Any nurse knows that taking care of patients' needs is a full-time job. But in one respect, it's only half the job.

Complementary to patients' needs are their desires and goals. That is where Dorothy Armens excels as a staff nurse, preceptor and educator in an orthopedic surgery unit. She's a natural patient advocate, spending time and listening to patients and their families, helping them articulate not just what they need but what they want, and making it all a reality.

Such caring figures heavily in patient satisfaction as does pain management, which is Armens' particular passion.

"Communication with the patient and their family is the key," Armens said.

She characterized good patient advocacy as asking questions, listening to answers and using sharp assessment skills.

"Working with orthopedic patients is uplifting because we can really help them to have a better life after their surgery and rehabilitation process," Armens said. "We see them actually walk out of the hospital [after surgery]."

Getting to that step in the shortest time possible requires smart pain management, which Armens has studied at length. In the interest of patient satisfaction as well as their well-being, she's written about it in scholarly journals and made presentations to the orthopedic staff, including physicians.

"We all need to be on the same wavelength as far as pain management," Armens said.

Although they are orthopedic patients, the main diagnosis often is not the only diagnosis. "We have all kinds of patients with co-morbidities," Armens said.

Planning for discharge begins soon after patients are admitted, she said.

Education masked as conversations center on respiration, circulation and things they'll need to know when they go home.

The best indicator of pain is what patients themselves report, Armens said. Ironically, they are the ones who, despite hurting, often need the most persuading to manage pain.

"We need to do a lot of teaching as far as making them realize that pain management is an important aspect of their rehab process," Armens said.

"Sometimes they don't realize that taking more pain medication is going to help them to be able to do the things they need to do at physical therapy and to do their exercises and deep breathing to prevent complications."

She said addiction is their biggest fear. "Especially in the Midwest, I think patients tend to be a little stoic and think they should just bear it," Armens said. "You have to educate them that if they have their pain under control, they can get better sooner."