Pain and Violence

When I first started nursing in the 80’s you really didn’t hear too much about pain assessment and management. It wasn’t until 2000 when Joint Commission on Accreditation of Health care Organizations issued pain standards as criteria for accreditation of hospitals. In 2001 JCAHO began scoring this standard as part of its survey. Nurses and Healthcare professionals were then all being educated on the importance of pain management.
There are not always clear distinctions among the different types of pain. Even though there is several ways to categorize pain. Acute pain has a recent onset. It is usually self limiting. Chronic Pain may be intermittent or continuous. The pain lasts more than six months. Referred pain is described as pain felt in another site other than the site of the injury. Then there is phantom pain. This is pain that a patient thinks he/she feels in an extremity that has been amputated.
When dealing with a patient who could be a victim of violence. You need to keep an open mind and observe the patient and listen. For a patient may have chronic pain due to the violence that was inflected on them, but they may not want to tell you. The patient may present as depressed, withdrawn with low self esteem.
This is where not only education regarding pain comes into play but also education regarding women who may have been a victim of violence. Violence, torture, different cultures, their beliefs and rituals these are topics I feel have grown in recognition as pain management has. Though we need to realize how these are all integrated and could affect our patients. Education due to our changing society is so important to our Healthcare and law enforcement professionals. Even thought I feel we have come a long way regarding the education of pain management we have a long way to go regarding education of violence.

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