Edith Cowan University, Research Online, Perth, Western Australia
Abstract
This study explored and described the experiences and perceptions of nurses managing acute pain in a Western Australian public hospital. The focus was nurses practising in the general ward setting and using current prescribing guidelines. The aim of this research was to explore nurses\u27 attitudes, beliefs and knowledge about pain and pain pharmacology and how this practice setting influences efficient pain management. Qualitative methodology was selected for its ability to explore complex issues in order to build nursing knowledge and guide nursing practice. This study used a descriptive, exploratory design based on a phenomenological approach. The sample comprised ten Registered Nurses who were working on general surgical wards in an acute care public hospital. Data were collected from tape recorded semi-structured interviews. Analysis encompassed transcription, coding and categorising of data that enabled concepts and themes to emerge. Nurses\u27 attitudes, beliefs and knowledge were examined. Nurses were found to accept the subjectivity of pain, to believe patients\u27 self reports of pain and to be generally supportive of numerical pain rating scales. Elderly patients and patients with a history of intravenous drug use were identified as groups that might be disadvantaged in regard to pain management in the general ward setting. Nurses\u27 roles as patient advocates and independent managers of pain at the bedside were highlighted and the lack of consistent pain management across nursing shills was identified as a problem that is potentially widespread. Continuing difficulties were acknowledged when analgesic medications were prescribed to be given as required, rather than on fixed time regimes. In recognition of this, nurses were supportive of the administration of regular analgesia. The hospital\u27s Acute Pain Service was perceived to be a valuable resource and non-pharmacological pain management strategies were recognised as an effective adjunct to analgesic medication and important to nurses\u27 independent practice. Effective pain management is a humane response to suffering, as well as being cost-effective for the health system in terms of reducing inpatient complications. This study provided an indication of current issues in acute pain management from the perspective of nurses in the ward setting. Implications for clinical practice and directions for future research are provided
