Looking Back
I want to reflect on a significant situation relating to my clinical placement. On my first consolidated clinical practicum day, I was assigned a patient who was admitted to the hospital for abdominal surgery for abscess drainage and wound debridement. Upon performing my head-to-toe assessment, I asked the patient if she had any pain, and she confirmed to me that she had lower abdominal pain that was sharp and severe, and she gave it a score of 7/10 on the numeric scale of pain rating. After completing my assessment, I informed the patient’s primary nurse about the pain, to which she replied that she had already given her pain medication.
Upon checking the patient’s electronic health record, I noticed that the patient was last given pain medication within the last six hours. I then asked the patient if she received any pain medication within the last hour, and she told me that the only medication that she received was Gravol for her nausea and vomiting. I then notified my clinical instructor of my observation. She checked the e-HR and confirmed to me that the pain medication was only given two hours after the patient reported the pain.
I was extremely frustrated and disappointed in this situation, as I felt that the patient had to unnecessarily suffer severe pain for a couple of hours instead of being medicated promptly. Because of that, the patient started having nausea and vomiting, which could’ve been prevented if the pain had been managed appropriately. Managing the pain is easier when the pain medication is given around the clock or as soon as the patient feels the pain.
This situation taught me that the patient’s complaint of pain must be taken seriously and that a thorough assessment should be performed immediately so that appropriate pain relief measures can be initiated promptly and efficiently, including administering pain medication. I also learned that honest and effective verbal and written communication between the staff is essential, as this could prevent adverse events and gaps in care delivery.
Examining Experience
An article by Angelini et al. (2020) examines the experiences and behaviors of registered nurses, physical therapists, and medical doctors about postoperative pain management. The study was about lumbar spine surgery, and the Swedish healthcare system was the setting. From the qualitative data collected, the researchers identified “connecting with the person,” “professionalism,” and “collaboration” as the conceptual pillars of competent postoperative pain management (Angelini et al., 2020, p. 1662). These inferences correlate with my idea that professionally applied empathy is the key to timely care.
Parkman et al. (2019) consider abdominal pain in the context of gastroparesis and describe both the symptomatology of this pain and the means of treatment. The authors describe symptoms very similar to my patient’s, such as queasiness and vomiting, with stomach pain being described as moderate-severe, which fits the patient’s pain score of 7 out of 10.
El-Hussuna et al.’s (2021) work concerns complications after abdominal surgical interventions. The article describes the pathophysiology of abscesses in detail and describes the most successful time for surgery. Their thoughts about abscesses as postoperative complications are similar to mine.
Appraising and Analysing
The patient’s experience was harrowing, resulting from medical inattention. The shortage of medicines, expressed in a solid, painful experience, made the client feel abandoned and neglected, which does not correspond to the principles of patient-centered therapy. The client thus experienced discomfort and disillusionment in the Canadian health institution, and their family should feel the same about them.
The implications of this error can also be viewed more broadly from the perspective of my colleagues in the profession. My coworkers would have thought the lack of medication by the patient indicated a lack of communication within the team. It also would seem to them that communication in the healthcare system is not established at the micro level.
Regarding nursing as a professional path and discipline, my case has shown that some Canadian nurses still lack pain management knowledge and general competence. It may be a sign of either a lack of resources or an outdated teaching method in medical education. From a societal viewpoint, my situation demonstrates that when society has faith in healthcare providers, the latter cannot fulfill that trust. The problem described undermined my confidence in my colleagues in the professional setting and made me question my competence in specific care areas.
Is the nursing community in Canada in a professional and communication crisis?
Research and Revision
Patient follow-up is essential on an ongoing basis, as my case and the article by Parkman et al. (2019) show. The paper by Angelini et al. (2020) and my situation demonstrate that professional behaviors that incorporate such ethical concepts as empathy and interconnectedness make the execution of pain management timelier. The work of El-Hussuna et al. (2021), combined with my case, gives specific examples of painful complications in patients who experienced abdominal surgery and abscess drainage. If I had read these articles before, I would immediately turn to a clinical instructor so as not to waste time and not make the patient suffer even more. I would also report my irresponsible colleague for negligence.
New Perspective
I plan to advocate for a more intense discussion in academic circles on the problem of negligence in nursing, the facilitation of the provision of necessary care, and patient diagnosis. I will also explore the pathophysiology of the disease in relation to the patient’s presumed condition. Potter & Perry’s Essentials of Nursing Foundation is a comprehensive resource for basic and advanced patient care practices (Sharma, 2021).
Concept Identification
If only the primary nurse had applied evidence-based decision-making, the patient might have been given timely medication, effective in emergent treatments. Communication is necessary since the lack of a dialogue between doctors leads to delays in taking essential medicines. Critical thinking is necessary for assessing the patient’s condition and care delivery; it allows one to define the trigger of the pain and correlate its occurrence with the medication schedule.
References
El-Hussuna, A., Karer, M. L. M., Uldall Nielsen, N. N., Mujukian, A., Fleshner, P. R., Iesalnieks, I., Horesh, N., Kopylov, U., Jacoby, H., Al-Qaisi, H. M., Colombo, F., Sampietro, G. M., Marino, M. V., Ellebæk, M., Steenholdt, C., Sørensen, N., Celentano, V., Ladwa, N., Warusavitarne, J., … Qvist, N. (2021). Postoperative complications and waiting time for surgical intervention after radiologically guided drainage of intra-abdominal abscess in patients with Crohn’s disease. BJS Open 5(5), 1-9. Web.
Angelini, E., Baranto, A., Brisby, H., & Wijk, H. (2020). Healthcare practitioners’ experiences of postoperative pain management in lumbar spine surgery care — a qualitative study. Journal of Clinical Nursing, 29(9-10), 1662-1672. Web.
Parkman, H. P., Wilson, L. A., Hasler, W. L., McCallum, R. W., Sarosiek, I., Koch, K. L., Abell, T. L., Schey, R., Kuo, B., & Pasricha, P. J. (2019). Abdominal pain in patients with gastroparesis: Associations with gastroparesis symptoms, etiology of gastroparesis, gastric emptying, somatization, and quality of life. Digestive Diseases and Sciences, 64, 2242-2255. Web.
Sharma, S. K. (2021). Potter & Perry’s essentials of nursing foundation. Elsevier.