes wear urbane 9502 should also feel comfortable in handling in pain patients so that they are at their best in taking care of them.