Pain Management Nurse
Pain management nurses are registered nurses who specialize in the care of patients with chronic, sometimes debilitating pain. They are experts on pain management interventions and techniques.
In 2001, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) introduced standards for healthcare providers to address pain assessment and management, to include more aggressive pain management such as opioid administration.
After about 10 years, the number of patients who developed opioid addictions/dependence skyrocketed. According to the American Society of Addiction Medicine, of the 20.5 million people with substance use disorder, 2 million had substance use disorder involving prescription pain medications. This epidemic led to healthcare providers finding alternative and safer pain management techniques, such as:
- Chiropractic medicine
- Vitamin therapy
- Stress/Relaxation techniques:
- Guided imagery
- Spinal blocks
- Botox injections
- Exercise/diet changes
- Transcutaneous Electrical Nerve Simulator (TENS) units
In 2005, the American Nurses Association recognized pain management as a nursing specialty. Nurses working in pain management assist with patients who may suffer from the following:
- Diabetic nerve pain
- Nerve/spinal injuries
- Status post motor vehicle accidents
- Chronic Headaches
- Stroke pain
- Degenerative disc disease
- Cancer pain
Nurses learn the basics of pain management in their accredited nursing programs. They are taught to assess pain, intervene per physician's orders, and evaluate the patient's response to pain. Pain management nurses are more specialized in that the patient population they serve are typically people suffering from chronic pain due to illness/disease. Pain management nurses should have top-notch assessment skills (to include non-verbal cues), enjoy teaching, and have lots of patience, as one pain management technique is not effective for every patient. Continuous assessment and reassessment may be needed.
What Are the Education Requirements for a Pain Management Nurse?
Those interested in the specialty of pain management should first pursue a nursing degree through a two or four-year university. Obtaining an Associate's Degree in Nursing (ADN) or a Bachelor's of Science in Nursing (BSN) degree is required. After completion of an accredited nursing program, an aspiring nurse must pass the NCLEX-RN examination, which is required for licensure.
In some healthcare organizations, a BSN degree is preferred. Nursing program graduates are encouraged to check each employment opportunity for minimum requirements.
Are Any Certifications or Credentials Needed?
The American Nurses Credentialing Center (ANCC) offers a Registered Nurse-Board Certified (RN-BC) credential in the specialty of Pain Management. Eligibility for credentialing includes:
- Hold a current, active RN license
- Have practiced the equivalent of two years full-time as a registered nurse
- Have practiced in a nursing role that incorporates pain management (assessment, education, or research) for at least 2,000 hours in the prior three years
- Have completed 30 hours of continuing education in the prior three years, with 15 hours related to pain management
The exam is computer-based, and is 175 questions. Certification is valid for five years.
Additionally, Advanced Cardiac Life Support (ACLS) and sedation certification may be required if invasive pain management procedures are performed.
Pain management nurses can work in a variety of medical settings. As healthcare providers battle the opioid epidemic, more alternative pain management techniques are being employed in:
- Outpatient clinics
- Private medical offices
- Rehabilitation facilities
- Sports medicine
Pain management nurses are responsible for assessing patient care needs, implementing a treatment plan, and evaluating the response. Specifically, pain management nurses may:
- Administer pain medications via various routes, i.e. intravenous, intramuscular, or intrathecal
- Monitor patient receiving conscious sedation
- Recover patients after receiving sedation
- Review medical records
- Assist physicians with invasive pain management techniques
What Are the Roles & Duties of a Pain Management Nurse?
Nurses specializing in pain management play an integral role in patients' recovery from injury, management of chronic illness, and overall well-being and quality of life. Roles and duties include:
- Assessing individual medical and psychosocial patient care needs
- Collaborating with physician to develop a plan of care
- Assisting in implementation of treatment
- Evaluating and documenting patient response to interventions
- Educating patients and families on available treatments for them to make an informed decision
- Demonstrating patience and empathy to patients who are suffering from pain
While the Bureau of Labor Statistics does not have data specifically on pain management nurses, it does outline the job outlook for rehabilitation counselors, a field which is expected to grow 9% by 2024. This, along with the projected 16% growth by 2024 for registered nurses, indicates a promising career opportunity for pain management nurses.
According to indeed.com, pain management nurses earn an average salary of $101,295 annually. This figure may vary depending on city and state of employment, degrees or certification held, and the organization of employment.
- American Society for Pain Management Nurses
- American Pain Society
- American Academy of Pain Medicine
- American Chronic Pain Association
- American Association of Moderate Sedation Nurses
Pain Management Nurse FAQs
The epidemic of deaths due to addiction has reached an all-time high. In spite of more education in schools and high-profile leaders and entertainers speaking out against drug and alcohol abuse, addiction rates are soaring. Pain management nurses are an important part of the healthcare team to aid in identifying and managing this growing threat.
According to the Department of Health and Human Services (DHS), the U.S. is in the midst of a prescription drug overdose epidemic. Overprescribing practices have stemmed from the push in the 1990s to treat a patient’s perceived pain without clinically-backed objective data such as validated pain assessment tools. Overprescribing, coupled with the importance of patient-satisfaction scores available online, created a snowball effect of opioid use in patients who would otherwise have been tapered off or denied prescriptions in the past.
Nurses are at risk of missing patients who are addicted to prescription pain medications for a number of reasons. One major cause is a lack of knowledge as to the risk of physical dependence created by opioid use. Physical dependence is where the body relies on an external source of opioids to prevent withdrawal symptoms. Normally, the body produces endorphins to prevent withdrawal, but as tolerance increases, the external source is required. Addiction is a disease classification where the uncontrollable cravings for opioids overwhelms the body’s ability to reason, even to point of harm and self-destruction.
The most important way nurses can help patients who suffer from addiction is to become educated on the disease process of addiction and the resources available to this fragile population. Education related to recognition and response to substance-misusing patients can greatly improve a nurse’s confidence in care for addicted patients. Many states require nurses to have pain management continuing education units when renewing their nurse license. Organizations such as the American Psychiatric Nurses Association offer free courses for recognizing and caring for patients who have substance abuse challenges.
Many institutions have implemented the use of validated tools to aid in the identification of addictive behaviors for patients being prescribed opioids for pain management. These tools, such as the Alcohol and Drug Diagnostic Instrument or the Opioid Risk Tool can either be administered by the healthcare clinician or completed by the patient. Some tools assess the potential for addiction whereas others assess the presence of substance abuse. Nurses must be aware of any screening tools available in their healthcare institution and become educated on how to administer or interpret the results of the tool.
As an integral part of the care team, pain management nurses must be confident in addressing the epidemic of opioid and other drug addictions in the U.S. The National Council for State Boards of Nursing, in partnership with many respected organizations, has created an Opioid Toolkit to address this growing concern among the healthcare community. Education can also address the challenge of nursing attitudes towards patients with addiction. Knowledge of the disease process and resources for treatment are the best ways to overcome biased attitudes that may hinder the nurse from effectively caring for this alarming and at-risk population.