Postsurgical pain relief: Patientsʼ status and nursesʼ medication choices

Abstract

The adequacy of pain relief in hospitalized post-surgical patients was assessed, and ways in which nurses on the same units chose analgesic medications were examined. Pain was considered a subjective experience. Patients (109) were interviewed and their charts reviewed on the 3rd postoperative day. After all patient interviews were completed, 121 nurses on the same units responded to a questionnaire which included clinical vignettes. Of these patients, 75.2% were in moderate or marked pain distress and a general question did not adequately assess pain. Chart review revealed these patients were actually receiving less narcotic analgesics than they could receive. Nurses were overly concerned about the possibility of addiction, choices of analgesic medications seemed irrational and knowledge of the drugs was inadequate. Complete pain relief after surgery was not the nurses'' major goal. In 2 sets of identical vignettes, in which the only difference was the sex of the patient, nurses selected less medication for pain for female patients (P < 0.001 and P < 0.025, respectively). Factors that nurses consider in administering and choosing postoperative analgesia are described.