Cicely on Assessing Pain

The concept of total pain

The pain is real

Importance of assessment

Importance of assessment

The doctor comes in, listens we hope, writes something down and goes away and then comes back, we hope, tomorrow to see what's happened. He's not there all the time, so he doesn't see the switch between somebody sitting up in bed anxious, who is the keeper of the keys, when are they going to open that drug cupboard and give me something for my pain, and the switch then to probably having to have a rather large dose of something, lying back drowsy or even stuperized with the family sitting dolefully beside them. That was all too often what one had seen with cancer pain in the general hospitals where I had worked. What we were aiming at as we started to work together in St. Joseph's, was a patient who was alert and themselves and free of pain. For the great majority of patients that isn't that difficult with drugs that are available to anybody in a method that is simple. But it does include the very important careful analysis and assessment at the beginning. One long interview and careful examination can carry an awful lot of shorter ones.

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