L.E.A.R.N.

L.E.A.R.N. Note 1

Brooke Gagnon

NUR420

Maria Isorena

February 12, 2019

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L.E.A.R.N. Note 1

Look Back

On February 5, 2019 in clinical at The Scarborough Hospital CP3, I struggled to find ways

to help my patient feel relief from the pain she was experiencing while waiting for her administered

analgesics to kick in.

Elaborate and Describe

At or around 7:30am on February 5, 2019 I entered my patient’s room with the intentions

of collecting vital signs and performing a head-to-toe assessment. The first thing I noticed when I

walked in was that my patient was curled up in a ball in her bed with no covers on. When I walked

around the face her, I noticed that she was crying and visibly uncomfortable. I introduced myself

and turned the light on before asking her if she was having any pain. My patient replied that her

leg hurt. I asked her if she could tell me which part of her leg to which she replied that it was her

whole leg but the pain was mostly coming from her upper leg. We went through a PQRST pain

assessment. I asked her if she knew what might have provoked the pain, she replied that she did

not know. Next, I asked my patient if she could describe her pain and asked if it was aching,

burning, sharp, or dull. My patient told me that it was a sharp pain. I then asked my patient to rate

her pain on a scale of 0-10, with 0 being no pain and 10 being the worst pain possible. She rated

her pain as an 8. Finally, I asked my patient if she had ever felt this pain before and if she knew

anything specific that would relieve the pain. To this my patient explained that she had never felt

this pain before and she did not know what would alleviate it. I asked my patient if she wanted

pain meds, she said yes, so I left the room and informed the primary nurse of the pain. After this I

returned to the room to perform vital signs and inform my patient that the nurse would be in soon

to give the pain medications. The nurse, shortly after, administered the ordered scheduled dose of

Acetaminophen 1000mg PO. A few minutes later I was working on my care plan in the nurse’s
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station when another student informed me that my patient was crying and saying that she wants to

die. I returned to the room to find my patient crying. I wasn’t sure what to do. I reassured my

patient that the pain medication would kick in soon but this knowledge did not seem to help my

patient. I tried placing a heated blanket and provided a light massage on the site of the pain but my

patient told me that this did not help either. At this point my patient kept telling me that she felt

alone and that if she had have known the pain would be this bad, she would have “committed

suicide years ago”. I reassured her again that the pain meds would kick in soon but this did not

seem to help. I squatted by her bed and held her hand for a while. I then went and got a cool cloth

for her forehead and told her I would check in on her every 5 minutes. This seemed to provide her

with some comfort. Eventually the pain medication kicked in and my patient rated her pain as a 0

by the end of shift.

Analyze

Applying heat and providing a massage are non-pharmacological pain relief techniques

(Lewis, 2019). They did not work for my patient, but they may help another patient in a different

situation. Providing reassurance that the pain medication will kick in soon is therapeutic but did

not make a difference in this situation. In a different situation it may have helped. I felt as though

I did not have enough knowledge on non-pharmacological therapies for pain relief.

Revise Approach

After researching non-pharmacological therapies for pain relief, I can utilize them.

Application of cold to the site of the pain is one intervention that I should have tried. Cold competes

for nerve transmission, reduces sensation, and is believed to be more effective than heat to treat

acute pain related to surgeries (Lewis, 2019). Another intervention I should have implemented is

distraction. Distraction provides competition for attention between pain and some other activity

(Lewis, 2019). I could have implemented this by talking to my patient about her past. Similar to
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distraction I could engaged my patient in relaxation techniques such as deep breathing. One more

intervention that I could have tried is exercise. According to one study, nonaquatic exercise is the

non-pharmacological pain treatment that most clients use (Park, Lavin, & Couturier, 2014). I could

have helped my patient perform light exercise by having her bend and stretch, or raise and lower

her legs.

New Trial
Now that I am more familiar with non-pharmacological therapies for pain relief, I can

implement them if I am in a similar situation again. Instead of feeling helpless, I will try applying

cold, distraction, relaxation, and engaging my client in exercise. I will also try applying heat,

provide a massage, and offer reassurance.

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References

Lewis, S., Bucher, L., Heitkemper, M., Harding, M., Barry, M., Lok, J., Tyerman, J., &

Goldsworthy, S. (2019). Medical-surgical nursing in Canada: Assessment and management

of clinical problems (4th ed.). Toronto: Mosby Elsevier ISBN 9781771720489

Park, J., Lavin, R., & Couturier, B. (2014). Choice of nonpharmacological pain therapies by
ethnically diverse older adults. Pain Management, 4(6), 389-406.
doi:http://dx.doi.org.libaccess.senecacollege.ca/10.2217/pmt.14.43