In order to do this the discussion will first of define pain, because it not objective as many nurses and health practioners may believe. In fact it is a very subjective term. The essay will then go on to the different types of pain relief and finally end with a discussion of the problems in the UK when dealing with patient’s whose wishes are hard to discern and whether we should be administering pain relief and life saving methods without proper consent.
Pain is a multi dimensional experience and has a sensory, emotional, cognitive component. Pain management approaches that address all these three factors are likely to be more successful and popular (Carr C.J. Ellois. 2001). The World Health Organization estimates that 22% of people experience some form of pain (Gureje et al 1998). Potter in 1993 showed that 11.3% of the visits made to General Practitioners were to get treatment for chronic pain (DAY.R. 2002).
The losses in terms of quality of life and economy were rated high enough for the WHO to give pain the status of a "world health problem," by the WHO in 1986. In the UK, the Working Party Report Pain after Surgery (The Royal College of Surgeons of England and The College of Anaesthetists 1990) recognized the need for professional supervision and protocol development for pain management. The committee also highlighted the historical inadequacy in pain management. Acute Pain Services (ACS) was initiated for managing post-surgical pain (Taylor. H. 2001). The Provision of Pain Services (Association of Anaesthetists of Great Britain and Ireland and The Pain Society 1997) propounded the specialized role of nursing in pain management. (Pain Society, 2001)
The Royal College and the Anaesthetic Association reported that 44% of hospitals had some form acute care services and 79% used modern analgesic techniques to manage pain (Carr C.J. Ellois. 2001.) A study of hospital services declares pain prevention to be one of the 10 most important indicators of care quality. (Susan M, 2003)
While the need for management is acknowledged, the resources allocated for the function were found to be inadequate. In a significant finding, the Clinical Standards Advisory Group found that although 81% of the functions involve nursing care and 7% of these were headed by nurses there was lack of specialized nursing care in the chronic pain department. The situation was further made worse by inadequate funding. (Pain Society, 2001)
Health professionals currently are found to have deficits in knowledge and skills for proper pain management. Nursing care is often found to be influenced by attitude of patients, their culture and value systems. (Redorbit.com, 2006) . The Services for Patients with Pain, in their study in 1999 found that 50% of trusts did not provide pain care services for children and awareness of guidelines were poor (Susan M, 2003) An analysis by Ferrell et al (2000) on the text books used in nursing