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4. The Team Approach to Pain Management
One of the most important perspectives when working as a team is viewing the child as the expert on their situation and as the most important member of the team. Each patient needs to be viewed as part of a larger system that affects how they perceive and report pain and how they respond to treatment. Children often respond to pain with fear, anticipating the pain before it occurs. This is a legitimate response to a prior experience, and should be taken seriously. Parents and clergy, as well as other care providers, can assist by reassuring the child he has not done anything to cause the pain.
The child’s family is also an important part of the pain team. Parents often feel responsible for their children’s medical conditions and may experience guilt. Families can be encouraged to be active team members by teaching them to observe and report the child’s pain, to play a role in soothing or distracting their child, and by asking them to be present when the child is having a painful procedure.
Health professionals assess, diagnose, and treat the pain and monitor the patient’s response to medications and other interventions. Social workers can help the family to identify and express concerns about the child and the effect that the illness is having on the family, as well as help with community resources available to the family. Others, including psychologists, clergy, and physical or occupational therapists can also play a role on the health care team.
The hospital or institutional system plays a factor in the treatment of pain. The hospital may have policies which affect how children in pain are treated, such as whether parents can be present to calm and soothe the child during traumatic procedures. The physical setting of the hospital may not allow isolation of one child in distress, which increases the distress of other children and families. The community, whether local, national, or global, also plays a role in the presence and treatment of pain. Beliefs about the value of women and children, the relief of pain and suffering, the accessibility of healthcare, and the view of those suffering from HIV are only a few of the factors that affect policy decisions and resource allocation on every level.
There are several important components in effective team functioning. The first is respect for the roles and knowledge of each team member and understanding of how these roles work together. Another important factor in team functioning is clear and specific communication between team members.
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