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TEDx Talks
Published: 2017-09-06
Source: https://www.youtube.com/watch?v=3hRS5QBackU
uhhuh some of them then he said my name is Meredith raising and I'm here to talk about something that I'm very passionate about I love my job I'm passion about it I've learned a lot about talking to people hoping he's serving society's center %HESITATION fear of the unknown and managing pain of managing so gain a little bit of a different perspective I think I'm very brutally
honest with my patients sometimes so much so that it put some off initially and so they how to get the program get what I'm saying and their head around it so I just want to share a little bit about what I've learned is you so it's going to start off by saying that pain does not have to control you there are millions of people every single
day dealing with pain and some aspect in some form in some regard physical pain mental pain a motional pain and my hair and my world in the hospital greasy surgical primarily what we're talking people come in for surgery to have an operation and hers we had some we sent him home right up the plan anyhow but it's not just the pain itself that we struggle with
it's the fear of the unknown the anxiety that surrounding this pain that's the real Sharmell that's what we have to overcoming contain with especially people they've never had surgery before maybe they never and that's so problematic they don't know how to cross they don't know what to expect part of the keys for the whole key with this solution is removing barriers because pain that is unavoidable
but it does not have to control you so let him examine every week I stand up and I talked to eighteen patients and their family members and their caregivers and I try as hard as I can sometimes it's harder than other sometimes it's a little harder than others I had to try and convince them that what they're going through is okay and that's not we kill
him we're all going to get your by the we take this time a whole surgical crafts so we talk about Korea post top once a pack in there overnight back what tests they have to for him to get ready for some Jerry when the members are on the team that are going to be taking Karen school Fairview part %HESITATION both after in one patient so I'm
done about seventy and he's talked roll so I can have it down here pretty good sign far as the amount of time on each time we have about six five minutes to get my point across to make sure all on the same page never was feeling really good and when I walk out those or so all the topics that we talk the number one and singular
talk that devotes the most time and attention it's a pain management when you see a photograph of your own question mark up there in a little slimmer that's and I don't pain management it's almost a lot of questions I get people don't ask things like what exactly happened soon surgery my doctor didn't explain it well or I really want to have my wife or husband spent
and with me not allow or Hey what's the password in the freeway that he might and I get this question but usually the questions are about pay people ask me is it going to hurt act surgery I had I had a I told my doctor that I don't want to feel any pain after surgery I don't want it to her I told him telling you who
else do I need to tell plus they actually how bad does joint replacement get all of these questions all the time sometimes I laugh and the whole class list together and I answer the same way yes this is going to hurt it is going to be uncomfortable you are going to get through it will you be in agony now are you going to suffer absolutely not
is your entire medical team going to do everything they can to take care of you and major pain so all conservative way yeah definitely and are you gonna get through it absolutely and here's how we're going to set realistic expectations that's step one any time you're talking about pain again no matter what kind of pain you are experiencing if you're having surgery if you're going through
a divorce just got fired from your job it is going to hurt it is going to be painful it's not pretty enough I mean when is it ever but if you can accept that around your head around I promise you you're going to be so much better off it is when I say that I see people's faces start to soften and economists aha moment where they
go okay well yeah at least he was honest it's going to hurt a little benefit is going to be okay two days later on the home and I'll get beyond it so setting realistic expectations is the number one key and overcoming this herbal he paid me and okay when you think about realistic expectations whenever you send them to high or they're not based in reality they're
often and Matt did you know that people say anyhow it's pretty common that ultimate expectations are the number one reason for divorce I believe it makes sense under my expectations leads to dissolution of processes they lied to people stepping Hurtado very nice Spencer general because I didn't either expecting I I met expectations I can kill your sex life move chairman and I am in my world
unmet expectations we the poor patient out patients are decided they're discouraged and their providers in themselves and their recovery so we sent those realistic expect from the beginning outline what's gonna when and how real it's gonna be some night and day difference so once we set those expectations the next step in the process is trying her best to reconcile perception with reality so we have this
little scale here we use us in any hospital if you've ever been in the hospital or the doctor's office and I can hear you probably see so this is a skill you select patients measuring and now skills pretty basic when you look at okay it's simple zero is no pain tad is the worst pain possible it sends a right there by the little frowning face with
tears coming down worst pain possible so this does not mean the worst pain compared to last but like an hour ago when we asked you or that pain compared to yesterday when you first heard yourself for for sustained an injury this is the worst pain possible that you could ever experience for an end to war and you're anti so when we put it in that perspective
and explain it to patients in a way they can understand it's another aha moment suddenly ten out of ten seems a little silly right because it's a hang nail so it's probably not the worst pain in terms of an expert it's in your lifetime if it is good for you as I will ever really know his fly so when we married that perception with reality our
outcomes are better when you were able to perceive what is happening to you and that's where the scale and you can put it in the context you actually require less energy to overcome what you're going it becomes less traumatic less of a fight less of a struggle when you can perceive bad and understand it and see how it fits with the expectation you have going into
whatever your ex here's where it gets a little tricky the expectations have been inside our perception is based in reality hi the next step in the process is treatment okay because everybody's pain is subjective that's a really huge take away with us everybody's going to experience things I frankly here hang now might be the worst thing you've ever heard right but this guy's broken ankle is
way worse okay or he thinks you're hails really bad and his ankles on everybody's perception is going to be a little better for the problem with our healthcare today is that pain is subjective and treatment is not treatment is objective if this then that if your pain is a six here's what you're going to get so that's where people in patients have to take ownership and
what they're experiencing going through so that way their treatments is actually appropriate for what they're experiencing so in my case a lot of the treatment is medication related and %HESITATION but it also is things like I'm a size or touch therapy somehow radio nutritional coaching or weight loss coaching for arthritis %HESITATION distraction techniques relaxation sort of thing but if you have been abreast of the news
you know what's going on in the world today it's pretty easy to think about how the majority of people associate pain with narcotic medication I'm in pain I want drugs that's the culture that we have growing until no one explained why how this came about and what we're doing to try and change it so and nineteen ninety one something happen that started us on this upward
trend of mobile use so this graph illustrates the amount of opioid prescriptions that we're filled a commercial pharmacies between nineteen ninety one and two thousand thirteen anybody have any guesses what happened in nineteen ninety one in the medical community that started this upward trend anybody now now it yeah yeah I've got somebody and I as an idea he has a fan vital sign a here ass
crack so in nineteen ninety one the American pain society came outside and the response of patients have pain in the hospital in surgery we want to do something that but they're getting really so we're going to declare that paying should be of faith vital signs if we are sharing vital signs are we're talking about things like heart rate blood pressure any minor restorations you take per
minute see these are things that keep you alive so when pain is as vital signs interviews all of a sudden providers on every single encounter are assessing as for pain and asking what is your level of pain on a scale from zero to ten so when you have a situation like that and you have a patient population if they're lacking education on these experts patients and
their purse action of reality on this scale of zero to ten of course they're going to say happened ten out of ten now one of those really good drugs Hey now is killing me and I really are for nine hours and I could use a lot it so that's how this process started so without proper education when our patient awareness of the risks side effects occasions
they use in these over your prescriptions started skyrocket between nineteen ninety one and two thousand thirteen these prescriptions a percentage rate of use when I have a hundred and seventy two percent a hundred and seventy two percent increase and the amount of Oakley prescription Spain fella pharmacies and has high so this is the battle that we are now fighting what's happening is healthcare providers are now
hi you to back it'll go wait wait wait wait wait wait maybe he wasn't such we need to assess pain maybe not so rigidly but we need to look at it so we've started to do non farm managing a all these other things I mentioned Hymes nerves can I'm a sort of light therapy for my new and upcoming that's not so the medical community is spending
millions of research trying to figure out ways that we can manage pain without causing all of this high I hope you will you send Ophelia epidemic an addiction so I don't know about you but I find it strangely ironic and that now return to revert back payment is that we used before all this started so I wound probably wasn't such so that's a lot of what
we're doing in my job I am find alternatives %HESITATION they get us out of this Jewish and we've created I don't know you can see this very well but I should probably point Nader is in millions so that number in two thousand thirteen is to million so part of problem so what we have found in our program we could bring us all together is that through
this education piece through helping patients understand these expect Asians and set from the beginning and let them know what their in store when we do that all of them understand the scale and go around their purse some random neighborhood of reality and that is five treatment that's come serve it at this point still managing their pain keeping them for more after surgery we take all those
things come we've increased our satisfy scores meaning that amount of patience that say there sat with their pain management surgery it was exactly what they expected and I got what they're looking for I'm doing all of that we increase manage yes I forty two to ninety per which is incredible ninety percent of patients after surgery say yeah you know I I knew all this ahead of
time it's exactly what I was a so this knowledge not only is great for the satisfy but more important to me especially these individuals are grateful they come to me and they come to their provider say thank you thank you for giving us this knowledge that help bridge that gap between the unknown and reality it took away my fear and it took away my anxiety so
when we apply those principles across the sky HM because as I talk about pain in a hospital because that's my specialty like I said in the beginning pain is not limited to the house we're talking about pain that your experience every day %HESITATION divorce loss of a loved one and I'm getting fired from a job that or losing a promotion that you've been working so hard
for for the last ten years it's all painful we all experienced pain on some different Bible but if we set our expectations reasonable level we perceive what's happening to us in a realistic way I'm lucky enough to have somebody there to kind of walk us through it and we have better outcomes I pain that is you know no different whoever you're talking tale I mean I'd
