There are three roles in each part of the role-play exercises Role of the PSW, who gathers, records, and reports information Role of the person who is in pain Role of the nurse to whom the PSW reports (ideally the instructor plays this role) the information provided below for that role. After completing Exercise A, the participants playing the In each role-play exercise, the PSW gathers information from the person who is experiencing pusing role of the PSW and the person in pain switch roles and complete Exercise B. The participant playing the nurse, preferably the instructor if available, does so in both exercises . Marking sheets for the instructor are provided on pages 71 and 72 at the end of this workbook The participants playing the roles of the PSW and the person in pain may find that the marking sheets will help them in playing their part. For Role-Play Exercise A, the PSW role starts below and Mr. J's role appears on page 43 Role-Play Exercise A: PSW Role Mr. J is 75 years old. He has prostate cancer and is dying. He lives alone. You visit Mr.J in his home daily to assist him with personal care, remind him to take his medications, and set out a meal Usually he is very happy to see you and he loves to talk. Today he acknowledges your anival but only mutters a response when you greet him. His dinner plate from last night is on the table, and the food was not eaten. When you ask him how he is, he says he did not sleep last night, is in pain, and can hardly move because his left hip is so sore. He says he is tired of being sick. When you suggest a bath he says that there is no way that he can even get to the bathroom. You realize Mr. J's condition has changed and that you need to record your observations of his pain, report to the nurse, and ask the nurse for help to develop a new plan for his care today You remember that you can use the System Framework for PSWS adapted for pain to gather information. You proceed to gather information from Mr. J. Symptom Framework for PSWS adapted for pain When did the pain begin? is this new, or has this happened before? Did it start suddenly or slowly? O Onset P Provoking/Palliating Q Quality R Region/Radiating S Severity T Treatment U Understanding V Values W What else? What makes the pain feel better? Worse? Can you describe the discomfor? How does this symptom affect you? Where are you feeling the pain? How severe is the pain? 0 no symptom and 10-the worst imaginable Small, medium, large Mild, moderate severe What do you think might be helpful? What do you think might be happening? What are your goals for your pain? What else do you want me to know or do For the PSW: Consider your knowledge of this person-what do you see? What do you believe would be helpful? Workbook-Chapter & Supporting Physical Comfort S B A R SITUATION My name is, I need to talk with you about Concern is a Change in person's condition a Ongoing issue Safety Issue Family issue is it a good time to talk now? When? BACKGROUND They are experiencing pain. Relevant information (include observations from PPS) ASSESSMENT Symptom (Record information gathered with the Symptom Framework for PSWS) Onset Provoking/Palliating Person's name Quality Region/Radiating Severity Treatment Understanding Values What else? Other concerns REQUEST/RECOMMENDATION Can you come and see What do you recommend that I do now? What is the plan moving forward?