Pain Management Nursing

Pain Management Nurses attend to those who are in pain whether it is acute, chronic, breakthrough or referred. There are numerous opportunities for Registered Nurses (RN) as well as Advanced Practice Nurses (APN) to utilize both pharmacologic and nonpharmacologic methods to manage the agony of pain.

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Pain Management Nursing

(Pain) "It's whatever the experiencing person says it is, existing whenever and wherever the person says it does." - 1968 definition of pain - Margo McCaffery, RN, MS, FAAN. We have all heard that. However, does pain have to exist for our patients? 

With effective pain management, most pain can be eliminated or at the very least, lessened. By using the best nursing practice and evidence-based medicine, pain can be effectively treated. It is now considered the fifth vital sign and per Medicare and Medicaid guidelines, must be addressed with each patient. Pain management teams are often set up in hospitals to address this issue across the board. Whether it is an infant undergoing a circumcision, an adult trauma patient with multiple fractures, a heroin addict with rhabdomyolysis or an elderly patient with a fractured hip, they all need pain management. There are many routes to alleviating pain utilizing pharmacological and nonpharmacological means. 

Work Environment for RN and APN

  • Bedside nurse for the patient in acute pain using patient-controlled analgesia (PCA)
  • Clinic nurse in a private pain management clinic
  • Perioperative nurse during pain pump procedures
  • Administering pain medications via Intrathecal, IM, IV routes
  • Monitoring patients during conscious sedation
  • Caring for addicted patients who have pain
  • Hospice nurse alleviating pain at end of life
  • Advanced Practice Nurse (Nurse Practitioners {NP}, Clinical Nurse Specialists {CNS}, Certified Registered Nurse Anesthetists {CRNA})
    • CRNA in pain management clinic
    • NP/CRNA Collaborator with physician and fellow APN colleagues to improve acute/chronic pain
    • NP/CRNA Consultant
    • NP Hospitalist
    • Sports medicine NP
    • CNS providing education for LPN and RN colleagues regarding new modalities of pain management

Qualities

  • Empathy for patients who have pain; a natural sense of caring
  • Knowledge regarding pain management techniques both nonpharmacological and pharmacological
  • Ability to be an advocate for the patient; mediator and liaison
  • Problem-solver
  • Fearlessly ask questions to get information
  • Practice effective therapeutic communication; listen effectively
  • Knowledge of both the medical cause of the pain as well as the proposed treatment

Education

  • Graduate from an accredited LPN/LVN or RN nursing program
    • LPN/LVN: Diploma, certificate, associate's degree in practical nursing
    • RN: Associate Degree in Nursing (ADN), BSN, or higher
  • Successfully pass the NCLEX-LPN/LVN or NCLEX-RN examinations
  • Current, unencumbered LPN/LVN or RN license in U.S. state of practice

RNs usually work with pain management patients at the bedside (few states allow LPN/LVNs to administer IV narcotics).

Advanced Practice Nurses (APN) working in pain management have a minimum of a Master of Science in Nursing (MSN) degree and many possess the Doctor of Nursing Practice (DNP) degree.

Certification

The American Society for Pain Management Nursing (ASPMN), in a partnership venture between the American Nurses Credentialing Center (ANCC), offers the Pain Management Certification Examination. The credential awarded is the RN-BC (Registered Nurse-Board Certified).

Eligibility (not all-inclusive)

  • Graduate from an accredited Registered Nurse (RN) nursing program
  • Successfully pass the NCLEX-RN
  • Current, unencumbered RN license in U.S. state of practice
  • Two years full-time RN experience
  • Experience must involve aspects of pain management such as pain assessment and management, patient education, research, etc., at least 2,000 hours in the three years prior to applying to take the examination
  • 30 hours continuing education in the three years prior to sitting for the exam; minimum 15 hours must be related to pain management

Professional Organizations

The American Society for Pain Management Nursing (ASPMN) is an organization devoted to educating nurses regarding pain management. They also have position papers, sponsor a certification examination, and provide ways to advocate for pain management patients.

The American Academy of Pain Medicine (AAPM) is a medical specialty society for pain clinicians, surgeons, nurses, and researchers providing education, advocacy, and research.

The American Association of Moderate Sedation Nurses (AAMSN) membership, "fosters its mission to promote high standards of nursing practice; advance healthcare quality and access for all populations; support the professional development of nurses; and promote the economic and general welfare of nurses".

The American Chronic Pain Association (ACPA). The ACPA's mission is, "to facilitate peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain; to raise awareness among the health care community, policy makers, and the public at large about issues of living with chronic pain".

Salary (2020)

According to salary.com, the average Pain Management Nurse salary is $126,342 with a range between $116,342 and $136,688.

According to indeed.com, the average salary for a Pain Management Nurse is $94,353 per year in the U.S.

Resources

WebMD: Pain Management - Treatment and Care

National Institutes of Health (MedlinePlus): Pain

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traumaRUs

About traumaRUs, MSN, APRN

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14-yr RN experience, ER, ICU, pre-hospital RN, 12+ years experience Nephrology APRN.

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Specializes in Public Health, L&D, NICU.

This is a GREAT article! I wish so many more nurses were like you! So many of us (the pain patients of the world) delay or avoid seeking help because we fear how we will be treated. In many cases, these fears are well founded and based on sad experience. Chronic pain doesn't look like acute pain, but it deserves treatment, too. We shouldn't be punished because we aren't as fixable as the person with the broken leg, or because we have years of coping strategies that allow us to mask it well.

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Specializes in Emergency Nursing.

I am lucky enough to be an LPN who administers IVP narcotics to patients in the ED. When I have a pt who c/o pain (and has a ride/is to be admitted) I always reinforce to the prescriber that if s/he does not write for pain medication our HCAHPS will decline. I am surprised at how effective the phrase "HCAHPS" is!! I'm glad that we all realize our salary/bonuses/annual raises depend on this pt's satisfaction scores!!

Personally, I came from a food service industry and the (A/O) customer is always right.

PS... pain is often considered the 6th VS. (1: temp 2: HR 3: RR 4: B/P 5: O2 6: pain)

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Specializes in Emergency Nursing.

PS- not just pain but when you work in the ED, like I do, discomfort other than mere pain can be further complications.

Let's think about the pt who has a fever and suffers from shivering. The family is up your butt! The pt is up your butt! Both are up every passing RN/LPN/Medic/PST's butt by the door to get a freaking blanket.....

Now, we can reduce or eliminate that need. Please cover the pt's hand's and feet with towels or blankets to trick the hypothalamus into thinking it has reached the proper homeostatis!! I love it!! Its in the new Nursing 2013 article.

November 2013 - Volume 43 - Issue 11 - p 49-51

doi: 10.1097/01.NURSE.0000434315.90818.45

I know that is not cited properly... i'm lazy and not in the mood. But there you go! The article, for those who have a subsciption, can see the layout of the different layers of fever and why covering just the hands and feet will relieve the pt's discomfort! This is the kind of information that makes me glad to be a nurse!

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Specializes in Nephrology, Cardiology, ER, ICU.

Thanks everyone for some thought-provoking comments.

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Specializes in PACU.
[h=1]Overprescribing of Opioids Impacts Patient Safety and Public Health[/h]"More people in the U.S. die from a drug overdose than they do from motor vehicle accidents and more of those deaths are caused by prescription opioids than those attributable to cocaine and heroin combined," said Alexander, associate professor of Epidemiology at the Bloomberg School and co-director of the new Johns Hopkins Center for Drug Safety and Effectiveness.

Overprescribing of opioids impacts patient safety and public health

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Specializes in PACU.
In the scramble to contain an epidemic of opioid misuse and overprescribing, one HMO is taking what a former federal prosecutor is calling a “highly progressive approach” to address the problem.

http://www.painmedicinenews.com/ViewArticle.aspx?d=Policy+&+Management&d_id=83&i=October+2011&i_id=770&a_id=19212

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