Therpeutic Nursing Intervention

Nurs 403 – Transition to BSN Practice

Purpose of Assignment
The purpose of this assignment is to define a clinical problem, review the
literature for appropriate research supported nursing interventions, critique current practice and
provide a plan for changing or adapting clinical practice.
Student Approach to Assignment
I approached this assignment coming from the perspective of an
individual that has been working in emergency medicine for almost two
decades in various roles from an EMT, to a paramedic, and now as a nurse.
As such, I consider myself to have a decent amount of exposure to people
dealing with pain that was caused by too many different reasons to list. This
exposure afforded me the ability to identify how people deal with their pain,
what interventions tend to work, and which ones do not. This assignment
displays the importance I place on alleviating the pain and suffering of the
patients that I encounter. All too often medical providers tend to lose sight of
what I believe is our purpose in the profession and that is to provide care for
our patients. To do so, we must be an advocate for them and trust them at
face value when they provide information to us especially when it comes to
the level of pain that they experience. I learned through the completion of
this assignment that pain is often overlooked and undertreated.
Interventions are not implemented in a timely fashion, nor is reassessment
done regularly to determine if the intervention worked or a new approach
needs to be taken. This assignment was approached in the manner that it
was because, as mentioned, being an advocate for the patient is something
that I value and strive to be every shift with every patient. Being in the
emergency room where the complaint of pain tends to encompass most of
the visits, I feel it the way it is handled needs to be addressed and
modifications made for the betterment of the patients we serve.
Reason for Inclusion of this Assignment in the Portfolio
This assignment was included in the portfolio because it highlights my
ability to think critically about my current practices regarding pain
management and how the policies and procedures of my place of
employment influence them. It also displays my ability to conduct research
on methods to enhance pain relief for my patients that are not currently
being used at the facility. This research demonstrated the use of evidenced-
based practice (EBP) to strengthen or reinforce the implementation of new
interventions. This assignment again shows that one of my main goals each
shift I work is to be an advocate for my patient doing what I can to help them
achieve optimum well-being, for this assignment it was through pain
management.

• Critical Thinking
o Engages in creative problem solving.
This was demonstrated through the identification of new and
improved ways to deal with a common problem within the emergency
department which is how to effective handle pain management for the
patient. Thinking creatively enabled me to conduct research on EBP
articles that highlighted new ways that can treat a patient’s pain
without the use of narcotic medications.
• Nursing Practice
o Applies appropriate knowledge of major health problems to guide
nursing practice.
One of the main health problems that is routinely encountered
within the emergency department is the complaint of pain, be it chest
pain, labor pain, abdominal pain, or musculoskeletal pain.
Understanding the underlying causes of said pain can lead to the
implementation of better techniques to manage it such as the methods
mentioned in this assignment. For example, the use of a TENS device
in lieu of narcotic pain relief or bubbles when dealing with small
children.
o Performs therapeutic interventions that incorporate principles of
quality management and proper safety techniques.
The purpose of this assignment was to identify a clinical problem
and critique current practices being used at the facility I work that
address that problem. I then had to research to find therapeutic ways
to improve upon the quality of the care that is being delivered. The
targeted problem was pain management and the therapeutic ways
identified that could improve upon the way it is currently being
handled were through the use of a TENS device and by using bubbles
with the pediatric population.
o Demonstrates an awareness of complementary modalities and their
usefulness in promoting health.
 This assignment discusses the uses of TENS devices for pain
management in lieu of the traditional pain relief practices such as
narcotic medications or to serve as an adjunct to support other
pharmaceutical uses. It also discussed the use of bubbles with
pediatrics as a diversionary tactic when painful procedures are being
implemented. Both therapeutic interventions serve as complimentary
modalities that can improve pain relief which in turn improves the
health and well-being of the patients involved.
Teaching
o Evaluates the efficacy of health promotion and education modalities.
Health promotion was demonstrated through the discussion of
treatment modalities that are designed to alleviate pain felt by the
patients such as the use of the TENS device, nurse-initiated analgesia
protocols, and the use of bubbles with pediatric patients. The efficacy
of them was demonstrated through the education that was gained by
researching these therapeutic interventions and the case studies that
were involved with them. The education gained enabled me to see how
these interventions could benefit my current emergency department.
Research
o Differentiates between descriptive nursing literature and published
reports of nursing research.
Nursing research was utilized to identify new EBP that can be
implemented into my current nursing practice within the emergency
department. Utilizing research rather than descriptive literature
enabled me to find data that was based on facts that were supported
by evidence of success rather than conjecture. For example, the use of
the TENS device to alleviate pain has been proven to be successful and
has improved patient satisfaction, therefore, it would be beneficial in
my department.
o Applies research-based from nursing as the basis for culturally
sensitive care.
Nursing research was used to find new ways that could
therapeutically treat and maintain the relief of pain for the patients of
a busy emergency department. Being an emergency department, it
sees and treats people of all ages, races, and sex with a wide variety of
complaints. As a result, the interventions identified such as the use of
bubbles for pediatric pain relief, or the TENS device for adults were
 identified through research to be applicable to all patient populations
encountered regardless of race or culture.
o Evaluates research that focuses on the efficacy and effectiveness of
nursing interventions.
The research that was conducted for the project was intended to
find therapeutic interventions that have been proven to be effective
and that are not currently being used at my clinical site. The research
found several practices that have been proven to be effective in the
management of pain such as TENs devices, nurse-initiated analgesia
protocols, and bubbles as a diversionary tactic for pediatrics. These
interventions are not currently in practice; therefore, they can be
implemented for use to improve upon our current pain management
scores.
Professionalism
o Advocates for professional standards of practice using organizational
and political processes.
This was demonstrated through the analysis of current practices
being used at my facility to manage pain for the patients. Upon the
discovery of discrepancies of between policy and actual practice and
then identifying ways to improve upon them and then bringing that
information to the management team helped improve the standards of
practice within the department.