Pain management has taken center stage as a hot topic in medicine recently. With prescribing of opioids at an all time high, we’ve seen an increase in deaths related to overdose as well as a spike in the number of patients addicted to these medications. As nurse practitioners, we struggle with the prescribing of pain medications as we treat our patients. Pain is real, and part of our responsibility as healthcare providers is to alleviate it. On the other hand, we must do so in a manner that mitigates the negative side effects and consequences of providing these drugs.
On a larger scale, as nurse practitioners, we face pressure from government entities when is comes to treating pain. The Centers for Medicare and Medicaid Services (CMS) is moving increasingly towards reimbursing healthcare providers based on patient satisfaction. Patients with untreated pain are generally unsatisfied with their care, a reality that can hit providers’ pocketbooks. Tension arises, however, as other arms of government carefully monitor prescribing of medications like opioids, penalizing providers who over prescribe. This disconnect makes working with chronic pain patients frustrating.
Dr. Tracy Jackson, assistant professor of anesthesiology in the division of pain medicine at Vanderbilt University, recently gave an exceptional TED talk on the matter. Rather than complaining about governments overstepping boundaries in dictating patient care, or focusing on the misperception among many providers that chronic pain patients are ‘drug seekers’, Dr. Jackson takes a different approach. She briefly outlines the pathology of pain and describes a new approach to treatment. Even if you don’t work with chronic pain patients as a nurse practitioner, her words give valuable information relating to treatment of all kinds of pain, and her approach to practice is to be commended.
Here’s a peek at Dr. Jackson’s TED talk.
For me, one of the biggest takeaways from the talk is that pain is somewhat of a learned experience. Based on differences in physiology and emotional make up, we all feel pain differently. Sometimes, it’s hard to remember this in practice. While most of my patients won’t have access to the functional rehabilitation centers Dr. Jackson describes in her talk, I can suggest a modified approach by recommending similar therapies to my patients struggling with chronic pain. It’s empowering as a provider to be able to back “opioids aren’t the answer” with science, and suggest an alternate path to relief.