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Discussions on Cole, Lynch and Cugnoni’s Paper on Nursing


This paper was about a very interesting article published in the month of June 2006 by the Journal of Nursing Standards, an internationally recognized journal dealing with the latest development in nursing and medical science. Its authors are Cole, Lynch and Cugnoni. Elaine Cole is a lecturer on nursing at the City University and a practitioner at the Accident and Emergency (A&E)/Trauma and the London NHS Trust. Antonia Lynch is a consultant nurse working for the A & E. Helen Cugnoni is a consultant in emergency medicine working at Barts and the London NHS Trust.

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The main topic of the article is to become a sort of manual for nurses working on Accidents and Emergency around the country when they deal with adult patients who present themselves with acute abdominal pain. The article tends to describe how to assess their pain, manage it and offer possible solutions.

Summary of the article

The authors begin their paper study by assessing the importance of the problem. Being the three of them practitioners and with a clinical background, they assess the confusion and bad management that sometimes arises in emergency departments due to the lack of proper identification from the nurses of the type and origin of abdominal pain that the patients have. This is the focus of their article.

In order to avoid such confusion and mismanagement / mistreatment they propose a health assessment procedure that each nurse should follow to properly diagnose their adults patients. It should be stated that their focus population in this article are older adults, especially males. The authors clarify this focus by presenting the data that this population group has been the most presenting to emergency and accident divisions with abdominal pain.

Back to the health assessment procedure. The authors argue that “a structured approach to history taking and pain assessment, nurses should be able to differentiate abdominal pain caused by acute rather than non-acute conditions” (Cole et al, 2006). The basic reason underlying this assessment is that within a contemporary, intra-professional healthcare environment, it will help increase the chances of a fast and as effective as possible treatment. From this framework we can deduce the tools the authors propose the nurses should use. History taking is the first and most important one. Accurate history taking is crucial for this process. Since a nurse is most probably the first healthcare professional that such patients encounter, it is also the closest to the event that might have caused the pain. That is why accurate history taking is essential. The nurse should be careful to respect all aspects of a professional history taking process taking into consideration the privacy and other personal rights of a patient.

After that, the nurse should make a physical assessment of the pain. That is the second tool. This should not be done in hurry but all the procedure should be followed accurately. The third tool for a nurse is the psychological assessment of the patients. Since abdominal pains are quite complex and might have many causes, psychological factors should not be underestimated. Many times they are determinant to the condition of the patient (Cole et al, 2006).

Evaluation of the article

The article was of much interest as it deals with an important problem relating to the profession of nursing. It is also important because it deals with patients in emergency needs and a mistake in such conditions may affect the patients entire health recovery. What was done extremely well in this article was the broad explanation of the causes of abdominal pain. This makes the article a must for each nurse dealing with such patients. The anatomy and physiology of the disease is important to assess its origin and this was done very well from the authors. Another important contribution of this article is the account of various situations that nurses might encounter. Being practitioners who serve on emergency units, the authors have made a quite impressive description of the situations that a nurse can encounter and how to deal with them. The third thing done well was the framework and tools provided for the nurse to properly hand such situations with adults with acute abdominal pains. This is a very beneficial health assessment strategy which could easily be put into practice. This easiness comes from the fact that it was described in details.

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Nevertheless, there are certain critical points that should be made about this paper. First of all, the authors could have easily expanded the targeted population not only confined to older adults but to include other groups as well. Another critique is related to the psychological factors influencing the patients. Since most of them come after an accident of any type, they may still be in a state of shock or trauma. This makes it difficult to pull out an accurate health history from them at such moments. The authors should have provided some kind of tool for the nurses to dig through the trauma.


This was an article published in the journal of Nursing Standards on June 2006 by three prominent authors. Their aim was to demonstrate the state of affairs in Accident and Emergency divisions around the country relating to patients who present themselves with abdominal pain. They demonstrate in the article the important role of nurses when making the first assessment of their patients and the problem arising with such situation. In order to avoid confusion and have the best possible assessment of the health status of the patients, they propose a certain framework and tools that will help nurse properly diagnose these adults. It was an interesting article with a very good proposal which might have a positive impact in applied on the field and turned into a sort of manual for nurses in emergency departments. Especially the application of the tools that the authors propose will benefit the nurse during their daily work.


Cole, E. Lynch, A. and Cugnoni, H. (2006) “Assessment of the patient with acute abdominal pain”. Nursing Standard. Vol. 20, Issue 39, pg. 67-75.

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