Reflection Interview: Pain Assessment and Management in Nursing

This assignment presents a reflection interview by a nursing student on their experience in assessing and managing a patient's pain following a total hip replacement surgery. The student details their approach, starting with a pain assessment using a numerical rating scale and patient communication to understand the pain's severity, location, and duration. The reflection highlights the interventions used, including repositioning the patient, encouraging stress management techniques, and administering muscle relaxants and opioid analgesics. The student emphasizes the importance of reassessment and monitoring for potential side effects. The reflection concludes with the student's personal insights, recognizing the importance of a combined approach to pain management and the value of their training in preparing them for future nursing practice. The assignment also includes references to support the student's approach to pain management.

Running head: REFLECTION INTERVIEW
Reflection Interview
Student’s Name
Institution affiliation
Date of submission

REFLECTION INTERVIEW 2
Reflection Interview
Reporting & Responding
My training has prepared me for my nursing career asit has equipped me with knowledge
and skills that I will apply during my practice. For instance, I was once presented with a 27-year
old male patient complaining of pain after a total hip replacement surgery. Before applying any
pain management techniques, I felt it was important to first assess the severity of the pain in
order to determine the best intervention method. I used a numerical rating scale and the patient
scored a 5, on a scale of 1 to 10. During the assessment, I felt that it was also important to ask the
patient how bad the pain was to avoid recording a score that was way above or below his own
assessment. He told me that it was getting worse and he was afraid he wouldn’t bear it for long. I
also asked him where exactly he was feeling the pain and for how long this had been going on.
The patient informed me that it had been going on for about one hour and the pain was around
the hip joint. This provided information on how best to monitor the effectiveness of my
interventions.
Relating
To manage the pain, I repositioned the patient ensuring that I did not apply any undue
tension on the new prosthesis and the surrounding tissues (Garson, Schwarxkopf, Vakharia,
Alexander, Stead, Cannesson&Kain, 2014).This is because, maintaining an appropriate position
of the operated extremity helps in reducing any muscle spasm (Stang, Hartling, Fera, Johnson &
Ali, 2014). I also encouraged the patient to engage in stress management techniques and
diversional activities such as progressive relaxation, visualization, meditation and imagery. From

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my personal experience, I figured that this would help in refocusing his attention from the pain
and he will be in a better position to manage or cope with any discomfort or pain for a while.
Reasoning
Additionally, I administered some muscle relaxants and opioid analgesics in the form of
morphine to help manage the pain and improve the patient’s comfort. Opioid analgesics pose
certain side effects such as reduced gastrointestinal mobility, nausea and respiratory depression
(Garson, Schwarxkopf, Vakharia, Alexander, Stead, Cannesson&Kain, 2014). As a result, I
frequently reassessed his respiratory rate, nausea and bowel movement. Further, the early
detection of a developing problem such as a dislocation of the prosthesis gives one an
opportunity to promptly intervene and prevent any more adverse complications (Joshi,
Schug&Kehlet, 2014).From this, I asked the patient if he was experiencing any sudden severe
joint pains and muscle spasms or any changes in joint motility and fortunately, his response was
negative. Had the patient experienced any of this, I would have administered an anti-emetic drug
to counter the sickness. After a short while, the patient reported that the pain was subsiding and
he also appeared a bit more relaxed and capable of sleeping.
Reconstructing
From my own point of view, I feel that this situation presented me with a platform to
show how best I can carry out pain assessment and management. This situation taught me the
importance of pain assessment before any intervention methods as it helps in making a well-
informed decision. I also learnt that it is important to engage the patient and ask questions
pertaining to the severity, location and duration of the pain before taking any measures. A study
done by Coll, Ameen and Mead, (2014) revealed that often, nurses record a patient’s pain score

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that is lower than the patient’s personal assessment. Therefore, it is important to always listen
and consider whatever the patient is saying (Fillingim,Loeser, Baron & Edwards, 2016).
Despite the fact that I did not apply all pain management techniques, I learnt that using
some of the methods helps in relieving pain. In my intervention, I left out methods such as
applying ice to the affected area which could have helped to promote vasoconstriction and
reduce any perception of discomfort. As a result, in future, I will consider all pain management
techniques and their benefits and apply those that are most appropriate for my patient, this is
essential in ensuring patient safety and quality of care. A combined approach is usually the best
option as it allows one to tailor pain management methods that are suitable to each individual
(Jensen &Karoly, 2013).To sum up, this situation has taught me that professional healthcare
practice requires calculated and combined intervention methods to relieve pain from a patient. In
this case, I have learnt that my training has sufficiently prepared me for my nursing practice and
my future practice as a nurse as I was able to carry out successful pain assessment and
management for the patient. Lastly, I need to use a combination of all relevant approaches that
are suitable for my patients’ condition in future.

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References
Coll, A. M., Ameen, J. R., & Mead, D. (2014). Postoperative assessment tools in day surgery:
literature review. Journal of advanced nursing, 46(2), 124-133.
Fillingim, R. B., Loeser, J. D., Baron, R., & Edwards, R.R. (2016). Assessment of chronic and
acute pain: Domains, methods, and mechanisms. The Journal of Pain, 17(9), T10-T20.
Garson, L., Schwarxkopf, R., Vakharia, S., Alexander, B., Stead, S., Cannesson, M., &Kain, Z.
(2014). Implementation of a total joint replacement-focused perioperative surgical home:
a management case report. Anesthesia and Analgesia, 118(5), 1081-1089.
Jensen, M. P., &Karoly, P. (2013). Self-report scales and procedures for assessing pain in adults.
Joshi, G. P., Schug, S. A., &Kehlet, H. (2014). Procedure-specific pain management and
outcome strategies. Best Practice & Research Clinical Anesthesiology, 28(2), 191-201.
Stang, A. S., Hartling, L., Fera, C., Johnson, D., & Ali, S. (2014). Quality indicators for the
assessment and management of pain in the emergency department: a systematic review.
Pain Research and Management, 19(6), e179-e190.