OASIS Alert

You can have a positive impact on your patients' pain outcomes if you use the Preserve-Accommodate-Repattern technique to formulate your plan of care, says Mary Curry Narayan, MSN, RN, HHCNS-BC, CTN, COS-C, home health clinical nurse specialist from Vienna, Va. To do so:

• Preserve the beneficial. Try to find out what helps the patient's pain. There may be practices that you don't use, but that have a body of evidence to suggest they are helpful, such as acupuncture. Encourage the patient to continue with these practices.
• Accommodate the neutral. Facilitate neutral practices such as herbal supplements. Research these approaches and let the patient know if they are contraindicated, but if not, make allowances for them.
• Re-pattern the harmful with LEARN. When you come upon a harmful practice, such as waiting until the pain is unbearable to take medication, use this technique to arrive at a solution:» » »

Listen to the patient's perspective. "I don't want to appear weak."

Explain from your medical knowledge. "Studies show that you actually take less pain medication when you take it regularly."

Acknowledge differences and similarities. "We both want you to live the best life you can."

Recommend a plan. Often, asking the patient what might help allows you to come up with a mutually agreeable solution. "Could you tell my family what you just told me so they don't think I'm weak?"

Negotiate a mutually agreeable plan.