Investigating the Role of Nurses in Postoperative Pain Management Care

This report investigates the crucial role of nurses in postoperative pain management, highlighting the significance of their knowledge, skills, and attitudes in ensuring patient comfort and well-being. The study employs a mixed-methods approach, incorporating qualitative and quantitative data collected through surveys and questionnaires, to understand the various strategies nurses use to manage pain in surgical wards. It explores themes such as the perception of nurses in pain management, the challenges they face, and the strategies they implement to overcome these difficulties. The report emphasizes the importance of regular monitoring of pain intensity, proper administration of analgesic treatments, and the use of holistic approaches to minimize patient discomfort. Furthermore, it discusses the significance of pain assessment in determining the severity of pain and selecting appropriate analgesia dosages, while also considering potential complications such as over-sedation. The findings underscore the necessity of comprehensive care plans, effective communication with patients, and the integration of physical therapies to promote resilience and overall well-being in postoperative patients.

Role of nurses in pain
management of post-
operative patient

Table of Contents
ABSTRACT.....................................................................................................................................1
INTRODUCTION (250)..................................................................................................................2
BACKGROUND (750)....................................................................................................................2
METHODOLOGY (2000)...............................................................................................................4
PICO framework....................................................................................................................4
Keywords................................................................................................................................5
Database selected....................................................................................................................5
Search strategy........................................................................................................................6
Inclusion and exclusion criteria..............................................................................................7
Summary of the article...........................................................................................................8
FINDING (2500)...........................................................................................................................10
Theme one: Notion of nurse in pain management in post-operative patient........................10
Theme two: Challenge for nurse in pain management in post-operative patient.................12
Theme three: Nurse strategies to overcome the difficulties in pain management in post-
operative patient...................................................................................................................14
DISCUSSION (1500)....................................................................................................................16
STRENGTH AND LIMITATION................................................................................................19
CONLCUSION AND RECOMMENDATION.............................................................................20
REFERENCES..............................................................................................................................22

ABSTRACT
Pain management is defined as the aspect which is essential for the nursing among the
postoperative patient. The lack of knowledge and inappropriate attitude to the pain management
among the nurses always an issue which is analysed within the healthcare setting. There are
various of ways and strategies are used to manage the pain in the better way within the surgical
wards. Therefore, the nurses used to take the proper role and responsibilities that helpful to
control the pain and manage the uncontrolled condition among the patient who facing the issue
of pain after operative fraction. The research aims to create the understanding towards the role of
nurses to manage the pain among the post-operative patient. Moreover, the study is usually focus
on the mixed method which include qualitative and quantitative with the descriptive study
design. Data is well collect that is associated with the help of survey and questionnaire regarding
the postoperative patient for the pain management. The statistic and other graph are plotted in the
paper to generate the better understanding which is well related with the pain management within
the post-operative patient.
1

INTRODUCTION (250)
The nurses used to play role in the post-operative pain management. In addition to this, the
pain medication is well prescribed which is related with the anaesthetists and the surgeon but as
per this, the wards nurses who spend more time with the patient pain intensity, show the accurate
and proper administration of analgesic treatment which help to provide the proper treatment and
monitoring with the term of efficacy (Asiri, AlBishi, AlMadani, ElMetwally, and Househ, 2018).
In addition to this, the regular monitoring of patient pain intensity which is come with the pertest
of wards showing the aspect of nurses which is well important in order to assess the standard of
the care which is usually provided and show the early detection of the treatment side effect. In
this, the new aspect of analgesic technique is properly used that require epidural analgesia that
require extensive, systematic monitoring by the term of nursing (Kamer, and Çolak, 2020). There
are enhancing interest which is showing the proper establishment which is showing the aspect
which may provide the context that close the cooperation and the participation of the nurses
which may play role to manage the condition of post-operative pain which is analyse among the
older population. In conclusion, the post-operative patient requires proper support and care
which is must show the aspect where nurses use to make proper communication and interaction
with the patient and reduce the coordination which may show the impact on the general older
people (Thompson and et. al., 2019).
BACKGROUND (750)
The patient is usually face the experience that is moderate to the severe pain that follow after
the concept of surgery. In addition, the measurement is used to taken which is orderable to treat
the pain which is present in the form of inadequate where the large number of patient is usually
experience uncontrolled pain. The pain causes various complexities where the patient may
experience the quality of life, prolong hospital stay and it help to enhance the morbidity (Joshi,
and Kehlet, 2019). In addition to this, the negative effect of the pain on the quality of life are
usually emphasises where they used to show the importance which is well related with the relief
of pain. In this, the international health organisation and various of firm assume that the pain is
usually act as the symptom of the disease and they pointed out the essential role in order to
determine the symptoms of disease. The disease usually includes the Crohn disease, Gallbladder
disease. It is also show that the disease progression also impacts the condition of the patient with
2

the patient is taking the context of surgery and after that the situation is well arise. Therefore, the
postoperative care nurse is usually taking the proper responsibilities which help to make the
assess towards the patient pain, teach the patient strategies in order to make the deal with the
pain and apply the analgesic treatment which is related with the monitoring where they can show
the result of the treatment where they usually educate the patient and the family pain
management. In addition, nurses used to document the rating of pain in the term of pain rate
scale. The nurses show their knowledge and skill with the approach which is holistic in nature
which is reliable in order to manage the pain and minimise the risk of patient towards the higher
level of pain which is related with the patient discomfort (Ishimaru and et. al., 2018)
In addition, the nurse uses holistic approach of pain management to minimise and reduce the
condition which is associated with the patient to reduce their discomfort that is causes by the
postoperative period after the surgery. In this report, the management of the postoperative pain is
effective which is related with the pain level which is must be measured appropriately.
Therefore, the main goals of the pain assessment which help to determine severity of pain which
help to choose the dosage of the analgesia that is effective for the patient to reduce their
discomfort which is faced the medication which may led to other complication by causing the
over sedation (Cohen and et. al., 2019).
Pain assessment that start with the time with the admission and should be include the
assessment and they should include and assessment of the patient that show the activities of the
daily lives. It is well associated patient question which is well answer that is showing the factor
which help to control the strategies. In this, the patient questions should well answer in order to
assess the cause of the pain (Bąkowski, Bąkowska-Żywicka, and Piontek, 2020). In the post-
operative period, it is well important in order to assess the surgical trauma or the medical
complication such as acute myocardial infection. The patient usually shows the response which
is well related with the pain in the specific term which is well related with the person, pain
should have evaluated individual (Kamer, and Çolak, 2020).
Assess pain in the both at the position of the rest and movement in evaluate the patient
functional status. Take into the consideration patient self-report of the pain and implement the
proper pain scale, document the intensity, quality, location, timing and duration and prior pain
treatment and their effectiveness. In addition, the surgical post anaesthesia care unit or the other
circumstance where the pain is usually show the aspect which is intense and re-evaluate
3

frequently that show the specific for every 15 min initially, then every 1-2 h as the pain intensity
decrease or decline (Yang and et. al., 2019). Overall, pain management is well show that they
used to reduce issue of pain with the proper care plan that is well helpful to show the impact
which is free from pain and also show the report analysis which may help to outline the condition
that is based on rotational factor. The pain therapies which may physical such as use of proper
massage therapies and so on which is well productive in order to develop resilience and
wellbeing among the patient comfort.
METHODOLOGY (2000)
Methodology is defined as the aspect which is outline in order to determine the specific tool
and technique, research resign, framework, and analysis which is taken in order to collect the
data. The data and information is well collected and they are important in order to produce the
context which is related with the topic that is role of nurses in pain management of post-
operative patient. In this, the research methodology is usually focus in order to provide the
various aspect which is well show the factor which is contributed for the methodology (Birnie
and et. al., 2019).
PICO framework
The PICO framework is defined as the clinical tool which is applied in order to make
question which is reliable for the elucidation of data and their information. Therefore, the study
also focusses in order to provide the in-depth analysis. The PICO usually include population,
intervention, comparison and outcome (Jungquist and et. al., 2020).
Population The older people are usually facing the issue of
post-operative patient due to the pain. Nurses
provide pain management therapies.
Intervention The pain management therapies are responsible
for the reduction in pain among the post-
operative patient.
Comparison The medication is used when the excess of pain
is feature within the post-operative patient.
Outcome The pain management therapies and their
alternative to control the unit of pain in post-
4

operative patient which may drive the comfort
among the people.
Thus, the above design PICO framework is suitable for the topic which is analysed with the
research process. In this, the study also shows the compatible analysis with the help of question
which is related with the PIO question which is mentioned as the:
In older people, what is the role of nurses in pain management of post-operative patient in the
UK (Rostin and et. al., 2019).
Therefore, the study helps to evaluate the vital role which is well performed by the nurses
for the controlling of issue which is well related with the pain in post-operative patient.
Keywords
Role of nurse in pain management, effect of pain therapies in post-operative patient, impact
of medication in reducing pain in post-operative patient, pain management, post-operative
patient, nurse and pain management, and so on.
Database selected
The database is defined as the source which is reliable for the providing the data and
information. In this, the primary and secondary studies are used to held for the collection of data
where the databased optimise the both studies from which the appropriate study is reviewed and
data is manipulated without copying. The database is referring as the source which have millions
of article, book and journals which is useful for the researcher in order to elucidate the data and
information. The major of database which is used within the research process for the collection
and selection of data are PubMed Central, EMBASE, CINAHL, Cochrane library and UpToDate
(Eastwood and et. al., 2019).
PubMed: The PubMed is defined as the number one of the source to the turn that is reliable
for the data collection. It is generally hosted by the National Institute of Health that is NIH and
used to provide the various of bibliographic information which is majorly include the abstract
and link that is showing the context of full text publisher website which is more than the 28
million of articles. Therefore, the derivation is also used to take which configure that the export
format is usually XML and NBIB.
EMBASE: The EMBASE is defined as the Excerpta Medica Database which is refer as the
proprietary research database which may also include in its corpus PubMed. In addition, it is
5

eligibly accessed by the other database provider which is also known as the Ovid. The coverage
is also analysed which may show the number that is about 38 million of article with the abstract
and related article with the reference which is well suitable for the topic in term of collecting and
selecting of data. In addition, the full text is also provided by the EMBASE as per the
requirement of institutional subscription to the EMBASE and individual publisher. The available
export format is RIS which is present in the context to the EMBASE (Zwakhalen and et. al.,
2018).
Cochrane library: The Cochrane library is also referring as the database which is used
within the medical research for the collect and gathering of data and information that is
associated with the topic. In this research process, the Cochrane library is deriving as the source
of database for the collection and selection of data and information. whereas, the Cochrane
library is well known for the review which is related with the systematic reviews. In addition,
there are 53 group which is around the world that help to ensure the published review of the high
quality and evidence group. The article is generally focus on the context which may show may
be updated as per time to time for the new research. The coverage is initially bounded with the
several of thousand high quality review, where the inclusion of the abstract and related article is
underlying. Therefore, the assigned export format which is showing their relevance in the
Cochrane library is RIS and BibTex (Schreier and et. al., 2019).
UpToDate: Within the research process, these database is used and at last the UpToDate
provide the review which is showing the clinical topics. Therefore, the review is well constantly
updated in order to provide the coverage is several thousand article which is showing the abstract
with the term of reference. There is no unavailability of the export formats.
Search strategy
Search strategy is useful within the research process in the term of website which is
reliable for data collection and help to optimise the collect of data with is related with the topic
which is role of nurse in pain management on post-operative patient. The data is essential for the
research and proper reliability and relevance with the research topic. The proper search strategy
which is used within the research process are PubMed, Springer Link, Medline Plus and so on
which is well suitable in order to extract the data which is related with the topic. The above
discussion is usually carried out with the help of review that is a part of data which is optimise by
the search strategy (Ashkenazy, and Ganz, 2019).
6

Inclusion and exclusion criteria
Inclusion criteria is defined as the aspect which is help to analyse the research process
where the inclusion criteria select the design, procedure and the process which may undertake
within the research process. Whereas, the exclusion is also referring as the aspect which may
outline the aspect which is disqualify within the process of research. Within the research process,
it is well analysed that the inclusion and exclusion criteria may help to determine the research
which is conducted within the protocol or not. With the topic, the inclusion and exclusion criteria
are used to made which may show the aspect that is related with the role of nurse in pain
management of post-operative patient (Swisher and et. al., 2020).
Inclusion criteria Exclusion criteria
 English language is mandatory which is
undertaken within the study.
 The post-operative patient is used to
undertaken within the research study.
 The patient with complication with the
pain management.
 The study is also focus on the older
people who is individually focus on the
research process which is based on the
topic.
 The primary review articles in
undertaken within the study.
 Rather than English language is not
required within the research process.
 The patient apart from the pre-operative
and other in excluded from the study.
 Cohort study and other systematic study
is not undertaken within the study.
7

Summary of the article
Title Source Summary
Nurses'
Knowledge
and Attitude
towards
Postoperative
Pain
Management
in Ghana,
2020
https://
www.ncbi.nlm.nih.g
ov/pmc/articles/
PMC7429762/
Pain is defined as the unpleasant emotional or the sensory
experience which may well associated with the actual and
potential damage which is well related with the tissue. In
addition, the study is well related with the determination of
work which help to identify the nurse knowledge and the
attitude which is effective for the postoperative pain. In
addition, the study is well focus on the support which is
provided by the concern of inadequate knowledge and the
negative attitude among the nurses which is providing proper
care and support to the people with the post-operative pain or
complication. In addition, the nurse’s knowledge and skills is
well helpful in order to control and manage the situation of
pain (Hamid, 2021).
Knowledge,
attitudes and
practices of
health
professionals
towards
postoperative
pain
management
at a referral
hospital in
Ethiopia,
2022
https://
www.sciencedirect.c
om/science/article/
pii/
S2049080121011171
In this article, the primary approach is used to taken where the
initially the discussion is used to made that is related with the
post-operative pain and their complication which is faced by
the number of people in the healthcare setting. The
postoperative is defined as the form of the acute pain
following the surgery. It is also show the result which is well
related with the procedure which is related with the skin
incision, tissue dissection, manipulation and the traction. It is
also defined as the immediate post-operative complication.
overall, the study helps to provide the approach which is non
physician anaesthetist which have good knowledge attitude
and practice towards the post-operative pain and their
management. The healthcare professional attitude and the
practice is poor.
Assessing
Knowledge
https://
www.dovepress.com
Nurses play vital role in the context of pain management. In
addition, they are about the nurse’s knowledge and attitude
8

and Attitudes
Regarding
Pain
Management
Among
Nurses
Working in a
Geriatric
Hospital in
Vietnam,
2020
/assessing-
knowledge-and-
attitudes-regarding-
pain-management-
among-nurs-peer-
reviewed-fulltext-
article-JMDH
pain which is more important that is well related with the
multidisciplinary pain service. In addition, the study has aim
which may assess the knowledge and attitude of the pain
management among the nurses which may taking their
responsibilities to manage the condition with the factor. The
nurses always provide effective care and support to the post-
operative patient for their pain which act as complication
which entail the comfort and rest. Therefore, nurses provide
adequate and proper medication and pain therapies which is
appropriate to manage the condition of pain and develop a
scenario which is conductive and may support the patient with
post-operative factor (Graves and et. al., 2019).
Knowledge
and attitudes
of nurses
toward pain
management,
2018
https://
www.ncbi.nlm.nih.g
ov/pmc/articles/
PMC5875209/
In this article, the major of discussion is initiated with the
concept of pain control which entail the pain control which is
vitally essential for the important goals because they are
untreated pain which has detrimental effect on the patient with
the vision of hopelessness. In this, the responses are counted
and negativity which may lead to affect the quality of the life.
In addition, the post-operative patient has the common
problem which is determine as the pain in which they are
require proper support which is fulfilled by the nurses with
their knowledge and skills. As per the evaluation, the study
relevels that the nurse’s knowledge and attitude toward the
pain management is well analysed which may support the
condition and develop scenario which is effective for the
patient comfort.
Factors
Related to
Nurses’
Knowledge
and Attitudes
https://
www.sciencedirect.c
om/science/article/
pii/
S152490422030148
The pain management is directly proportional to the nurse’s
knowledge and their attitude which is associated with the
pain. The studies are limited but the major of research have
usually focus in the nurse behaviour that they take to control
and manage the situation of the pain. Therefore, the nurses in
9

Toward Pain
in Hospitals
in Low-
Income
Areas, 2021
X the country hospital of the low income areas which has shown
the deficiency with the various aspect of the pain management
knowledge. It is better to educate nurse with the higher
professional aspect or position.
A survey on
the
knowledge
and attitude
on pain
management
among
nurses
employed in
the
government
hospitals,
2020
https://
www.saudijhealthsci
.org/article.asp?
issn=2278-
0521;year=2020;vol
ume=9;issue=2;spag
e=97;epage=101;aul
ast=Panlican
The article is well focus on the common outcome which is
based on knowledge and attitude of nurses towards the pain.
There is dearth explore minute detail which is like
demographics which may help to serve as the key address the
issue. The article has the simple aim which is usually show
the aspect identify the knowledge and attitude of the staff
nurse and whether the difference exist when their
demographic profile is well considered (Johnson and et. al.,
2019).
FINDING (2500)
Theme one: Notion of nurse in pain management in post-operative patient.
In the post-operative period, patients regularly feel moderate to severe pain. However, in
nursing care, the pain management is an essential part of it. This research suggests that, in the
postoperative pain nursing management remains inadequate. The nurses of postoperative care are
responsible to evaluate the pain of patient, to deal with the pain teach strategies to the patient,
regulate the analgesic treatment strategies, analyse the results of surgical and analgesic treatment
strategies, educate the family of patient and patient on the pain management and also document
the outcomes or results of the pain management. The holistic approach of nurses to pain
management is maximizing the comfort by reduce pain in the period of postoperative after
surgery. There are different role of nurses in control of post-operative pain as like: Before the
10

any scheduled painful procedures as like physical therapy, dressing change and so on, administer
the analgesic drug in timely manner to the patient. Evaluate the results of pain treatments.
Manage a suitable or appropriate environment for the patient (Gonzales, and et. al., 2021).
Remove that sources which make discomfort for the patient as like infiltration of IV, full bladder
and medical wastages and so on. To enhance blood circulation and eliminate the pressure sore
regularly reposition the patient. Encourage the patient for maximum possible movement on the
bed because low movement can cause muscle spasm and decrease blood circulation. Among the
post-operative patient pain management is a very significant side of nursing care. Bad attitude
and deficiency in the knowledge among the nurses towards the management of pain is very big
problem in some country. For providing the better pain management, nurses in the surgical wards
should be well qualified in terms of knowledge of assessment of pain and management of pain.
Nurses who are involved in pain management of post-operative patient must identified the
requirement for adequate pain management and the use of other techniques involved in like as
patient controlled analgesia. In the postoperative pain management, nurse have responsibility to
mange the pain effectively for which there is the requirement for them to have a high skills and
appropriate knowledge about the pain management. During the deal with patient pain is the most
common problems which is faced by the nurses in surgical unit. On the basis of appropriate
knowledge and good skills or practice of pain management nurses can faced minimise the
complication and severity of postoperative pain. As the research shown maximum nurses lack
the appropriate knowledge and have negative attitude regarding the post-operative management
of pain. Also finding that due to lack of funding, less number of workshops are organized for
nurses which is insufficient for nurses to achieve appropriate knowledge and skills for post-
operative pain management. Negative attitude of nurses towards learning the new information
was generating a gap between their skills and post-operative pain management practices. New
information learned at the work shop was not applied appropriately in the pain management
clinical practices. Nurses which are working in the postoperative care gives an intensive care to
patient as they are taken anaesthesia during the surgical process. Because the nurses who are are
working in the surgical department can provide the special care for those patient. Nurses who are
working in the surgical care have equipped with the appropriate skill and be able to recognise the
complication and provide the intervene as soon as possible. The postoperative nurses are able to
recognise the condition of patient that when he is ready to move from the post- anaesthesia care
11

unit. She is also able to recognise the severity of pain of patient after the surgery. Those nurses,
who is evaluating the side effects of drugs after the surgery, should always ready to find and
provide an appropriate treatment according to the scope of available nursing practices. As for
example if any patient showing the symptoms of respiratory depression after the surgery and
post-operative pain management then the post-operative nurses should ready to stop the
medication as opioid and gives and injection through the IV route also provide the patient some
oxygen support and meanwhile informed the Doctor. All of these procedure is also carefully
evaluated and documented by the post-operative nurses (Gray, and et. al., 2018).
Theme two: Challenge for nurse in pain management in post-operative patient.
In order to effectively management of postoperative pain, it must be essential to measure
the level of pain accurately. The main objective of the assessment of pain is to measure the
severity of pain so that, it assists in the calculation of dosage of analgesic drugs, which is
accurate to that specific level of pain. But during the assessment of postoperative pain, there are
several challenges for nurse like as: to evaluate the functional status of patient evaluate or assess
the pain of patient in both movement and rest stage, take into attention self-report of pain of the
patient and apply the appropriate pain scale, document the location, quality, intense, alleviating
and aggravating factors, duration and timing, and prior treatments for pain and effectiveness of
that treatment (Zontag, and et. al., 2022). Before and after all treatment intervention, the effect of
a provided treatment is analysed by monitoring pain. In the surgical care unit of post anaesthesia
or other conditions in which pain is very severe assess treat and reassess the pain frequently like
initially in every 15 minute and then after in every 1-2 hour as intensity of the pain decreases.
Assess, treat and reassess frequently as 4-8 hours both the response of patient to treatment and
the patient's pain in post-operative pain management. Need to provide the highest score of pain
above which analgesic drugs is offered as for example at rest ratings score is 3 and in moving
score is 4, on a 10- point scale. Some patient's required special attention for their pain
management because some of those patients are unable to communicate properly due to
insufficient knowledge, cognitively impaired, or they are from the different cultural or
educational background. It required to evaluate immediately when there is unexpected severe
pain and in those cases in which patient is associated with altered vital signs like tachycardia or
high heart rate, low blood pressure or hypotension, fever, hypertension or so on. Carefully
documentation of pain assessment. All new diagnosis should be considered such as wound
12

dehiscence, deep vein thrombosis or other infection. Report the result to the team of pain
management (Karlsen, and et. al., 2022).
Pain may lead to number of adverse medical complications and giving pain relief is central
to provide caring. Effective pain management is significant in clinical care because in number of
cases it was seen that pain after surgical is too much severe for patient which is essential to
treats. More than eighty percent of patients who undergo surgical process feel acute
postoperative pain and approximately seventy-five percent of those patient with post-operative
pain found the severity as severe, extreme and moderate. But there are only less than half of the
patients who undergo surgery report appropriate post-operative pain relief (Tsai, Jeong, and
Hunter, 2018). Improper controlled pain shows negatively effects on function, quality of life, and
functional recovery. Nurses faces the problems like risk of persistence post-operative pain and
post-surgical complications. During postoperative pain management nurses faces number of
problems like communication gap with patient, appropriate knowledge gap, lack of appropriate
sources to manage pain, lack of knowledge towards using the pain scale. During providing the
treatment to manage postoperative pain nurse and patient faces communication related issues.
Such as in case of geriatric patient they cannot express their feeling of pain after the surgery in
appropriate manner due to the lack accurate senses. Some patient feels fear to take medicines and
injection so try to hide their pain and they do not express it appropriately, therefore in this case
nurse have face a huge problem to provide the appropriate treatment and analgesic drugs. In the
case of some child patient they cannot communicate with nurses because they do not know how
to express their symptom therefore in this case nurses have to face lots of problems. Children are
also hide their post-operative pain due to the medicine and injection. So nurses face lots of
difficulties to handle the post-operative pain in these patient. In several healthcare there are
shortage of medication which is essential to provide for the post-operative pain management. In
this case nurses had to manage post-operative pain with some other drug which not much
effective as those analgesic drugs. Some of the nurses do not know how to use the pain
assessment scale. In these case they are facing a huge problem to measure the severity of
postoperative pain after the surgery of patient. The first steps to manage postoperative pain is its
evaluation and diagnosis that is appropriate post-operative pain assessment tools and techniques
are necessary for effective postoperative pain management. This types of tools and techniques
contribute to make appropriate decision at the time management of post-operative pain and
13

enhance post-operative pain diagnosis and evaluation. For this an effective post-operative pain
assessment scale should be the essential part of the recording procedures system. But in some of
the cases it seen that nurses have knowledge gap to operate these type of system which is a very
big challenge to nurses during post-operative pain managing process (Staggers, and et. al., 2018).
Theme three: Nurse strategies to overcome the difficulties in pain management in post-operative
patient.
During the postoperative management of pain, nurses faces numbers of problems
therefore, to overcome that difficulties nurses have to make some strategies which are following:
monitoring of complication after the surgery, documentation of data of post-operative pain
management treatment, patient and family education towards the pain management, evaluation of
the pain management, treatment of pain and many more things like this. In this research,
according to the treatment of the pain it finds that the nurses who provide the care for patients
have an ethical responsibility toward the treatment of postoperative pain through the approaches
like non pharmacological or pharmacological. Important points which are considered by the
nurses during the postoperative pain management are following: administration of analgesic
drugs according to the clock basis not as required. The dosages are individualized. Use opioid as
a drug in the postoperative pain management because it cannot be addicted in short term use.
Calculate the dose of drugs after evaluating the level of sedation, tolerance, severity, respiratory
status and the condition which is prior existed. Utilization of most appropriate route for drug
administration. Familiarize and describe the method of patient controlled analgesia. Educate the
patient and their families about the appropriate route and method of use of patient control
analgesia because the route of administration of patient control analgesia are different such as
oral, subcutaneous, sublingual, intramuscular, nasal epidural and intravenous. Try to avoid the
placebo drugs because using of placebo drugs can break the trust and relationship of patient and
a post-operative care provider nurse (Kehlet, 2018). To overcome the complications in post-
operative pain management the second strategies which is applied by the nurses is monitoring of
complications. In this approaches postoperative nurses provides the service to monitoring those
complications which are occur after the surgery. According to this, it finds that postoperative
nurse takes proper observation of the side effects of patients like over sedation, respiratory
depression constipation and so on. Some of the opioids which are taken for the anaesthesia can
cause muscle rigidity,spasm and seizures, therefore, through the close observation of patient,
14

post-operative nurses can manage these complications. Some the patient is suffering from the
chronic obstructive pulmonary diseases (COPD) or asthma may have to face some of the
respiratory problems or another breathing related issues due to opioids so, need to monitor
carefully (Luque Oliveros, and et. al., 2022).
Number of studies reflect that the emotional wellbeing of person can be affected by the
experiences of postoperative pain. Therefore, for managing the postoperative pain it is necessary
to understand the reason and then after find the effective ways to deal with the postoperative pain
(Ballard, and et. al., 2019). Make some of the effective strategies to overcome the postoperative
pain which can enhance the quality of life. There are number of key pain management strategies
which can overcome the difficulties for nurses at the time of postoperative pain management. In
which some of the key postoperative pain management strategies are following: (1) Pain
medicines: to provide the appropriate postoperative pain management nurses have to get the all
pharmacokinetic and pharmacodynamics features of those analgesic drugs which are used in
post-operative pain management (Dassieu, and et. al., 2019). By the appropriate knowledge of
pharmacodynamics and kinetic of drugs nurses can overcome the side effects associated with
drugs. They can also reduce the adverse effect of drugs due to drug – drug interaction or drug –
food interaction. By these strategies number of difficulties can be solved which occur during the
treatment of postoperative pain management such as reduce lots of complication, enhance
emotion wellbeing, decrease pain, and so on. (2) use some physical therapies like as cold or heat
packs, hydrotherapy, and massage and so on. These strategises can be utilise on those patient
who are not expressing their postoperative pain due to the fear of medicine and injections. By
using these therapies nurses can reduce their difficulties at the time of providing postoperative
pain management to those patients (Heath, Sommerfield, and von Ungern‐Sternberg, 2020). By
using these physical therapies, the problem associated with the medication in the management of
postoperative pain assessment faced by nurses can also be resolve. In these therapies there are no
need to use any analgesic medication for postoperative pain management therefore problem
associated with side effects, adverse effect and post-surgical complication due to these
medication of postoperative pain management can be reduced. Some of the other strategies like
mind and body techniques known as acupuncture can be used in the treatment of postoperative
pain management. It resolves number of difficulties for nurses in providing postoperative pain
assessment like no need to take any analgesic medication. So, complication associated with this
15

medication can be reduced. In some of the cases nurses can use massage which is better suited
for the soft tissue surgical injury. Some of the relaxation and stress release post-operative pain
management techniques can also be used to decrease the difficulties for nurses faced during the
assessment of post-operative pain management (Rainer, Schneider, and Lorenz, 2018). some of
the educational session on the pain management scale should be organised by the healthcare to
reduce the difficulties faces by the nurses at the time of post-operative pain management
assessment.
DISCUSSION (1500)
In this research report, the major discussion was based on the roles of nurse in post-operative
patients. The post-operative periods start with transferring the patient to the post anaesthesia care
unit whereas ends with ensuring the patient safety and healing. Nurses play a crucial role in post-
operative pain management as in some cases patients suffer with severe pain. Nurses
contributing in post-operative pain management improves the patient experience. The
management of pain requires skilled nurses who have knowledge how to manage the pain in
uncontrolled condition among the patients. In postoperative care, nursing approaches required
includes monitoring the rate and patency of IV fluids, assessing the patient's level of sensation,
pain control and patient's level of circulation. Postoperative patient care is very important in
order to regain the patient strength so they can go back to their regular life. It is very difficult for
a patient to manage the pain being at home. That is why the post-operative patient care is
compulsory otherwise it is not possible to access the care management in a hygienic
environment. Management of post-operative patient care is done by evaluating patients by the
analysing the symptoms. The main goal of post-operative management is to maintain the
adequate body system functions and to restore the body homeostasis. The certain complication
raised after the operation managed by the post-operative patient care. In post-operative care
nurses control pain and watch for infection (Dagal and et. al., 2019).
The patient waking in the ward need to keep under supervision in order to analyse
physiological state. Post-operative nursing facility is only provided when an operation theatre is
having recovery room. Post-operative care is conducted to minimize the possibility of infection
at the site of surgical wound. A patient receives post-operative care just after the ongoing
surgical operation. In case of spine surgery, hip surgery, cardio surgery and thoracic surgery it is
compulsory to provide post-operative nursing care in order to achieve patient safety. Nurses
16

mange the post-operative pain need to measure the level of the pain. Patient having severe pain
need to treated with high dose of analgesic. So the dosages only depend upon the severity of the
pain. Nurses maintain patients' airway by maintaining pulmonary ventilation. It prevents
hypercapnia and hypoxia. It is required to assess respiratory rate and oxygen saturation.
Postoperative complications raised includes embolism, deep vein thrombosis, wound infection,
atelectasis and severe fever. Nurses take care of the prescribed medications and keep patient
follow up appointments. Nurses prioritize maintaining circulation and cardiac complications in
post-operative care. Patients are assessed deeply for any infection at the site of surgical wound.
Assessment of pain is required for the evaluation of infection and pain and thus dosages can be
calculated on the basis of severity. Experienced nurses are appointed to conduct the post-
operative care in order to minimize errors. Post-operative patient care improves patient
satisfaction as well as ensures patient safety. The nurses visit to patient to observe the patient
condition and on the basis of observed condition medication are provided. Post-operative patient
care enables nurses to analyse and evaluate the care provided. Functional and structural changes
can be made according to the feedback from the patients. Post-operative patient care promotes
adequate discharge planning and health teaching. The nurse should implement specific concern
to the patient surgical site. Every movement of the patient should deeply have observed by the
nurse to eliminate further strain on suture (Farley and et. al., 2019).
Nurses observe the patient' s skin colour if any redness is marked need to be treated. To
determine the neurological status of the patient it is important assess neurological status and level
of consciousness. Cardiovascular assessment is done by evaluating the patient's symptoms. Nurse
examines the operative site regularly to detect the infection. The findings revealed that nature of
pain is unique to every individual patient. The patient feels severe pain when he wakes up from
anaesthesia. The acute pain is observed in case of tissue damage and cannot be tolerated. In post-
operative patient care pain assessment is a crucial nursing activity. Communication between
patient and nurse is very important for the pain assessment. The observation is done by the
various processes such as self-report from the patient, physiological response and intensity of the
pain. Mostly nurses ask patient if they felt pain to evaluate the intensity of the pain. A well
proved paradigm should be followed by the nurses which minimizes the difference between
clinical practices and research. Sometimes nurses to observe facial expression of the patient
because it is one of the biggest sign that the patient is suffering from severe pain. Self-report
17

made by the patient is the most acceptable and standard tool for the measurement and
identification of the pain. The aim of conducting post-operative patient care is to eliminate
discomfort and facilitate recovery. In most of cases pain was managed by the administration of
prescribed drug after the surgery. Pharmacological interventions used for pain relief includes
administration of prescribed medications and non-pharmacological pain relieving estimate like
diversion-al therapy, relaxation and music therapy. Post-operative pain is a predictable and
physiological response experienced after the surgery but can be treated by administrating
appropriate analgesic (Kelley-Quon and et. al., 2021).
As per the above analysis, it is well related with pain management is also used to provide the
effective sense of comfort when they are provided to patient for their pain. In addition, it is also
analysing that nurses play vital role in order to provide the therapies of pain and other term such
as using medication named class of sedative and hypnotic which may help to reduce the pain and
make the patient comfort and they take prolong time to make their body rest. In this, the study
research work well focus on the current work which may applied in order to generate the aspect
which show deliberation support from their nurses in order to make the change and apply pain
management in gradual way. Post-operative pain assessment done by the nurse need to be skilled
and have good communication skills so can be build a healthy relationship with the patient and
this make patient share all the experiences to the nurse. In some cases, it is analysed that nurses
did not use any pain assessment tool for the post-operative patient care. Self-reports help nurses
to identify and analyse the sign and symptoms.
As per the above finding, the discussion is also follow the aspect which is related with the
challenge which may face by the nurses while providing the pain management in the post-
operative patient. Therefore, the complexity of fragmented healthcare system which may create
the aspect which is arise the barrier which is well related with the effective pain management in
the all areas of the medicine and across the different age group. In addition to this, the treating
pain is the major aspect which is follow in the context to the struggle to contain the cost means
they have better education and training, better interdisciplinary communication and the
cooperation and also show the better reimbursement for the proven treatment option that is
desperately needed. According to the survey and report, the treatment of pain is disorganised,
ineffective and inaccessible. In this, there are number of public, people with the context with the
pain and number of health professional are not adequately prepared in order to make the change
18

which is well prepared with the preventive action, recognise the warning sign and also show the
context which is inadequate procedure are sometime carried out the approach, it include the
counselling, prevention and self-management might that is carried with the more appropriate.
There is significant variability among the clinicians in applying which new and even existing
knowledge which is well related with the pain and their management. It is generally reflecting in
the term of document which is inappropriate or indeed lack of treatment for cancer patient that is
HIV and AIDS patient, and neonates and the post-operative pain.
To address the barrier which is based on the context which is help to enable the self-
management of pain which is well recommended that is useful in order to provide the factor
which may promote and enable the self-management of pain. There are some of the aspect which
is easily accessible and show the cost effective educational opportunities in the assessment of the
pain and show the treatment in the term of primary care (Angus and et. al., 2019).
STRENGTH AND LIMITATION
From the research nurses gain and increases their strengths that are the characteristic of
nurse which may helpful and effective in their job through which patient get best quality care.
The skills and potential strength of nurse towards their working role is denotes their strength.
There are some strengths of research are as follows:-
 Adaptability:- From the research, nurses learn about the adaptability because they are
dealing with many patient with different diseases. Healthcare professionals should be
aware and adapt individual care which increases the patient satisfaction and decreases the
misunderstanding and concern of the patient (Harmon and et. al., 2021)
 Creative approaches:- Research provides the many approaches and opportunities to the
nurses which are effective in their professional work. Research provides the skills and
knowledge to the nursing staff which may helps in their further medical treatment.
 Flexibility:- Research enhance the knowledge and skills which are acquired by the
nursing staff and they used in their role with the help of research. Performing the research
in their professional work is beneficial for the nursing staff and the patient. Flexibility is
the strength of the healthcare provider which is learned by the research report.
 Critical thinking:- From the research report, nursing learn and increases their analytical
thinking which they are applying in their healthcare field. Nurses faces many challenges
in their professional work and solve analysis the patient complication and delivery the
19

best solutions for their treatment. For the post operative patient nursing staff have main
focused on providing solution for their difficulties by which patient can overcome with
their pain.
Research having the limitations because it needs the proper evidence based study and
taking long time for completing the research. Nursing staff do not applied in their professional
work because they causes the consequences in providing the medicines of the post operative
patient. The limitation of research is that there is unavailability of resource and small amount of
sample size creates the disruption in research. These limitation does not used by the nursing staff
in their professional due to the lack of scientific approved. There are various human complexities
occurs during the research (Marino and et. al., 2019). The problems occurs in the measurement
during the research process this makes the research incomplete which is not used by the nursing
staff. Nursing staff does provides relevant information to their patient in pain management
because the research is incomplete and also not having the the scientific approval. These
limitation provides the consequence in data which is not beneficial for the patient. Ethical issues
are also their which makes the research impractical. Human behaviour is also the part of research
limitation because people having different thoughts and ides which leads to cause the
complication in research and nursing staff does not make it relevant and informative research and
they are not applying them in their their professional field(Fay and et. al., 2019). There are
various intervention provided by the surgeons for the pain relief and also therapies are available
for the relaxation and reducing the pain.
CONLCUSION AND RECOMMENDATION
Recommendations
It is recommended that, the effective therapies and medicines are given to the post-
operative patient by which they can recover faster from the pain. From the research report, it is
analyse that nurses faces many challenges in pain management which includes effective skills
and knowledge. It is recommended that nurses should have the proper skills, which can helps to
analyse the patient complexities. Monitoring is most important process for the measurement of
pain intensity level because that can help surgeons and nurses to give the appropriate pain
therapy to the post-operative patient. In this report, it is find that most post-operative patient
having severe pain and patient requires the immediate therapies by which they can overcome
with their pain faster. From the research, it is found that there are various strength and limitations
20

and nurses should have acquired only strength which are beneficial for the pain management.
Most of the nurses faces the the difficulties due to the lack of relevant knowledge so it is most
important for nurses to having proper knowledge. Nursing staff should have to focused on
reducing the pain intensity level by giving therapies and medicines after the surgery. Proper
monitoring is the main part component of the pain management and then give the proper
treatment. Post operative patient is treated with the operative patient care unit with the specialist
surgeons. Pharmacological intervention is given to the post operative patient for best medical
treatment to overcome with their diseases. The pain is predictable after the surgery but nurses
have the responsibility to reduce the pain by giving appropriate medicines and consult with the
surgeons.
Conclusion
From the above discussion, it is concluded that nursing staff play a crucial role in
providing the medication and better treatment to the post operative patients. Pain is managed b
the specialist doctors and surgeons which prescribes the effective medicines to the patient. The
nursing staff provides the therapies by which patient get reliefs and overcome with their pain.
Monitoring is the important process because it can analysis the intensity level of pain which
helps nurses to give the right medicines and therapies according the intensity of the pain. Post
operative patient requires the nurses with appropriate skills and knowledge by which they can
delivery the best quality care to the patient. Managing pain is the key to improving quality of life
and also reduce the pain by giving appropriate medical therapies. In postoperative care there are
various nursing approaches which includes monitoring the pain intensity level and
conspicuousness of assessing the patient's level of aesthesis, IV fluid pain control and patient's
level of circulation. There are various challenges which are faced by nurses in the pain
management which includes knowledge and skills which are required to the post operative
patient. Physical therapies are given to the patient in pain management which recovers their
health condition faster. In this research report, there are strength and limitation of the nurses
which are acquired by the nurses in their professional work but limitation is not beneficial for
the nurses because of the lack of scientific approval.
21

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Bąkowski, P., Bąkowska-Żywicka, K. and Piontek, T., 2020. Clinical practice and postoperative
rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey
among polish arthroscopy society members. BMC musculoskeletal disorders, 21(1), pp.1-
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Birnie and et. al., 2019. iCanCope PostOp: user-centered design of a smartphone-based app for
self-management of postoperative pain in children and adolescents. JMIR formative
research, 3(2), p.e12028.
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of postoperative respiratory complications: Alternating intervention clinical
trial. European Journal of Anaesthesiology| EJA, 36(5), pp.320-326.
Dagal and et. al., 2019. Enhanced perioperative care for major spine surgery. Spine, 44(13),
pp.959-966.
Eastwood and et. al., 2019. Improving postoperative patient reported benefits and satisfaction
following spinal fusion with a single preoperative education session. The Spine
Journal, 19(5), pp.840-845.
Farley and et. al., 2019. Association between quantity of opioids prescribed after surgery or
preoperative opioid use education with opioid consumption. Jama, 321(24), pp.2465-
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Graves and et. al., 2019. Intraoperative intercostal nerve cryoablation during the Nuss procedure
reduces length of stay and opioid requirement: a randomized clinical trial. Journal of
pediatric surgery, 54(11), pp.2250-2256.
24

Gray, M.L., and et. al., 2018, October. Postoperative pain management after sinus surgery: a
survey of the American Rhinologic Society. In International forum of allergy &
rhinology (Vol. 8, No. 10, pp. 1199-1203).
Hamid, H.K.S., 2021. Pain management after laparoscopic colorectal surgery: inference to
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surgery. Journal of British Surgery, 105(12), pp.1688-1696.
Johnson and et. al., 2019. Racial and ethnic inequities in postpartum pain evaluation and
management. Obstetrics & Gynecology, 134(6), pp.1155-1162.
Joshi, G.P. and Kehlet, H., 2019. Postoperative pain management in the era of ERAS: an
overview. Best Practice & Research Clinical Anaesthesiology, 33(3), pp.259-267.
Jungquist and et. al., 2020. American Society for Pain Management nursing guidelines on
monitoring for opioid-induced advancing sedation and respiratory depression:
revisions. Pain Management Nursing, 21(1), pp.7-25.
Kamer, E. and Çolak, T., 2020. What to Do When A Patient Infected With COVID-19 Needs An
Operation: A Pre-surgery, Peri-surgery and Post-surgery Guide. Turkish Journal of
Colorectal Disease, 30(4).
Kamer, E. and Çolak, T., 2020. What to Do When A Patient Infected With COVID-19 Needs An
Operation: A Pre-surgery, Peri-surgery and Post-surgery Guide. Turkish Journal of
Colorectal Disease, 30(4).
Karlsen, A.P., and et. al., 2022. Opioid consumption as a core outcome domain in postoperative
pain management. Pain, 163(6), pp.e786-e787.
Kehlet, H., 2018. Postoperative pain, analgesia, and recovery—bedfellows that cannot be
ignored. Pain, 159, pp.S11-S16.
Kelley-Quon and et. al., 2021. Guidelines for opioid prescribing in children and adolescents after
surgery: an expert panel opinion. JAMA surgery, 156(1), pp.76-90.
Luque Oliveros, and et. al., 2022. Bupivacaine infiltration for acute postoperative pain
management after cardiac surgery. Nursing in Critical Care, 27(2), pp.223-232.
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theatre with hospital discharge to a skilled nursing or long‐term care
facility. Anaesthesia, 74(4), pp.457-467.
Schreier and et. al., 2019. Post-treatment symptoms of pain, anxiety, sleep disturbance, and
fatigue in breast cancer survivors. Pain Management Nursing, 20(2), pp.146-151.
Swisher and et. al., 2020. Erector spinae plane versus paravertebral nerve blocks for
postoperative analgesia after breast surgery: a randomized clinical trial. Regional
Anesthesia & Pain Medicine, 45(4), pp.260-266.
25

Thompson, J.C., Cichowski, S.B., Rogers, R.G., Qeadan, F., Zambrano, J., Wenzl, C., Jeppson,
P.C., Dunivan, G.C. and Komesu, Y.M., 2019. Outpatient visits versus telephone
interviews for postoperative care: a randomized controlled trial. International
urogynecology journal, 30(10), pp.1639-1646.
Yang, M.M., Hartley, R.L., Leung, A.A., Ronksley, P.E., Jetté, N., Casha, S. and Riva-Cambrin,
J., 2019. Preoperative predictors of poor acute postoperative pain control: a systematic
review and meta-analysis. BMJ open, 9(4), p.e025091.
Zontag, D., and et. al., 2022. Agreement between children's, nurses’ and parents’ pain intensity
reports is stronger before than after analgesic consumption: Results from a post-operative
study. International Journal of Nursing Studies, 130, p.104176.
Zwakhalen and et. al., 2018. Basic nursing care: The most provided, the least evidence based–A
discussion paper. Journal of clinical nursing, 27(11-12), pp.2496-2505.
26

27