1.3 Outline agreed ways of working that relate to managing pain and discomfort

This guide will help you answer 1.3 Outline agreed ways of working that relate to managing pain and discomfort.

Managing pain and discomfort in health and social care settings involves following specific agreed ways of working. These are the policies, procedures, and practices set by the organisation, which ensure staff provide safe, effective, and consistent care. Understanding these agreed ways of working is essential for delivering quality care and maintaining the dignity and comfort of individuals.

Agreed ways of working may include:

• Organisational policies and procedures
• Guidance and instructions in care plans
• Relevant training and competency frameworks
• Adherence to legislation and standards, such as the Health and Social Care Act 2008 or the NICE (National Institute for Health and Care Excellence) guidelines

Staff must work in partnership with the organisation, individuals in care, their families, and other professionals to manage pain and discomfort appropriately.

Understanding Pain and Discomfort

Pain is a physical or emotional experience that signals the body is injured or unwell. Discomfort may involve less severe experiences, such as restlessness, irritation, or unease, which could affect an individual’s overall quality of life. Both aspects are subjective, meaning each individual may experience or express them differently.

Pain can be:

• Acute – short-term and sudden, typically following an injury or surgery.
• Chronic – long-lasting, such as pain associated with arthritis or other long-term conditions.
• Neuropathic – caused by damage to the nerve system.
• Somatic – originating from skin, muscles, or bones.

By identifying and understanding the type of pain or discomfort, you can help to determine the most suitable intervention based on agreed ways of working.

Person-Centred Approaches

Person-centred care is a foundation for managing pain and discomfort. This approach respects the individual’s rights, preferences, and personal experiences. Agreed ways of working should focus on considering the needs and wishes of the individual.

Key practices include:

• Discussing and agreeing on pain management strategies with the individual.
• Involving the person in making decisions about their care.
• Ensuring care plans outline specific methods for addressing pain and discomfort.
• Respecting cultural, religious, or personal beliefs that may affect how the person perceives or manages pain.

Effective Communication

Good communication is vital when managing pain. Staff need to listen to the individual, recognise non-verbal cues, and document their findings in line with organisational procedures.

Agreed ways of working related to communication may include:

• Using pain assessment tools to establish the severity of pain.
• Encouraging the individual to express how they feel.
• Observing behaviours, such as grimacing, restlessness, or withdrawal, which might indicate discomfort.
• Sharing information with colleagues and other professionals to provide coordinated care.

Pain Assessment Tools

Pain assessment tools provide a structured way to measure and understand the severity of pain. Using such tools ensures consistency and accuracy, which aligns with agreed ways of working. Options vary depending on the individual’s age, communication abilities, and condition.

Examples include:

• Numeric Rating Scale (NRS): The person rates their pain on a scale from 0 (no pain) to 10 (worst imaginable pain).
• Wong-Baker Faces Pain Scale: Individuals choose a face that best describes their level of pain. This is often used for children or those with limited communication skills.
• Abbey Pain Scale: Used for individuals with dementia who may not be able to verbalise their pain.

Documenting the results and following the processes outlined in policies are vital for capturing a full picture of the individual’s needs.

Following Care Plans

Care plans are documents agreed with the individual, family (if appropriate), and health professionals. They detail the strategies for managing pain and discomfort. Staff are required to refer to these plans to ensure interventions align with preferences and organisational procedures.

Care plans may include:

• Prescribed pain relief or medication.
• Physical aids, such as cushions or supportive seating.
• Therapies, including massage, physiotherapy, or aromatherapy.
• Monitoring routines, such as watching for worsening symptoms.

Reviewing care plans regularly ensures they remain relevant to the individual’s current condition.

Safe Use of Medication

Medication often forms part of pain management. Organisations must have clear medication policies that staff are required to follow. Guidance includes correct storage, administration, and recording procedures.

Agreed ways of working in relation to medication might include:

• Only giving medication that is properly prescribed for the person.
• Following dosage instructions carefully.
• Recording medication given in a MAR (Medication Administration Record) chart.
• Reporting any side effects, adverse reactions, or concerns to the relevant person, such as a line manager or GP.

Non-Medical Interventions

Non-medical approaches can complement or replace medication, depending on the agreed ways of working and the individual’s preferences. These methods aim to relieve pain naturally or address discomfort caused by emotional or environmental factors.

Examples include:

• Heat or cold therapy: Using hot water bottles or cold packs to soothe injuries or inflammation.
• Relaxation techniques: Encouraging deep breathing or mindfulness to reduce stress and tension.
• Physical activity: Gentle exercise, like stretching or walking, to promote circulation and reduce stiffness.
• Environmental adjustments: Removing noise, adjusting lighting, or ensuring the individual’s surroundings are calming and supportive.

Monitoring and Reviewing

Pain and discomfort can change over time. Regular monitoring and reviewing of care are part of the organisation’s agreed ways of working. Recording changes helps ensure that the individual receives continuous support.

Monitoring may involve:

• Observing the person’s physical and emotional state.
• Asking the individual regularly about their pain levels.
• Checking the effectiveness of interventions, such as medications.

When reviews identify that pain management is no longer effective, it may be necessary to involve other healthcare professionals for advice or alternative treatments.

Training and Competence

Staff must be trained and competent in pain management techniques. Agreed ways of working will outline expected levels of knowledge and skills. Training may cover:

• Understanding pain assessment tools.
• Safe handling and administration of medications.
• Recognising signs and symptoms of pain and discomfort.

Ongoing supervision and opportunities to refresh knowledge help workers maintain competence and comply with organisational standards.

Safeguarding and Consent

Ethical practices, including safeguarding and obtaining consent, are essential in managing pain and discomfort. Agreed ways of working must prioritise the individual’s rights and safety.

Safeguarding involves:

• Protecting individuals from harm, neglect, or inappropriate treatment.
• Reporting concerns about an individual’s pain or discomfort.
• Preventing the overuse or misuse of medication.

Consent means making sure the person agrees to treatments or interventions. This must be informed, meaning the person fully understands the risks and benefits.

Legislation and Regulations

Law is a key driver of agreed ways of working. Several pieces of legislation and guidance play a role in managing pain and discomfort, including:

• The Care Act 2014: Focuses on the well-being of individuals and their right to personalised care.
• The Health and Social Care Act 2008 (Regulated Activities): Ensures care providers meet certain fundamental standards.
• NICE Guidelines: Provide evidence-based recommendations for managing pain.
• The Mental Capacity Act 2005: Governs how decisions are made for individuals who may lack the capacity to make choices about their care.

Good practice involves aligning day-to-day activities with these legal expectations.

Collaboration with Professionals

Agreed ways of working often include consulting with health professionals, such as doctors, nurses, or physiotherapists. They can provide advice, assess the individual’s condition, or prescribe new treatments.

Care workers can contribute by:

• Sharing observations from their daily interactions with the person.
• Following instructions given by professionals.
• Providing feedback on the effectiveness of treatments.

This ensures a joined-up approach that benefits the individual.

Promoting Comfort and Dignity

While managing pain is important, promoting overall comfort is equally critical. Simple measures, such as adjusting the person’s positioning, offering a warm drink, or providing emotional reassurance, can go a long way.

Organisational procedures may include guidance on:

• Maintaining hygiene and cleanliness.
• Offering suitable clothing or bedding for comfort.
• Being empathetic and respectful to help reduce stress and anxiety.

Final Thoughts

Managing pain and discomfort using agreed ways of working ensures care is safe, effective, and respectful. Strategies involve communication, person-centred planning, adherence to care plans, and the use of appropriate tools and training. By working consistently and following organisational guidelines, care workers play a vital role in enhancing the comfort and dignity of those they support.