Reflective report: Patient’s perspective on diversional activity to reduce pain

It has been 12 weeks period of learning practicum in nursing. This is my first experience learning practicum in UMMC. I had been in renal ward, hemodialyis unit, CAPD unit and transplant unit.

In renal ward and HD unit, I got the chance to communicate with the patients. From there I like to share about patient’s perspective of diversional activity to reduce pain. Since HD patients are facing with pain, nurses are required to be sensitive in giving pain relief measure.

There was new patient started HD a few weeks ago. She had created AVF, and I met her on the next day of operation. I checked the incision site to see any sign of infection and the condition of fistula. During that time, she stated that it was very painful, and she could not sleep well last night because of pain. Then, she shared with me about her experience in operation room for AVF creation.

She said that nurses and doctors are talking to her too much, and they asked her so many questions. She had to reply to them, and she felt more pain. When she mentioned that, I realized nurses and doctors must have tried to divert her perception of pain by talking to her. I also used to talk to the patients when I did painful procedures like cannulation. I have learned that diverting patients mind is one of the nursing interventions to reduce pain.

With this understanding, I explained to the patient that nurses and doctors might have tried to change your attention so that you would have less pain. Patient did not agree my explanation. She said it did not work for her. When they talked to her, she had to reply to them and she felt more painful. If they were not talking to her, she would keep her mind somewhere else, away from operation room so that she would not feel any pain. She used to divert her mind in that way before.

Listening to her conversation, I came to realize the individual differences on perception of pain. I also realized that what we think true is sometimes not right for certain persons. We had believed that talking to the patient (chit chatting) will divert their mind and pain will be reduced. But it is not true for some patients.

We nurse need understand the individual differences. Moderate pain to one person may be severe for another person. The same idea that therapeutic talk may divert some patients’ perception of pain, where as it increases pain for certain patients.

The Editor of nephrology nursing journal (2012) stated that managing pain requires understanding pain experience of the patient. Therefore, assessment of pain should include description of pain and what relieves or increases pain.

Understanding patient’s experience and perception will help provide sensitive care according to the patient’s needs and preferences. I really appreciate this conversation with patient because I got to learn new thing about patient’s perspective. At the same time, I valued qualitative study on life experiences and learning some important phenomenon of the patients that nurses need to understand.