Advance Practice Nurses and Pain Management

[bsnanat2]

This question is concerning APRN's who work in/with Pain Management. In Georgia (as I suspect other states) APRN's can write schedule three - five, but not schedule two. Only MD's & DO's can write schedule two in Georgia. I realize that some viable pain drugs are available in these schedules, but the big guns are in schedule two. This being the case, how do APRN's function in a pain management capacity? I would appreciate any information. Thanks.

[NPinWCH]

I don't work in pain management, but due to lack of this specialty in my very rural area see way more of these patients than I would like. Most of the time a referral to pain management gets a patient 1-3 months of appts at the specialist and then they are referred back to me because they are stabilized on a pain regimen. This usually includes some type of schedule 2-3 med.

Obviously, Georgia is much like Ohio where I practice as I cannot write for schedule 2 meds. So, what I do is see the patient, evaluate how they are doing and then go to my collaborating doc and discuss with him/her what I think. Since we have a good working relationship, they will refill the schedule 2, or rarely if needed increase the dose/frequency for the patient. In my note I simply state something like: Consulted with Dr. Collaborator and he agrees that refill of percocet 5/325 as the patient is stable on this medication. My collaborating doc then prints/signs the script and I send the patient on their way.

I suppose in states with restrictions like mine and your APNs in Pain managment do much the same. They assess and plan and then consult with their collaborating doc who then prescribes. I also use this for other meds I cannot prescribe in Ohio, such as ADHD meds and some antidepressants.

[bsnanat2]

Thanks for your reply!

This makes sense. It would be nice for NP's to have more autonomy in this area, but I guess the potential for abuse is too great.

[traumaRUs, MSN, APRN]

IL just got schedule II privileges for APNs - however, we still have to have a collaborating agreement that specifically states what meds we can write for and only for a 30 day time frame.

[bsnanat2]

Trauma,

I'm not sure where Georgia is on this, but IL's policy sounds like a good start.

Thanks for the info.

[nomadcrna, DNP, CRNA, NP]

nevermind

[psychonaut]

We sure can!

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[nomadcrna, DNP, CRNA, NP]

At least that is the first NP/CRNA clinic I've heard about. On the other hand, I've heard about MANY physician pain centers being like that.

I am selective about the chronic pain patients I treat. There are so many drug seekers!