Nursing Reflection 3: Pain Assessment and Management in Practice

This nursing reflection details a student's experience in a surgical ward, specifically concerning the care of a patient post-knee replacement surgery. The student reflects on an instance where a pain assessment using a pain rating scale was overlooked, leading to feelings of anxiety and shame. The reflection analyzes the incident, acknowledging the failure to adhere to nursing protocols and standards, particularly regarding pain management. The author references relevant nursing competency standards and emphasizes the importance of systematic assessment and safe practice. The student outlines an action plan that includes evidence-based research on pain management, maintaining resilience, and adhering to nursing guidelines to improve the standard of care provided. References from AHPRA and other sources are included to support the reflection.

Running head: NURSING REFLECTION
NURSING REFLECTION
Name of the Student
Name of the university
Author’s note

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Description
In my placement in surgical ward, I was allocated to take care of a patient, named Mr.
Brown, who had just undergone a knee replacement surgery. Mr. Brown had been operated for
the replacement of the right knee under an epidural anesthesia. After the patient was brought to
the ward, the anesthesia monitored the infusion pumps that has been prepared for Mr. Brown.
One of the infusion pump contained 1mg/ml dosage of morphine given in the form of a patient
controlled anesthesia. I asked the patient about the pain he had been experiencing, based on
which, I administered the prescribed dosage of diclofenac Sodium and oxycodone. At the end of
my shift I was called upon by one of my peer, who informed that he had overheard the matron
saying that, I did not use any pain rating scale on the patient, which could have helped me to
assess the pain status.
Feelings
During my nursing study, I had studied in details about the importance of the pain rating
scales, but forgot its implementation in real life clinical practice. I was anxious and perturbed
thinking about what would happen if the pain still persist or if the dosage of the pain relievers
needs to be altered depending upon the severity of the pain. I felt ashamed of myself that I did
not do my job properly.
Evaluation
Evaluating my experience, I understood that there is a large difference between the
theoretical study and execution of those in real life. I remembered that the workload of this

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critical care department had been more than usual for the last few days. Hence, job stress can be
one of the predisposing factors for this mistake. I believe that, throughout the time, I was caring
for the patient, I made it sure to communicate well with the patient.
Analysis
Analyzing this incident, I can admit that there had been a mistake from my part for not
abiding by the nursing protocol of pain management. I should have accurately conducted the
assessment as according to the standard 4 of the nursing competency standard, nurses are
responsible to use a range of assessment techniques for collecting data systematically for an
informed practice. Again, as per standard 6 of the NMBA practice, a nurse should be able to
provide a safe and standardized practice for achieving the agreed goals and the outcomes, which
are responsive to the nursing needs of the people (AHPRA, 2018). Nurses are liable to practice in
accordance to the nursing and the health guidelines. Assessment of pain is an important aspect of
the role of the nurses in the management of pain. Management of pain after a total knee
replacement is challenging and an integral part of the nursing interventions (Meissner et al.,
2017). Again, it was also necessary to ensure that in addition to consulting with the patient
asking for the pain score. There are other factors that has to be notified like body gestures, facial
grimacing (Ming et al., 2017). Being a nurse, I should have complied with these standards, as it
will not only help in committing no mistakes further, hence assisting in the future professional
development.

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Action plan
I intend to do evidence based researches on pain management to remain acquainted with
the latest pain management techniques and pain assessment. I intend to maintain my resilience of
mind and gather confidence, not to commit any such mistakes in future. I ensure to abide by all
the nursing guidelines and the competency standards for improving the standard of care provided
by me.

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References
AHPRA, (2018).National competency standards for the registered nurse .Access date: 5.2.2020.
Retrieved from: https://www.nursingmidwiferyboard.gov.au/search.aspx?
filter=0&access=p&entqr=0&output=xml_no_dtd&sort=date%3Ad%3Al
%3Ad1&site=nursingmidwifery&ie=utf-
8&client=default_frontend&q=10+competency+standards&start=0
Meissner, W., Coluzzi, F., Fletcher, D., Huygen, F., Morlion, B., Neugebauer, E., ... &
Pergolizzi, J. (2015). Improving the management of post-operative acute pain: priorities
for change. Current medical research and opinion, 31(11), 2131-2143.
Ming, J. L., Hung, S. P., Huang, H. M., Tseng, L. H., Huang, C. H., Chen, I., ... & Tung, C. Y.
(2017). Effectiveness of Different Pain Control Methods in Patients with Knee
Osteoarthritis after Knee Arthroplasty. BioMed research international, 2017.