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For the best possible experience using our website we recommend you upgrade to a newer version or another browser. The chief nursing officer for England has unveiled a new four-year plan for nurses, midwives and care workers focussed on how the profession can drive changes to services and help reduce unwarranted variation in health and care provision. There is a pressing need to enable registered nurses to reach their full potential at higher-than-basic-registration level in clinical practice. This week feels like an opportunity, a chance for nurse leaders to take control of some of the problems facing the profession and plot a course through some challenging times. Choose your subscription package Individual subscription Student subscription Corporate subscription Individual subscription Our subscription package is aimed at qualified nurses to help support CPD and improve the quality and delivery of care given to patients.Select Student subscription This subscription package is aimed at student nurses, offering advice and insight about how to handle every aspect of their training.
Bennett M (2001) The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. This would fulfil two requirements: personal professional advancement and workplace clinical need.

Select Organisational access Our package is designed for organisations who want to purchase access and benefit from a group saving. The nerves transmit the signals to the spinal cord, and then to the brain where the signals are interpreted as pain, which is often described as aching or throbbing.Neuropathic painThis is caused by damage to or dysfunction of the nervous system, and is a major contributor to chronic pain.
This article describes the process of pain transmission and how this relates to pain management. However, there is evidence that this is often underestimated or mismanaged by health professionals (Herr, 2011; Hirsh et al, 2010). In the presence of high levels of bacteria, white blood cells release enzymes and free radicals, which cause tissue damage.Pain may result from direct stimulation of peripheral pain receptors, tissue damage and from the swelling that occurs as part of the inflammatory response. Any sudden onset of pain, change in type of pain or increase in intensity of pain in any wound type is therefore a significant indicator for infection (Cutting et al, 2005).
1), S3-S13.Herr K (2005) Pain assessment in the older adult with verbal communication skills.

Worrying about the reason for the pain is common and, when it is not effectively managed, as may happen in chronic wounds, patients can become depressed, have poor concentration, poor sleep quality and may fear movement, which in turn leads to functional limitations and increasing disability (Mason, 2009).Prior experiences of pain will also affect patients. They ranked infected wounds, pressure ulcers, cuts and abrasions, paediatric wounds, cavity and fungating wounds as less painful wounds (adapted from EWMA, 2002).Management strategiesPharmacologicalThe principles of wound pain management apply to any painful wound. Unfortunately, not all wound pain responds to systemic analgesics and studies have revealed that there is often a stigma attached to the use of pain-relieving medication.
The direct benefit of pain relief on wound healing rates requires more detailed research, but simply showing respect, empathy and care to our patients is the essence of good healthcare.

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