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Non-medical pain relief 'can benefit'.

NURSING LEADERS spoke about new approaches to pain management without medication and finding your leadership potential, at NZNO's Nurse Managers' New Zealand regional forum in Palmerston North in March.

MidCentral Health's acute pain service nurse practitioner Judy Leader spoke about the latest research on pain. Commenting on the presentation, NZNO professional nursing adviser Wendy Blair said it suggested that pain was much less rooted in physical causes than previously thought, and can be the body's "over-reaction" to perceived danger. "Research into pain tell us its concept is quite different than we have been taught," Blair said. "Now research supports that pain is normal, and can be caused by the brain perceiving danger, not pain sensors."

While still physiological, it was messaging in the brain, rather than nerves, which were creating a sense of pain. "If something feels dangerous, the brain infers pain," Blair said. "People develop chronic pain due to an over-reaction of the body to danger. That doesn't mean the person can control it, but they can end up with worse or chronic pain."

The implications for pain management were significant, Blair said. "We should be looking at how we can distract the brain from thinking there is pain, rather than using pharmaceuticals, which simply block nerve receptors and are not effective in those cases."

Blair said the gate control theory was "well and truly out the door". The gate control theory of pain, developed in the 1960s, suggested pain could be controlled by activating certain nerves to interrupt pain signals. A more contemporary response might be meditation, being more active, sleeping well, eating better and working on the pain triggers, Blair said.

Another point made by Leader was the value of communication, Blair said. "Understanding why we hurt, makes us hurt less."

Nurses had known for a long time that good pain relief immediately after an event like surgery reduced the likelihood of chronic pain, as the brain was not triggered.

Blair said it was fascinating and relevant for nurses, as some pain medication had serious side effects.

Nurses should be encouraged to "think outside the square," Blair said. "It's getting away from the medical model and looking after people more holistically."

Nurses and leadership

Whanganui District Health Board associate director of nursing Maree Sheard then drew on her years in the New Zealand Defence force to talk about trusting others' view of your potential.

Commenting on the presentation, Blair said it suggested people were often not very good at finding their leadership skills. But in the army, people were helped to do so. "They look out and identify potential leaders and support them, so you end up being a leader, even if you didn't think you could."

Nurses then discussed how to transfer this approach into a health environment, where nursing leadership needed strengthening. They also talked about the depletion of nurse leadership across many district health boards.

Caption: Judy Leader

Caption: Maree Sheard

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Title Annotation:section & college news
Publication:Kai Tiaki: Nursing New Zealand
Date:Apr 1, 2019
Words:487
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