The remit of an Acute Pain Service is to relieve post-operative pain after surgery and trauma (Royal College of Surgeons, 1990).
Post-operative nausea and vomiting (PONV) is one of surgery’s most distressing outcomes and can incur major physical and psychological suffering. Unfortunately, pharmaceutical management of PONV is not always successful, leaving patients distressed and health-care staff struggling to manage this event.
Poole Hospital NHS Foundation Trust have introduced an innovative way to alleviate PONV; with acupuncture.
Here Lead Nurse of the Acute Pain Service Lucy Bufton tells us more about their initiative…
“We introduced acupuncture to alleviate PONV as part of Acute Pain Nurse Specialist Polly May’s Masters Degree course. It was undertaken as a ‘skills’ section that was self directed with an opportunity for the development of nurse led services within the local Trust, under the auspices of the local university. It has been a great opportunity for experienced nurses to develop and lead a new innovation during financially constrained times.
The service was initially developed to aid surgical patients by aiming to reduce the post-operative problems that can cause patient distress and prevent timely discharges. We have now expanded within the Trust to include a selection of patients struggling with chemotherapy induced nausea. We trialled the service and then embed it on a Day Case Unit, where patients would be expected to have a quick turnaround after planned ambulatory surgery and it has proven to be very successful over the past five years.
For this service to be a success, communication plays a vital part; as does the position of an advanced or specialised practitioner with excellent skills. This can be a very powerful stance to have in ensuring people gain confidence in the proposed treatment.
Whilst P6 acupuncture for PONV is most commonly used within a hospital setting, it can also be delivered at home, by trained practitioners for select patient groups. In some instances, it is also possible to continue with acupuncture therapy once a patient has been discharged from a healthcare setting. The patient can be given instructions on how to continue to stimulate the acupuncture point at home for up to 24 hours and will receive instructions on how to discontinue. We are always there for the patients to contact us for further advice.
There is lots of research around P6 acupuncture and although the methodologies and client groups sampled may vary and results differ. The underlying ethos is that it works especially well in surgical patients; as proved in many published trials. There are, however, very few hospitals in the UK who currently offer this service; to date only one other is known in the South of England. The reason for this may be that not many nursing groups have taken up the mantle of advancing their practice with this skill; traditionally acupuncture per se is a skill often provided by doctors or anaesthetists who have a special interest and training.
A common preconception of acupuncture is that it is ‘all in the mind’ but we have found that patients who come to surgery with hope, optimism and open mindedness are often those who benefit most from this complimentary approach. A practitioner who is confident in their knowledge and ability can easily overcome scepticism, either from patients or other healthcare staff around the efficacy of the treatment.”