We know about the dangers of opioid prescriptions: A recent study linked opioid addiction to just one encounter with opioids for pain control, usually prescribed in an emergency department. (To learn more about safe opioid prescription medication patient teaching, read an article here.) The question is, how can you effectively manage pain without opioids? Pain requires frequent assessment and the setting of realistic expectations by a patient and his or her care team. Patients need to know that although it may not be possible for them to feel entirely pain-free, they are still entitled to some level of pain control. Below is a review of non-pharmacological methods for controlling your patients’ pain.

Heat it up or cool it down. Many of us neglect the value that a hot blanket or heating pad or a cold pack or bag of ice can have on our patients’ pain. It may not help with their chronic pain, but for acute pain, applying heat or cold can be very effective. Just monitor the patient’s skin for any burns or skin irritation at the site, and leave heat or cold on for no longer than 15 minutes at a time.

Guided imagery or relaxation. There are several guided imagery scripts you can find online that you can run through with a patient or even print off and hand to a family member at the bedside. Several institutions have caring or healing patient channels that provide relaxing music or imagery exercises.

Distraction. Can you help your patient turn on the TV, or bring them some magazines or books? When patients are lying in a bed with nothing to focus on but their pain, their perception of the pain can increase. Try to distract the patients with music, TV, art therapy, or books. These methods can help a patient alter their perception of pain.

Promote rest. Make sure your patients can get plenty of sleep. We all know that the hospital is ironically one of the worst places to get a good night’s sleep, but sleep deprivation decreases the patient’s pain threshold and increases their stress response. Excessive stimuli should be reduced for patients as much as possible, so take care to eliminate excess noise by closing doors, adjusting the room temperature, and decreasing harsh artificial lighting.

Fed is best. If your patient is able to eat, ensure they are getting adequate nutrition and enough food to feel full. Hospital food can be notoriously unappetizing, but a feeling of hunger can also exacerbate patient perception of pain. If possible, suggest to family or friends that they bring some favorite snacks or meals for the patient to enjoy.

Advocate. Frequent assessment and evaluation of patients’ pain and their response to pain interventions is crucial for our patients. Be sure you are re-assessing frequently and advocating to the physician if you feel that pain is being inadequately managed.

Laura Kinsella

Laura Kinsella, BSN, RN, CEN, is an emergency room nurse in Washington, DC.

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