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.
