FONAMENTS PER A LA REALITZACIÓ DELS NOSTRES TREBALLS DE RECERCA

The factors that the participants perceived to improve pain management were discussed, along with the need for professional development to provide continuous learning (education) and updating of nurses’ knowledge. This education includes coursework, cultural training or orientation, self-learning and professional development opportunities such as seminars and lectures. The intervention measures for the correction of deficiencies in pain management were mostly hinged in education. However, the time for nurses to advance in their education is limited due to an overload of work. The solution put forward was for hospitals to assume responsibility by providing in-service training for nurses at their workplaces.

First thing is education. When the education department in any hospital is active and they will go into the hospital and find what area that nurses need. They know that the nurses have a poor knowledge in the area of pain assessment and pain management. They have the ability to offer those courses to us as nurses, but unfortunately they are not. Yeah, education, that will help us, which is not there.

Education was identified as the key solution. Participant A2 suggested that health facilities should take up the initiative once it is identified that their nurses are not efficient in pain management. The participant portrayed a willingness to learn and be active in such programmes, but was disappointed that health facilities are reluctant to address their staff needs to upgrade their knowledge.

One nurse recalled that during their college years, pain management was sparsely covered, hence the need to advance in the topic despite the experience they have gained:

I remember now my college days; this pain management is not a vast topic. We are getting little knowledge already, but with experience we will get more knowledge. But I think any classes or lectures about pain management and assessment of pain—that will improve all staff knowledge about pain (participant K).

Another nurse felt that inadequacies in the delivery of pain management could be solved through nurses advancing their level of education: ‘The university…must upgrade their degree to bachelor. The nursing office must provide courses about pain management, continuing nursing education. All those factors would help’ (participant Z).

Participant Z proposed that universities must upgrade the qualification they offer from a diploma in nursing to a Bachelor’s degree. The respondent also highlighted the role of pain management courses, which help to improve nurses’ knowledge regarding pain and its management. Continuing education among practicing nurses was also identified as a solution to poor pain management in the health facility. Continuing education is essential because it not only keeps the nurses up-to-date with new methodologies of pain assessment, but it also

provides a forum where nurses can share their experiences with the subject and how some situations can be improved.

This is also good thing. This continuing education. I think—I don’t know if they give more important about pain management, but in my previous hospital this is one of the continuous education that we’re taking—this pain management (participant Q).

This respondent had confidence in continuing education as an effective solution to the

associated knowledge deficiencies that may hinder effective pain management. In addition of cultural competence courses, coursework was suggested on pain management. This was particularly true for non-Saudi or foreign nursing staff, who need training during orientation and upon entry to the workforce to enhance their awareness of Saudi culture. The concern posed by foreign nurses regarding cultural education may be attributed to the frustration and challenges they deal with on a daily basis because they cannot effectively communicate with patients:

It really helps if you go deep especially how to deal with these individuals you don’t really know, you don’t understand what they’re—his beliefs, his cultures, his

knowledge…Because me in my country, I know my culture so I know how to deal with the patient. I know how to deal with the patients but here, [but] it’s a new culture, so very different. You don’t know how to give the right words, you don’t know how to say this, or he might be offended or something. You might say something to him that is not really applicable with his beliefs so I think they must give that. In my own opinion, I’m not really well-versed about these cultures of the Saudis, so when I come here, I really have these difficulties, really. Because of—how will you say this

properly—because they have different perspective, different religion, different from my culture. It’s a very big difference. So when I come here I really have those problems with me, how to adjust. So it’s very hard.

Participant G was frustrated at not being able to deliver services to patients in Saudi Arabia due to an inability to communicate with the patients and a lack of understanding of their religion, level of education and cultural upbringing. Participant G perceived these challenges as limiting his or her responsibility and roles as a nurse, hence suggesting mandatory cultural induction and education for foreign nurses.

This was noted by participant M, who discussed the multicultural nature of the area and stated that cultural diversity training or orientation would be helpful:

They should have a preview of what they are going to have during their stay in the country. Because we already live in a multi-cultural community. It’s not just like, oh we are in our country, so we have only people from my nationality or we are in Saudi Arabia oh we have Saudis, no. We are all, [our] nationalities are all mixed.