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Nurses use more than medication to relieve pain
In 2015, Cleveland Clinic Fairview Hospital opted to expand its Healing Services and Spiritual Care program, led by Director Tricia Gilbert, MDiv, BCC, LMT. “Pain management was one of the first areas where we utilized these untapped resources to meet patient needs,” says Deborah C. Small, MSN, RN, NE-BC, Chief Nursing Officer at Fairview Hospital.
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Gilbert joined the hospital’s ad hoc Pain Management Committee, whose members include a pain specialist, an ICU physician who manages chronic pain and several nurses. She introduced healing concepts to the team and educated nursing staff on healing services and tools that can help patients control pain. Gilbert also is available for consultations with the pain management team.
Healing Services and Spiritual Care offers an array of tools for patients who aren’t responding to pain medication, can’t take a lot of medication, want alternatives to medication or are in chronic pain. These include acupressure, massage therapy, Reiki, guided meditation, aroma therapy, breathing exercises, music therapy and guided imagery.
Last year, the Healing Services department held several classes instructing nurses in Reiki, a Japanese touch therapy that is a safe, gentle, noninvasive form of energy-based healing. In February, the department offered a class on guided imagery, explaining how to talk patients through painful procedures or reduce their anxiety and stress. Gilbert will teach upcoming classes on acupressure.
“Oftentimes we only look at pain in one way – as something going on in the body. So we address that issue with medications,” says Gilbert. “But sometimes medications don’t offer relief because pain may be spiritual or emotional. With integrative therapies, we can address the pain on these deeper levels and are sometimes able to help individuals work through issues.”
Gilbert has teamed with nurses throughout Fairview Hospital to help patients. In February, she led a patient through guided imagery to distract him while a nurse put in an IV line. Another patient had difficulty falling asleep because of her pain, despite taking pain medication. Gilbert and a nurse used a combination of Reiki, guided imagery and soothing music, which assisted the patient to sleep.
Offering integrative therapies for pain management has been successful. In 2014, Fairview Hospital’s pain management domain scores hovered between the 10th and 25th percentile. By the third quarter of 2015, those scores had risen to near the 90th percentile.
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“The next step is to be proactive in meeting the needs of certain patient populations,” says Small. For example, Gilbert may target ventilator patients who are going to be extubated, using integrative therapies during removal and immediately afterward to help reduce anxiety. In addition, she plans to team with the critical care unit to adopt a proactive approach to pain, anxiety and sleeplessness.
“Having healing services tools provides nurses an opportunity to think more holistically about the patient’s care,” says Small. “It gives nurses more tools in their toolbox, and the patients can take these tools home when they are discharged and use them for free.” It’s all part of creating a healing environment and a more positive patient experience.
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