Research by JU’s Dr. Cheryl Bergman: Emergency Department environment can create barriers to treating patient pain

By Phillip Milano

A trip to the emergency department can often be a pain – literally. After all, one of the main reasons people seek care in the ED is that they hurt.

But too often, their misery is not eased quickly enough, says Dr. Cheryl Bergman, Director of Undergraduate Programs for Jacksonville University’s School of Nursing.

She chose to study the process used by ED nurses to manage adult patients’ pain, and the results of her research have been published in the Journal of Emergency Nursing and presented nationally at an Emergency Nurses Association conference.

“Pain is what is important to the patient,” she said. “The patient wants to know the causes and have actions taken to alleviate it as quickly as possible.  A more satisfied patient will work with you more collaboratively and can concentrate on your questions instead of on the pain. There’s also a human dignity aspect to this, having respect for people. To not address pain is not a holistic approach to nursing care.”

Analyzing her interviews with nurses from a variety of Northeast Florida emergency departments and the local ENA, Bergman discovered that the emergency department environment itself is the main barrier to patients receiving adequate and timely pain treatment, for three reasons: 

• Nurses feel overwhelmed because of overcrowded emergency rooms, and treating pain becomes secondary;
• A perception of a lack of teamwork among nurses, physicians and administrators; and
• Frustrations over patient misuse of the emergency room for non-emergencies, as well as unrealistic patient expectations.

The solution? Change the environment.

“We need a culture in which pain treatment is a priority,” Bergman said. “We need a team approach between the nurse and physician. This team needs to be focused not only on treating the disease or condition but on the pain being experienced by the patient. We need to educate the public on the proper use of the ED, so the overcrowding is eased.”

Bergman is proud of her research being published, which arose from her dissertation work in 2009 for her Ph.D. in Nursing from Miami Shores’ Barry University.

“It was really important to me to share these perceptions and research findings with others in the nursing specialty. If you want to reach ED nurses, The Journal of Emergency Nursing is it. I feel proud that the journal chose to publish my work. ”

Now she’s pursuing efforts to take what she’s learned from this study and use it in further research endeavors to promote what she called a “gold standard model of care.” This model might, among other things, involve having trained volunteer liaisons help nurses address patients’ physical needs, whether it’s for a drink, a blanket or just some added comfort.

“I want to continue to explore ways to make a difference for patients experiencing pain in the ED and for the nurses and healthcare providers caring for them. I feel very passionate about improving this aspect of patient care in the emergency department setting,” she said. “That’s what research is all about.” 

Bergman’s article is “Emergency Nurses’ Perceived Barriers to Demonstrating Caring When Managing Adult Patients’ Pain,” Journal of Emergency Nursing, Volume 38, Issue 3, Pages 218-225, May 2012.