Examples

Taking the pain out of pain relief

Immediately after surgery most patients have epidurals or use patient-controlled analgesia system until they are ready to change to oral medication.

Nurses in a specialist thoracic hospital were aware that a lot of patients suffered unnecessary pain during the changeover. Junior doctors were not always available to write up medication when it was needed, and often they didn’t have the knowledge or confidence to prescribe what patients really needed.

The clinical nurse specialist looked for a way to improve patients’ pain control at this critical time in their recovery. She worked with the Acute Pain Team to develop a step-down protocol for analgesia for thoracic surgery patients. Now junior doctors follow the protocol so they know what to prescribe for basic pain control and for breakthrough pain, and nurses can then administer appropriate analgesia when patients need it.

Staff use the patients’ pain assessment charts and have the backup of the Acute Pain Team.

The nursing staff teach new junior doctors the system when they start work – an example of collaborative practice.