Palliative care is regarding the management of the pain in the patients, it involves assessment of the pain and development of a plan to make sure that the physical component of palliative care. Pain is subjective and everyone perceives their pain differently and it is necessary that the assessment of the pain should also be subjective. There are many assessment tools that can be used to assess Geoff’s pain. Firstly, the brief pain inventory (Short Form) which was initially used for the assessment of pain in Geoff’s case.
Secondly the PQRST pain assessment. This type of assessment can help Geoff describe and assess the amount of pain he is experiencing. With PQRST being an acronym, each letter refers to various questions related to the patient’s pain. P refers to provoking or palliation and is used to find the cause of the pain. Questions such as ‘What were you doing when the pain occurred?’ or ‘What makes the pain worse or better?” can be used to determine the cause of the pain. Q stands for quality, it’s used to describe the type of pain. Questions that can be asked are, ‘What does the pain feel like?’, ‘is it dull, burning or sharp?’ R stands for radiation or region in which the patient is experiencing the pain. For example ‘Where does the pain radiate?’ or ‘Did the pain start elsewhere and now localized to one spot?’ S refers to Severity, meaning how painful the pain is. Health professional may ask patient to rate their pain by asking them to rate pain from 0-10, with 0 being no pain and ten being the worst pain. It is also important to understand how the pain impacts the patient’s day to day activities as this can potentially help to determine patient’s treatment and care planning. The final letter T stands for timing. Timing focuses on questions such as ‘When did the pain start?’ or ‘How long does it last for’? ((“What is the PQRST Pain Assessment Method?, n.d)
Although pain is subjective, Abbey pain scale can also be used in this case. Geoff, has been trying to control his pain so he can go home, thus it is very likely that Geoff will not report his pain. The Abbey pain scale can help to provide an insight to Geoff’s pain. This pain assessment scale uses nonverbal observable cues then scores observations to determine what level of pain a person is experiencing. It focuses on facial expression, vocalization, flushing or pallor, changes in the patient’s body language, behavior, physical change and physiological change. (Department of Health, 2013)
- What strategies can your team implement to address the pain?
There are many pharmacological and non-pharmacological pain management options that can be used to relief Geoff’s pain. When using pharmaceutical drugs for severe pain management, (Morriss & Goucke, 2016, p. 22) suggest that using non-opioid in addition with opioids analgesics will lead to reduction in pain and adverse effects. In Geoff’s case, he is prescribed paracetamol in addition with Ordine and MS Contin. The team’s role will be to administer Geoff analgesics on regular basis with an RN, as per doctors’ order. Before administering analgesics, the team will need to check medication chart and check for when the last dose of analgesic was administered.
Another alternative for managing Geoff’s pain is the non-pharmacological treatments. “Both physical and psychological factors affect how we feel pain”. (Morriss&Goucke, 2016, p.22).
- Physical pain management, the team will ensure Geoff is positioned in a semi fowler’s position (45°) with pillow propped behind his right shoulder. He will be repositioned at least every 2 hours or when required.