Pain Management: Barriers In The Emergency Department

1221 words - 5 pages

Pain is “an unpleasant sensory and emotional experience associated with the actual or potential tissue damage” (“Pain Management Nursing Role”). Pain is categorized into acute and chronic and its management is an integral part of all areas of health care. Pain management is alleviating and reducing pain to a level that is acceptable to the client. Pain is managed with analgesics, or pain killers. One specific When admitted the nurse needs to properly document the patient’s report of pain or oligoanalgesia, or the under treatment of pain could occur. Pseudoaddiction is when a client being undertreated for pain becomes demanding for more medication and seems like he is inappropriately seeking drugs.

Statistics
The major concern of clients that have made an Emergency Department visit is due to pain. In fact, according to Tanabe and Buschmann 70 percent of patients who go to the Emergency Departments are going due to pain. (Duignan & Dunn, 2008, p. 30). Olioganalgesia is a prevalent issue in emergency health care. In a study by Wilson and Pendleton in 1989 on 198 patients, 56% patients received no pain medicine while waiting in the emergency room; 69% had to wait more than one hour to receive pain medication, and 42 had to wait more than two hours. These patients that received analgesics, 32% received too little to meet their needs. Many factors seem to lead to this problem by it seems that the most widespread reason in the emergency department is the lack of time. There is much bias that contributes to inadequate treatment of pain. An evaluation of 321 clients showed 80% of the young clients received pain medicine received pain medicine while only 66% of the elderly patients received the same treatment. A study conducted by Pletcher and some colleagues demonstrated that 31% of white patients received an opiod pain mecication while only 23% of African Americans, 24% Hispanics, and 28% or Asians or other minorities received the same type of analgesic. It is clear that bias is present in the Emergency Department, and ultimately in pain management. (Motov & Khan, 2009).

Problems
Many issues lead to oligoanalgesia including: nurse’s and physician’s lack of time, failure to properly assess initial pain, failure to document pain accurately, lack of proper pain management knowledge and education, and bias.
ED Nurses Lack of Time
A large problem in the emergency department that leads to the under management of pain or lack to acknowledge pain is lack of time. According to Bryne and Heyman (1997), emergency nurses feel that if they give a lot of their time to one patient, they are taking away time they could be spending with other patients. (Duignan & Dunn, 2008). Nurses feel rushed and try to see and help as many patients as they can in as little time as possible. Rushing through a health history and assessment can lead to the nurse and physician being ill informed on the patients current health status, and ultimately their pain status.
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