October 22, 2014 — Blog Post
Health Literacy and Pain: A Nursing Perspective
“I don’t want to get addicted to pain medications.” “Don’t give me anything too strong.” “I will only take pain medication when I absolutely have to.” I have heard these concerns from patients way too often in my nursing career.
Particularly in the geriatric population, the fear of becoming addicted to opioids is prevalent. According to Dr. Herr, Nurse Leader’s Seminal Research Addresses Pain Management for Older People, “Many older adults have other deeply rooted fears about pain that can prevent them from getting relief.” The fear of becoming addicted and refusing proper pain relief will ultimately lead to increased rehabilitation time, increased chances of further complications like blood clots and pneumonia, increased length of stay, and a lot of frustration for the patient and family.
Overall, the patient experience will be compromised. Patients and family members are the core of the health care team. Educating the core team members on the benefits of pain medication, needs to be done consistently.
For example, say a 72-year-old female, “Edith,” is admitted to the hospital after a fall. She had been relatively healthy before the fall. But it caused fractured ribs and a reddened area on her tailbone that turns white when pressed on.
The nurse enters with Edith’s morning medications.
Nurse: Are you in any pain?
Edith: Yes dear, but, I don’t want to get addicted to those pain meds.
Nurse: You won’t become addicted. This medication will help you.
Edith: No, thanks.
Noon rolls around during the nurse’s busy shift. She goes to check on Edith, to see how she’s doing.
Nurse: How are you feeling? I notice your breathing is a little shallow.
Edith: Yes, it hurts to take a deep breath.
Nurse: Would you like some pain medication?
Edith: No, thank you, I am only going to take those things if I really need them.
As the nurse begins to educate on the benefits of taking opioids, her phone starts to ring; the patient down the hall blood has arrived and needs to be started STAT. So their time is cut short.
At 2pm, the physical therapist comes into Edith’s room to assess her mobility. He also notices her breathing is shallow. While she admits to being in pain, she reiterates that she’s afraid of addiction and only wants pain medication if she really needs it.
Ultimately, Edith’s refusal of pain medication and lack of subsequent education resulted in inadequate ventilation and immobility. This turned into hospital acquired pneumonia, deep vein thrombosis (DVT), and a bed sore.
There are many concerns about opioids, and rightly so. But educating the patient/family team members on the benefits of pain medications with acute and chronic pain is a necessity. As a caregiver, I see scenarios such as this all too frequently. With time constraints, and the hustle and bustle of the hospital environment, nurses don’t always feel they have the time to provide a high level of education to all their patients. I hope one day, there will be a subspecialty of medical professionals who solely provide patient education on a variety of health topics, medications, diseases, and illnesses in a patient-friendly manner.
October is Health Literacy Month, please help to raise awareness this month on the need for education on pain. Always remember, education is key in the overall patient experience.