麻豆传媒

ANAHEIM, Calif. -- Nurses are on the front lines of pain management following patient surgeries. But one of the biggest barriers they face is the competing demand for their time, according to a new study presented here at this year's of the American Pain Society.

Led by Tami Chambers, MSN, and John Shepler, MD, of the University of Wisconsin School of Medicine and Public Health in Madison, they found that nearly all surgical nurses (98%) surveyed reported over half their time was spent taking care of patients with pain.

The analysis included a 33-item survey completed by 94 nurses from 9 general and intermediate surgical units. When asked which components describe optimal pain management -- including a pain score of <5 on the Visual Analog Scale, ability to complete activity of daily living, sleeping status, patient-reported tolerability, patient-reported satisfaction with pain control, or other -- the majority of nurses replied that optimal management consisted of three or more components.

Among these, the most commonly selected component was patients satisfaction with pain control (80%), followed by the patient reporting that the pain was tolerable (78%). The ability to complete activities of daily living, such as walking to the bathroom, was also commonly chosen as an important component to optimal pain management (73%).

"We're sometimes fixated on this number scale -- are they rating it as a severe number, are they rating it 10/10," Chambers told 麻豆传媒. "But we really need to go back to that patient and say: one, is this tolerable -- and some patients will say 'yes' -- but we need to dig a little deeper and say 'Are you satisfied?' 'Can you tolerate this for a long period of time?' And really just use those questions to stimulate a more in-depth conversation to figure out what is appropriate treatment for this patient."

In regards to future research, Chambers noted hopes to build another kind of study around this analysis, incorporating the patients' perspectives on pain. "I thought it would be fascinating to interview or gather some information from the nurses and see how they would classify pain as tolerable for a specific patient and then also have the patient complete a survey to say, 'is it tolerable,' how would they rate it, and really see if we see eye-to-eye because I don't think that we probably do," she said.

"I think clinicians often ask that question: is pain tolerable? And the patient probably thinks in their mind: 'well, yeah, it's tolerable for right now,'" Chambers continued. "But is it going to be for a couple of hours? So as a clinician, once a patient says 'yes,' it's sort of out of their mind, they're not going to treat that pain necessarily until they say 'no.' But on the flip side, I want to know is that really, truly tolerable for that patient, and I think that's where we would have a discrepancy between those two groups."

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