Non-Pharmaceutical interventions for Pain

[gwenith]

We are about to hold a day seminar for ICU/High Dependency nurses and amoung it I would LOVE to include some non-pharmaceutical interventions for pain. Simple quick stuff that an acute care nurse COULD and SHOULD use to adjunct pain management in an acute care setting. Some of our patients include young teenagers undergoing spinal instrumentation for scoliosis (they seem to need lots of sympathy as well as pain relief) through to elderly patients with multiple co-morbidities who require post-op monitoring, especially of repiratory functioning.

Would enjoy hearing your suggestions

[JentheRN05, RN]

Being a holistic health practitioner, I use ALOT of different non medication treatments for my residents.

We do guided imagery, relaxation techniques, I have many books on accupressure, but haven't had the chance to try it yet. I do aromatherapy, and crystal therapy as well. I haven't had many chances to use these two yet, but since I plan on being here for the long haul I will get them implemented.

We do foot massages - which if you understand accupressure then it is able to be coordinated into a foot massage pretty easily.

With teenagers - they need to be in their comfort zone. One poster mentioned videos, and music. I believe a combo of the two - music videos - if they so please would help them. Aromatherapy works good with teens, even if they don't realize it is going on - a simple 'plug-in' with lavender scent is enough to relax almost anyone. Another teen pain relief is (I can't think of the name of it at the moment) but when you give them something to squeeze when the pain is great - it gives them focus on something else, rather than their pain. Visitors is also very important, must keep a connection with the outside world - because teenagers feel they are the center of the universe, and if they are not an immediate part of it, they feel left out and isolated.

Repositioning is first and foremost, beyond that relaxation techniques is my next option, followed closely by the guided imagery.

I plan on implementing exercises for the elderly in the coming weeks (work in an elderly residential home). I also want to start getting aromatherapy going. Lavender for the bedrooms, and citrus or some other awakening scent for the living areas (dining room, tv room - which is never used) These are in my list of things to do.

There is so much more to do in holistic nursing. Just letting the patient know you see them as a real person. Really does do alot for them. Get to know their interests and talk to them about them.

[derelys9]

I don't work in ICU or acute care, but two things I find useful for pain management are Reiki and reflexology. Both methods can be taught to the patients and done on themselves and used at any time. I think it would be wonderful for more nurses (and everyone in general) to have some basic working knowledge in these areas, as they are not overly time consuming, they are effective, and most importantly (I think) they give the patient as sense of being in control of what is happening to them and a feeling of them being able to do something about it. Two very good webistes for more information:

http://www.reflexology-usa.org

http://www.reiki.org/

[zahryia, LPN]

Is aromatherapy and acupressure an independent intervention or do you need to consult the doctor?

[sorrento]

Music is something that works. There is a paper that has been published by Scandinavian CRNA's around 2002 that suggested Music as a therapeutic tool. 5o beat/minute music pace and any kind of music the patient likes. Hypnosis is also known to be a non-pharmacologic painreliever. Search in Medline and Cinhal.

Cheers

[LPNNHP]

It would be nice to know the points for accupressure, with training, a Nurse could do that modality (at least in the state of Colorado).

Any suggestions Josh on that training?

I am going to be taken a class on accupressure and will have to implament it during my clinicals as part of my NHP training. I am excited.

[OHIBB]

Guided Imagery would be a wonderful non pharmaceutical addition to treatment. In a recent article by the American Psychological Assn, (go to their website and the article is, Want Better Health? Use Your Head) they refer to studies where patients that underwent surgery that used guided imagery before their procedures, used less medication after the procedure, had increased recovery time, and had fewer post op complications. Guided imagery has a lot of research behind it that supports it's effectiveness in reducing pain, especially chronic pain.

[sicushells, RN]

Honestly, I'm not sure I have the time at the bedside to implement things like reiki or aromatherapy for my patients in severe pain. I think they are wonderful options, but as the primary nurse the list of things I'd like to do for my patients is usually twice as long as the list of things that I'm actually able to get done for my patients.

I do frequently encourage focused breathing (is that the right phrase?). When we do baths and reposition patients with surgical pain they often writhe in agony, even if otherwise their pain has been well-controlled and i've pre-medicated them. So while the patient is on their side I encourage them to focuse on feeling the breath move in and out of their lungs... let the clean, fresh air come in... blow your breath out, allowing the pain to leave your body... in my "soothing" voice. It seems to help them, or at least distract them enough from the discomfort we're inflicting.

Also, my coworkers laugh at me a lot, but I do it anyway.