Joan Simons

Pain assessment tools: children’s nurses’ views:

The persistence of inadequate treatment of pain in children could be due to lack of knowledge and nurses’ failure to assess and manage pain effectively. It is recognized that effective pain assessment leads to more satisfied children and families. This study explored children’s nurses’ views on the use of pain assessment tools in a tertiary referral centre. Almost two-thirds of nurses did not have a preference for a pain assessment tool, but nearly three-quarters of nurses surveyed agreed that the introduction of pain assessment tools would improve documentation. When nurses were asked how much time they needed for education on these tools, 83 percent wanted only two hours, although almost half stated lack of knowledge or education as the main obstacle to use of a pain assessment tool. The inconsistencies in these replies could reflect the conflicting demands between the nurses’ need to increase their knowledge of pain assessment while managing a heavy workload.

A Proposed Model of the Effective Management of Children's Pain.

The aim of this study was to understand the various factors that contribute to the delivery of effective pain management. The current picture of pain management is complex and contradictory, with children in the hospital still experiencing unnecessary pain, nurses reporting better pain care than is evidenced, and parents who are reluctant to report their childs pain. There is a real need to focus on areas of excellence where pain management innovations have been successfully implemented. Five hospitals were visited in three countries: the United Kingdom, Sweden, and Australia, spending a week in each country. In all, 28 health care professionals were interviewed exploring innovations in pain management; the effect of improvements on children, parents, and nurses; and what helped and hindered the delivery of effective pain management. Better pain management provides nurses with confidence, which in turn gives children and parents confidence in their care and reduces anxiety for nurses. Resources, on the other hand, were a common issue in relation to obstacles to innovation. A recurring theme in all areas visited was the issue of culture and how it affected both negatively and positively on the management of childrens pain. Strong leadership was integral to moving practice forward and to introducing the innovations that led to effective pain management. The key findings identified that underpin the effective management of childrens pain are effective leadership, resources, and confidence; the consequences are less stress for children and nurses, more trusting relationships, and greater job satisfaction. A model of effective pain management is proposed.

Stories of Children’s Pain: Linking Evidence to Practice

Working with a child in pain is difficult, unavoidable and especially challenging when the child cannot explain what they are feeling. In this important book, Bernie Carter and Joan Simons bring together experience, evidence and research to deconstruct the topic and present the reality of childrens pain. Each chapter starts with a personal story from a child, a family member or a healthcare professional. The stories are drawn from a wealth of original research, and focus the reader on the individual child and their family. The chapter then goes on to introduce the relevant research, theory and implications for practice, so health professionals can use the evidence to support compassionate, child-centred care.

Navigating Uncertainty: Health Professionals’ Knowledge, Skill, and Confidence in Assessing and Managing Pain in Children with Profound Cognitive Impairment

There is limited evidence to underpin the assessment and management of pain in children with profound cognitive impairment and these children are vulnerable to poor pain assessment and management. Health professionals working with children with profound cognitive impairment from a single paediatric tertiary referral centre in England were interviewed to explore how they develop and acquire knowledge and skills to assess and manage pain in children with cognitive impairment. The interviews were transcribed and subjected to thematic analysis. Nineteen health professionals representing different professional groups and different levels of experience participated in the study. A metatheme “navigating uncertainty; deficits in knowledge and skills” and two core themes “framing as different and teasing things out” and “the settling and unsettling presence of parents” were identified. Uncertainty about aspects of assessing and managing the pain of children with cognitive impairment tended to erode professional confidence and many discussed deficits in their skill and knowledge set. Uncertainty was managed through engaging with other health professionals and the childs parents. Most health professionals stated they would welcome more education and training although many felt that this input should be clinical and not classroom oriented.

Children’s experience of postoperative pain relief: children, parents and nurses use various pharmacological and non-pharmacological approaches, particularly distraction

Commentary on: Sng QW, Taylor B, Liam JL, et al. Postoperative pain management experiences among school-aged children: a qualitative study. J Clin Nurs 2013;22:958–68.[OpenUrl][1][CrossRef][2][PubMed][3] Children are dependent on parents and nurses to help them cope with their pain following surgery. However, school-aged children are able to evaluate how their pain is managed and what strategies they prefer. Although pain medication is the cornerstone of pain management, there is increasing recognition of the value of non-pharmacological pain relieving methods. In addition, parental presence … [1]: {openurl}?query=rft.jtitle%253DJ%2BClin%2BNurs%26rft.volume%253D22%26rft.spage%253D958%26rft_id%253Dinfo%253Adoi%252F10.1111%252Fjocn.12052%26rft_id%253Dinfo%253Apmid%252F23311588%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1111/jocn.12052&link_type=DOI [3]: /lookup/external-ref?access_num=23311588&link_type=MED&atom=%2Febnurs%2F17%2F3%2F88.atom

What Factors Promote Student Resilience on a Level 1 Distance Learning Module

Abstract Resilience is understood to be the ability to adapt positively in the face of adversity. In relation to new students on a distance learning module, this can mean how they adapt and make sense of the demands of their chosen study to enable them to persist in their studies. This article reports a small-scale study involving semi-structured telephone interviews with students on a level 1 distance learning module at the UK Open University. Students identified the challenges they experienced such as carving out time to study alongside other commitments, as well as developing their academic writing. Students also identified factors that enabled them to adapt to these challenges and be successful in continuing to study. Students rated highly the support they received from tutors in the form of tailored, detailed feedback on their assignments. Other factors that enabled students to persist in their studies were time management, self-belief and motivation.

‘Nurses do assess pain, they just don’t write it down!’

I clearly remember one nurse’s response to my expressed frustration at the lack of pain assessment on children’s wards in the UK. Her explanation that ‘nurses do assess pain, they just don’t write it down’ did not reassure me that all was well with children’s pain assessment or the leadership of children’s pain management.

How to prepare conference abstracts and poster presentations

An effective way of disseminating nursing research is to present it at a national or international conference.

Hospital clowns boost healing through the power of laughter

The article discusses the findings in light of other studies, pointing out that Ford et als (2014) study goes further than previous research. The authors acknowledge the complexity that underlies the interactions between the clown doctors and the children, and the skill involved in matching the play to the situation and to the hospital environment.

G230 Supporting parents of children who have complex needs to assess and manage their children’s pain: health care practitioners’ perspectives

Aim The aim of this paper is to present findings on the ways in which health care practitioners who work with children with complex needs can support parents in assessing and managing their child’s pain. Methods The data reported here are from semi-structured interviews undertaken with health care practitioners based at a tertiary children’s hospital in the UK. These data are part of a larger mixed methods study. Data were analysed using thematic analysis. Results Nineteen healthcare practitioners from a variety of disciplinary backgrounds (e.g. neurologists, nurses, physiotherapists) and with different experience (1–27 years) of working with children with complex needs participated in the study. Only one of the nineteen practitioners interviewed had had formal training on the management of pain in children with complex needs. Practitioners reported taking a multi-layered approach to managing pain in children with complex needs, which meant including parents, using skills of observation and referring to other members of the multidisciplinary team. The practitioners supported parents in the management of their child’s pain by engaging with them, listening to them and also managing their expectations, although it was noted that parents’ relationships with nurses could be problematic. Most practitioners felt parents had a central role in the management of their child’s pain, although it was noted the role could vary and that the multidisciplinary team needed to provide opportunities for parents to give feedback. Practitioners felt that parents had a critical knowledge of their child’s pain but not of pain itself. It was suggested that a critical knowledge of their child’s pain takes time to develop and that some parents can misread pain cues. Most practitioners felt that parents did not receive adequate training and support to manage their child’s pain. Conclusion Practitioners value the knowledge of parents of children with complex needs and acknowledge the central role parents play in managing their child’s pain. However, there is a need for practitioners to have formal education in the management of pain in children with complex needs so that they in turn can provide training and support for parents.