Learning Pain Assessment and Management:

¶ … Learning pain assessment and management: A goal of the end-of-life nursing education consortium," Sherman et al. re-examine safety guidelines in the administering of pain reliving drugs and other pain management techniques in the care of patients with life-limiting illnesses and end-of-life patients (Sherman et al., 2004). Rather than a research study or literature review, this study outlines current knowledge and practices in the management of pain from the perspective of chronic disease and end-of-life treatment. The focus of the article is mainly on continued education of end-of-life nurses on the different causes and types of pain, as well as effective methods of treatment (Sherman et al., 2004). Safety of the patient is considered both in the direct results of the various pharmacological remedies most commonly used in the treatment of pain, as well as in the affect of decreased pain on other symptoms, general patient stress, and the quality of care provided by non-medical family caregivers (Sherman et al., 2004).

In addition, the article also outlines the barriers to pain relief, which if not understood will necessarily lead to mismanagement of pain (Sherman et al., 2004). Improving the quality of life is the most essential goal of pain management in end-of-life patients, and this cannot be accomplished without understanding the barriers to treatment (Sherman et al., 2004). Not only will treatment likely be ineffective, causing the patient greater pain, stress, and aggravation of other symptoms than is necessary, but mistreatment -- especially with pharmacological remedies -- can very easily endanger the patient's life (Sherman et al., 2004). Thus, in addition to the primary cause of improving the quality and condition of life for chronically ill and end-of-life patients, proper knowledge and skills of pain assessment and management are essential skills for a nurse at any level of practice for the safety and most basic well-being of the patient.

As a registered nurse in the state of Indiana, my first defined duty is to "assess the patient/client in a systematic, organized manner" (Indiana Nurse Practice Act [INPA hereafter], 2007, pp. 43). The pain assessment guidelines set forth in this article will have an immediate effect on my first encounter with a patient, particularly if that patient is a chronic pain sufferer or end-of life patient. The sixth defined responsibility in the INPA is also of particular importance in regards to the information contained in this article; this is the responsibility to "evaluate with the patient/client the status of the goal achievement as a basis for reassessment" (INPA, 2007, p. 43). The evaluation of pain and the assessment of necessary and reasonable care in end-of-life patients is a complex task, as this article points out, so the implications of this article's information on this task of the registered nurse are huge.