Essay: Post Graduate Reflection on Pain and Wound Management (Nursing)

This essay presents a reflective account by a post-graduate nursing student on their experience managing pain and wound dressings in a surgical ward. Utilizing the Gibbs reflective cycle, the essay details a specific encounter with a patient who underwent surgery for intestinal obstruction. The student describes the situation, their feelings, and evaluates the experience, analyzing the importance of pain management, patient communication, and the application of vacuum dressings. The conclusion highlights key learnings, and an action plan outlines future goals for enhancing knowledge and skills in pain and wound management, including further study, certification, and the use of pain assessment tools. The essay emphasizes the significance of building therapeutic nurse-patient relationships and adapting to challenging patient interactions within a clinical setting, offering insights into the complexities of patient care.

Running head: ESSAY
Post Graduate Reflection
Name of the Student
Name of the University
Author Note

1ESSAY
Introduction- Reflective practice refers to the procedure of explaining and expressing
one’s own views and experiences. This reflective assignment will look at the management of
pain and wound dressings during placement at a surgical ward. The Gibbs reflective cycle will be
used as a guideline, and it comprises of six steps namely, description, feelings, evaluation,
analysis, conclusion, and action plan (Gibbs, 1988).
Description- During my placement as a second year nursing student in the surgical ward,
I came across the male patient X (pseudonym), aged 55 years. The actual name will not be
revealed due to confidentiality issues since the code of conduct guides us nurses to respect rights
of patients to confidentiality, and disclose information only when the patients are at a risk of
harm. When I arrived at the ward on the third day of placement, I had been briefed by the senior
nurse about the patient who underwent operation for intestinal obstruction and was under post-
operative care. When I arrived at the patient bedside, I found him screaming in tremendous pain.
I started looking for his drug chart and immediately administered oral morphine, as per the
prescription since the last dosage had been given more than five hours ago, and he had been
prescribed 10 mg four hourly oral morphine. I had prior clinical knowledge about wound
management and later tried to assist the senior nurse while changing the vacuum dressings.
However, the patient advised that he would only prefer the senior nurse to change the dressing
and did not want me to intervene.
Feelings- My initial feelings were that the patient X was in severe pain due to surgical
complications, and there was an immediate need to administer strong analgesics, in order to
provide him relief. On observing the patient scream with pain I was extremely taken aback and
started sympathizing with him. However, the uncertainty expressed by the patient regarding my
capability of successfully changing the wound dressing reduced my self-confidence and served

2ESSAY
as a blow to my self-esteem. I became extremely uncomfortable, apologized for my extra
initiative to help him, and moved aside.
Evaluation - This was the first encounter where I met a patient suffering from acute pain
and it played a significant role in increasing my theoretical and practical knowledge about the
same. According to Pironi et al. (2018) patients who are diagnosed with intestinal obstruction do
not merely report physical abnormality, but also suffer from psychological stress, which all
nursing professionals must be aware of. After the incident, the senior nurse appreciated my
actions, in relation to administration of morphine, according to the drug chart of the patient and
also mentioned the importance of following the drug chart to know the actual dose regimen of
different prescription medications that need to be given. The incident also help me learn that
dealing with hostile patients can be a challenging task while delivering healthcare services, and it
is essential for acknowledging the anger of a patient, while identifying the root cause of concern,
in order to avoid further conflicts.
Analysis- Despite the fact that the patient X did not want my presence while changing the
vacuum dressing, I looked at the entire procedure from a distance and was able to witness the
steps that need to be followed during the procedure. The experience helped in understanding that
vacuum dressings comprise of application of negative pressure on the site of injury or operation,
for stimulating the formation of granulation tissue and subsequent wound healing (Bast et al.,
2017). I also understood the importance of formulating a good nurse patient therapeutic
relationship while providing care. Not only is this relationship based on mutual respect and trust,
but also requires both nurses and patients to be sensitive to each other and self. Gratification of
the emotional, spiritual, and physical needs of a patient is important through personal skills and
knowledge. The experience helped me appreciate the importance of following traditional

3ESSAY
therapeutic techniques like reflection, active listening, and empathy, while dealing with patients
who suffer from pain.
Conclusion- I feel that the entire placement experience involving pain management and
wound management of the patient X went smoothly, despite few initial disturbances. I could
have spent more time in fostering a rapport with the patient, before engaging in the wound
dressing procedure. Since I have realised that pain sensation is often subjective, there was a need
of displaying more support towards the patient, while putting myself in his shoes, and spending
an extra minute in making the patient feel comfortable.
Action Plan- In future practice, I would like to study and reflect on the different
management strategies of acute and chronic pain and the role of nursing professionals in such
scenario. I would also like to increase my knowledge on different types of wound dressings. I
also intend to complete a certificate course on skin and wound management, apart from learning
the appropriate uses of pain assessment tools.

4ESSAY
References
Bast, F., Chadha, P., Jakharia-Shah, N., & Collier, J. (2017). Treatment of Large Cutaneous
Defects of the Scalp by Vacuum-Assisted Wound Dressing. Ann Clin Otolaryngol. 2017;
2 (3), 1020.
Gibbs, G. (1988). The reflective cycle. Kitchen S (1999) An appraisal of methods of reflection
and clinical supervision. Br J Theatre Nurs, 9(7), 313-7.
Pironi, L., Corcos, O., Forbes, A., Holst, M., Joly, F., Jonkers, C., ... & Sasdelli, A. S. (2018).
Intestinal failure in adults: recommendations from the ESPEN expert groups. Clinical
nutrition, 37(6), 1798-1809.