I have been working with a patient who has a history of chronic back pain. Recently she has had an exacerbation that left her in severe pain that has her searching for relief. Before I became involved, she told me she had gone to various emergency departments and found indifference, attitudes, and a disregard for her as a person. She did not know what to do. A friend of hers told her to go to a teaching hospital as they might know how to treat her better. Her husband looked up various teaching hospitals in the area and they chose one. Finally, the patient was admitted for pain management.
Enter the Nurse Advocate
This is where I became involved and found a whirlwind of things to do to help meet the needs of the patient – mostly trying to get the various doctors who have seen the patient to talk to each other. As her pain became more controlled, she was able to talk and I spent time talking to her, learning about her history and the challenges she has had over the years with a set of complex conditions that included chronic back pain. Working with her, gave me insights into the challenge’s patients with chronic pain face when they have exacerbations.
As we all know the Opioid epidemic has changed how pain management is practiced in this country. It seems it has gone from one end of the pendulum to the other, leaving doctors with their hands tied when managing patients with chronic pain.
Less is better – but is it?
What happens to people who are on high doses of pain medication to control their everyday pain and need additional medication during the exacerbations? Managing pain is a challenge for the healthcare team and is a challenge for the patients living with chronic pain. Professionals who specialize in this area are working on innovative ways to manage patients with out lower levels of pain medication, but we are not there yet.
Here are some things that I learned when working with patients with chronic pain:
- Look at each patient individually.
- Listen and do not prejudge.
- Put yourself in their shoes for a few minutes.
- Treat the patient as you would want to be treated.
- Work with the treatment team to do a thorough examination to rule out any medical problems.
- Take time to talk to the doctors who have been treating the patient – this will give you insights into what they have gone through and where they are in their journey.
- If you can do diagnostic testing at the time of care, try to do that – an admission for a day or two can go a long way in helping the medications work in hopes of getting the paint under control.
As an advocate I have learned that I need to meet my patients where they are – not where I think they should be or where I want them to be.
I hope this post is a reminder of the work you do. It is hard work and sometimes we can become desensitized to the pain and sufferings our patients go through. Kindness and empathy can go a long way in healing. So as the Golden Rule says, Do unto others as you would have them do unto you.
Have a good week. Looking forward to your comments and insights into how we can all do better.