In this video we are going to be talking about Pain Management while you are in the hospital.
Pain is a very unique experience, one that only you as a patient can truly understand.
We believe in a team approach to your pain management and that team includes yourself,
your family members and your health care providers.
If at any time you are experiencing pain, make sure you let someone know.
Nurse: So, while you are in hospital, if you do experience any pain, make sure you let
someone know.
Patient: Ok.
So what do you want me to do?
Nurse: So what will happen is you just need to let someone know.
So, if you’re working with your nurse, or you’re working with your physician, or a
physiotherapist and you start to have pain it is important that you call and let someone
know.
You can use your call bell that is on your bedside.
Patient: Ok.
And what should I tell them?
Nurse: When your nurse comes in, they will assess where you are having pain.
Patient: Should I point to that area?
Nurse: Whatever way you want to describe it.
They are going to want you to put your pain into words.
Like I said before, pain is a very unique experience.
So, whatever way you feel comfortable explaining it, that’s the way that we want you to let
us know.
Patient: Ok.
There is no special way I should explain it to them?
Nurse: No.
Next thing they are going to ask you to rate your pain on the 0 to 10 scale.
If you take a look at the scale, zero (0) is no pain, while ten (10) is the worst pain
possible.
Patient: Ok.
Oh, so I guess five (5) is in the middle?
Nurse: Moderate.
So, what we aim for, we want you to be as comfortable as possible.
But, comfort is whatever it means to you.
Keep in mind you want to be able to do the things you need to do while in hospital.
So, if that means doing your physiotherapy exercises, or just getting up out of bed and
sitting in a chair, or going out for a walk, we want you to be comfortable doing those
things.
Patient: Ok.
So, by comfortable, you mean if my pain goes above a four (4), then I should tell somebody?
Nurse: If you are finding that four (4) is uncomfortable.
We say, in terms of numbers, we want people to aim for a four (4) or lower.
We consider that the mild range.
If you are comfortable at a higher number and you are still able to do everything…
then it is at whatever comfort means to you.
Patient: Ok.
Sounds good.
Nurse: If you are finding that the pain is getting worse and you let someone know, there
are different things we can do to help you get comfortable.
Patient: What do you mean by that?
Nurse: Well the first thing that we can try is different medications.
So we might use something like Tylenol, or we might use an anti-inflammatory such as
Ibuprofen.
Or we might need something a little bit stronger.
We might use opioid, like morphine.
Patient: Excuse me, but can't those drugs be addictive?
Nurse: There is always a possibility but for the amount of time that you would need it
while you are in hospital, it’s very unlikely.
Patient: That's good to know.
I've used Tylenol and Ibuprofen before.
Nurse: Ok.
We will start off with those medications, but if you do need something stronger there
are those options we can try.
One thing to keep in mind - if you do need something stronger, so if you do need an opioid,
those medications can cause side effects.
They might make you a little sick to your stomach, the might make itchy, they might
make you feel drowsy or they might make you constipated.
If at any time you do experience any of those side effects it is really important you let
someone know.
Patient: Will I for sure get some side effects?
Nurse: Not definitely.
But sometimes it does happen and it’s important that if you do, that you let us know.
Patient.
Ok.
I’ll do that.
Nurse: Now, we don't just use medications.
There are other things we can try - and your health care proviers will tell you about that
- but other things you can try such as watching TV, or reading a book, just spending time
with a friend or family member, even changing your position in bed.
Things that will help you get conformable to help you minimize the pain.
Patient: I see, I guess like distractions?
Nurse: Yes, so you’re not just focusing on the pain.
Patient: Ok.
That sounds really good.
Nurse: The other treatment options that I talked about: The first one is a Patient Controlled
Analgesia or a (PCA) is the way that people refer to it.
It might be something you might have started if you had an operation, you might have it
even if you didn't have an operation.
So, the way the pump works is… this is a computer and it allows you to push a button,
and when you push a button, that is when you’ll get the medication.
One of the safety features with the pump, though, is that it only lets you get the medication
once every five (5) minutes.
So, when you push it, you’ll get a small amount of medication and you can push the
button, every 5 minutes, or whenever you feel the pain is starting to get worse
So when you do push the button and it beeps, that means you’re getting the medication.
If you push the button and it doesn’t beep, it hasn’t been that five (5) minutes yet.
So, you’re technically locked out of the pump.
Patient: Right.
Nurse: Ok.
So try giving it a push, and listen to the sound that the machine makes.
(beeps)
Patient: Ok.
Nurse: So that means that now you are getting the medication.
So, you could use it before you go for a walk, say if walking is uncomfortable for you.
Give it a push before you go.
Patient: Ok.
Nurse: So, now if the pain is quite bad and you want to push the button again.
Try pushing it now.
Patient: Yeah, I didn’t hear anything.
Nurse: It didn’t beep.
So that means it hasn’t been five (5) minutes yet.
Now, while you’re on the PCA, you’ll be visited every day by the Acute Pain Service.
The Acute Pain Service is a group of physicians and nurse practitioners that work with you
to help manage the pain.
They’ll come and see you everyday, they will make sure that the pump is working.
Do we need to be trying something different?
Are you having any side effects?
We want to make sure that using this medication is helping your pain.
Patient: OK.