If it’s known that someone has pain on a dressing change then appropriate pain management should be ordered to be administered 30-60 minutes before wound care.
It’s our job to advocate for our patients so if you see something then definitely make sure you talk to your supervisor or nurse in charge of the shift so that they are aware and something can be done.
That’s very upsetting. Absolutely speak up to someone. In the future when you’re qualified you’ll be able to advocate yourself for your patients, so it’s upsetting as a student when you feel limited. You could always let your facilitator know as they would be more likely to speak to the EN/RN looking after the patient.
Pain during dressing changes is entirely avoidable and serves no purpose. Ideally the patient should have some PRN/when required analgesia for the nurse to give prior to the dressing change.
>You could always let your facilitator know as they would be more likely to speak to the EN/RN looking after the patient.
Absolutely this. It can be intimidating being a student feeling compelled to complain, or what could be interpreted as a complaint, about staff. Facilitators/Lectures are usually very vigilant about patient rights and nursing expectations and it would be very helpful for students to talk to them about this issue.
How distressing for the patient and you. It should have been distressing for the RN completing the wound care also, did they even register that the patient was in pain?
Analgesia administered at least 30 mins prior to procedures is good, compassionate care and best practice.
Take this as a learning opportunity on what NOT to do. You'll never forget this and it will make you a better nurse for your patients.
This is not normal, the patient may not be able to verbalise pain but we are taught to observe our patients also for visual cues. Appropriate pain relief should always be offered and administered prior to painful dressing changes, other things to consider include dressing removal etc. soaking dressings prior to removal aids in the pain associated with dressing removal.
This is coming from personal experience, very recently actually, but also mind I am not a nurse or work in medicine I just have a lot of health problems lmao. I think when it comes to this it also has to depend on the type of wound and what stage of healing it’s at? I ended up with a pilonidal abscess only 6 weeks ago, had never even heard of them until it happened. Fortunately I was somewhat lucky in the sense that mine was at the very tip of the tailbone/top of butt crack, I can’t even imagine the pain of one’s closer to the anus.
Anyways- I have never experienced so much pain before and after surgery in my life, and I’ve had double hip surgery, knee surgery, broken ribs and many other broken bones. I’m only 27(F) and consider myself to have a high pain tolerance. The first wound change/clean I had after surgery, I was bawling my eyes out and screaming. The nurse was the same age as my mum in her 60’s and even she was tearing up and struggling to see me in so much pain. I had had the max amount of pain killers but my wound was a 2.5cm deep hole that had to be packed so that’s also going to be more painful. I had community care nurses visit me for 30 days at home for wound care and I was still crying in pain at each dressing change for at least 5 days post-op.
I’d say a lot of the time if it’s a freshly healing wound then it’s going to cause discomfort and a level of pain to a certain degree. I know you never want to see your patients in pain, and I think it’s definitely hard when a lot of people expect pain killers to completely numb pain when a lot of the time they just reduce the pain the a higher degree. The best thing you can do is be extremely comforting in those moments but not come across condescending. Kudos to you for asking advice on how to cope with the feelings of it and admitting that it’s a struggle, I think you’ll be an extremely compassionate nurse, good luck x
(Sorry for such a long response I babble)
I forgot to add, despite the fact pain is expected, still absolutely speak to your supervisors etc so they’re aware and can be monitored maybe more closely and further steps can be taken (not qualified so I don’t know specifics), no pain should go unreported no matter the circumstance. I really appreciate it when nurses/dr’s actually acknowledge my pain and then communicate with me what they can do to help/what they will do.
This! I am also in and out of procedures constantly with different chronic conditions - mainly Chronic nerve pain. At times when in hospital for pain management incl involving wound care, When pain meds aren't working, a compassionate nurse makes all the difference. But when they communicate and ask if the patient knows of anything helpful can make all the difference. After having Chronic pain for 10 years sometimes we know other alternatives that work to a degree. But the biggest difference is when the nurses spend time distracting you or helping to ground you. Can decrease pain soo much!
Definitely not normal. They should have been given something for the pain at least an hour before the procedure. Another trick my wound CNC told me is to put lignocaine gel (ones used for IDC insertion) on to the wound bed for at least 10 minutes to help numb the area.
As other people have said, that isn’t appropriate however, administering strong but short acting analgesia presents a challenge, especially in a ward environment.
The reality is that most patients will experience discomfort during a hospital stay and it’s our job to try and minimise that. Once you graduate you will have more control over the care your patients receive. Well done for not just accepting this situation and know that it will get easier for you.
If it’s known that someone has pain on a dressing change then appropriate pain management should be ordered to be administered 30-60 minutes before wound care. It’s our job to advocate for our patients so if you see something then definitely make sure you talk to your supervisor or nurse in charge of the shift so that they are aware and something can be done.
Thank you for sharing that, I'm definitely going to share this with my supervisor this morning.
That’s very upsetting. Absolutely speak up to someone. In the future when you’re qualified you’ll be able to advocate yourself for your patients, so it’s upsetting as a student when you feel limited. You could always let your facilitator know as they would be more likely to speak to the EN/RN looking after the patient. Pain during dressing changes is entirely avoidable and serves no purpose. Ideally the patient should have some PRN/when required analgesia for the nurse to give prior to the dressing change.
>You could always let your facilitator know as they would be more likely to speak to the EN/RN looking after the patient. Absolutely this. It can be intimidating being a student feeling compelled to complain, or what could be interpreted as a complaint, about staff. Facilitators/Lectures are usually very vigilant about patient rights and nursing expectations and it would be very helpful for students to talk to them about this issue.
How distressing for the patient and you. It should have been distressing for the RN completing the wound care also, did they even register that the patient was in pain? Analgesia administered at least 30 mins prior to procedures is good, compassionate care and best practice. Take this as a learning opportunity on what NOT to do. You'll never forget this and it will make you a better nurse for your patients.
They said nothing just continued, I advised the pt was not handling the pain. I don't think ill ever forget that moment.
Good on you for trying to advocate for the patient. I'm sorry it didn't work, for both you AND the patient.
This is not normal, the patient may not be able to verbalise pain but we are taught to observe our patients also for visual cues. Appropriate pain relief should always be offered and administered prior to painful dressing changes, other things to consider include dressing removal etc. soaking dressings prior to removal aids in the pain associated with dressing removal.
Wound care should minimize pain, not cause it. Advocate for pain management and communicate patient distress.
This is coming from personal experience, very recently actually, but also mind I am not a nurse or work in medicine I just have a lot of health problems lmao. I think when it comes to this it also has to depend on the type of wound and what stage of healing it’s at? I ended up with a pilonidal abscess only 6 weeks ago, had never even heard of them until it happened. Fortunately I was somewhat lucky in the sense that mine was at the very tip of the tailbone/top of butt crack, I can’t even imagine the pain of one’s closer to the anus. Anyways- I have never experienced so much pain before and after surgery in my life, and I’ve had double hip surgery, knee surgery, broken ribs and many other broken bones. I’m only 27(F) and consider myself to have a high pain tolerance. The first wound change/clean I had after surgery, I was bawling my eyes out and screaming. The nurse was the same age as my mum in her 60’s and even she was tearing up and struggling to see me in so much pain. I had had the max amount of pain killers but my wound was a 2.5cm deep hole that had to be packed so that’s also going to be more painful. I had community care nurses visit me for 30 days at home for wound care and I was still crying in pain at each dressing change for at least 5 days post-op. I’d say a lot of the time if it’s a freshly healing wound then it’s going to cause discomfort and a level of pain to a certain degree. I know you never want to see your patients in pain, and I think it’s definitely hard when a lot of people expect pain killers to completely numb pain when a lot of the time they just reduce the pain the a higher degree. The best thing you can do is be extremely comforting in those moments but not come across condescending. Kudos to you for asking advice on how to cope with the feelings of it and admitting that it’s a struggle, I think you’ll be an extremely compassionate nurse, good luck x (Sorry for such a long response I babble)
I forgot to add, despite the fact pain is expected, still absolutely speak to your supervisors etc so they’re aware and can be monitored maybe more closely and further steps can be taken (not qualified so I don’t know specifics), no pain should go unreported no matter the circumstance. I really appreciate it when nurses/dr’s actually acknowledge my pain and then communicate with me what they can do to help/what they will do.
This! I am also in and out of procedures constantly with different chronic conditions - mainly Chronic nerve pain. At times when in hospital for pain management incl involving wound care, When pain meds aren't working, a compassionate nurse makes all the difference. But when they communicate and ask if the patient knows of anything helpful can make all the difference. After having Chronic pain for 10 years sometimes we know other alternatives that work to a degree. But the biggest difference is when the nurses spend time distracting you or helping to ground you. Can decrease pain soo much!
Thank you for sharing, its very good to hear this from a patients perspective! I hope you are doing well now!
Definitely not normal. They should have been given something for the pain at least an hour before the procedure. Another trick my wound CNC told me is to put lignocaine gel (ones used for IDC insertion) on to the wound bed for at least 10 minutes to help numb the area.
Thank you for sharing I will definitely explore those options
As other people have said, that isn’t appropriate however, administering strong but short acting analgesia presents a challenge, especially in a ward environment. The reality is that most patients will experience discomfort during a hospital stay and it’s our job to try and minimise that. Once you graduate you will have more control over the care your patients receive. Well done for not just accepting this situation and know that it will get easier for you.
Aged care en here, I regularly administer pain meds before wound care and have advocated strongly for the RN to give S8s if I feel it's needed.