The dance of pain

Learn the right movements within yourself to help patients deal with discomfort.

As nurses, we all must deal with pain, either in those we care for or within our own lives – or sometimes even both! Our relationship with pain, how we embrace or fear it, will inform our experience and interactions with it.

Whilst there are many different areas of nursing that you can work in, the one symptom common to many of them is pain. Whether it’s the pain of acute trauma or the chronic pain of cancer, pain management is a skill with which you should be comfortable.

The following tips will help you with this. They’re easy and basic, but without them you may find yourself lost in the dance of pain without knowing the steps.

KNOW YOUR PHARMACOLOGY

The first and perhaps easiest task in becoming proficient in pain management is understanding the basics of pharmaceutical agents you can use. This isn’t too difficult, as there are only a handful of medications to become familiar with and once you learn about their effects and efficacy, you’re set. There are a number of Australia-based sites that can help you find this information. Most of them are free.

IT’S ALL SUBJECTIVE

Vital to the management of pain is the recognition that it is a subjective experience. There is no way that you can know what a “7 out of 10” pain level in your patient feels like. I’ve encountered patients who were able to sit placidly, telling me that their pain was a 7. I’ve also had people unable to sit still, writhing in anguish, who say their pain is “getting really bad, up to 7”. The subjective experience of pain, based on each person’s experience and meaning of pain is what can make its management so difficult.

THE MEANING OF THE WORD

Illness means different things to different people. Some people see their pain and suffering as a form of punishment for something they’ve done, or for how they’ve lived their life. Others see it as an opportunity to learn how to live in spite of the pain. Some people want to be free from their pain to the point that they’re willing to be groggy and somnolent as long as they’re pain free; others are willing to live with their pain as long as they can interact with their world. Knowing and honouring these differences will help make you more skilful at treating the human being as a whole.

KNOW THYSELF

The ancient Greek aphorism “know thyself” is one of the most important skills to have in managing the pain of others. Unlike many aspects of illness that we treat, pain is a symptom that we all have experienced in our own lives. And our comfort, or discomfort, with this “fifth vital sign” will determine how effective we are when working to alleviate it in our patients.

If we have unresolved challenges with pain from our past, or aren’t comfortable with pain, then our ability to meet our patients where they are may be hampered. Our own distraction from the bedside, due to fear or uncertainty in the face of pain, may prevent us from recognising our patient’s predicament. Knowing yourself and your vulnerabilities to pain is key to bringing relief to others who are caught in the clutches of pain.

MEDIATE YOUR MIND’S PERCEPTION

The best way for us to serve our patients is to meet them with learned wisdom, that it – learn how to work your mind around pain before you try to help your patients with their mind.

Ongoing research into mind-body interventions has continued to show that a practice in meditation or contemplation can change how we perceive pain. In fact, in one study, meditation was shown to be more effective in relieving pain than morphine! Whether we practise meditation or some other method, there are ways to work our own mind around pain. When we learn how to deal with our ideas and perceptions of pain, then we can better help our patients to do the same.

SEAL YOUR CARE WITH COMPASSION

Your education is the most important tool you can bring to the bedside. Once you arrive there, shine the light of your compassion. Through the compassion of realising that who you see in the bedside is none other than another you – another human being who wants to be happy and free from suffering – you’ll be able to connect with your patient, no matter who they are and what circumstances brought them to the hospital.

Jerome Stone is an RN based in Colorado in the US. He is the author of the book, Minding the Bedside: Nursing from the heart of the awakened mind.

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