Pain is personal: How faculty and staff can enhance pain care and treatment for patients
Approximately a 5-minute read
- September is Pain Awareness Month.
- Pain is a personal experience which should be understood and considered in treatment.
- The Pain Committee offers many pain management resources and treatments.
September is Pain Awareness Month, making it the perfect time for the Rewrite the Script Team and Pain Committee to share their knowledge and resources around pain and opioid management with the Michigan Medicine community. The goal is to help support best practices and institutional policy and enhance the care provided by faculty and staff.
Same procedure, different experiences
Most importantly, the team wants everyone who works directly or indirectly with patients to know that pain is a very personal experience and that the one important first step in developing an informed and thoughtful treatment approach requires knowledge of what pain is and how patients experience it.
“Studies show that people have a different physiological response to the same stimulus,” said Associate Professor of Anesthesiology Paul Hilliard, M.D. “Each person experiences pain in a different way. We see this all the time. Two different patients can have the same procedure with the same provider using the same type of anesthetic but go on to have very different pain experiences.”
According to the International Association for the Study of Pain (IASP), pain is defined as: “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
But there is so much more to it. The IASP also outlined six key points care teams should understand about pain:
- Pain is always a personal experience that is influenced to varying degrees by biological, psychological and social factors.
- Pain is not solely an activity in sensory neurons.
- Through their life experiences, individuals learn the concept of pain.
- A person’s report of an experience as pain should be respected.
- Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.
- Verbal description is only one of several behaviors to express pain; nonverbal individuals can and do experience pain, and often represent an especially vulnerable group of patients, deserving special consideration in pain assessment and treatment.
Treatment options for pain
When patient’s medical care involves pain, especially chronic and acute pain combined, it can present a unique set of challenges. There are several aspects to pain and treating it, especially chronic pain. Treating multiple sources of pain well often requires more than a pill, a nerve block or physical therapy. Paying special attention to the cognitive and behavioral aspect of a person’s pain experience is key to success.
“So much of the experience of pain has emotional health implications – feelings of frustration, discouragement and sometimes despair, which all need to be considered when treating an individual experiencing pain,” said Pain Psychologist Eric Scott.
According to Pain Pharmacist Jillian DiClemente, “taking the time to actively listen to a patient’s pain story can lead to the development of a more comprehensive pain plan and build trust with the patient. Understanding these factors provides a comprehensive approach to treating and monitoring a patient’s pain.”
“Our goal is to promote evidence-based practice and use multimodal analgesics and non-pharmacologic therapies to improve the quality of care and patient outcomes,” said Pain Management Coordinator, Alex Koumoutsopoulos, MHSA, RN, PMGT-BC.
“Simple interventions like aromatherapy, warm blankets, music therapy and distraction can have extremely positive results and shouldn’t be discounted as valuable interventions to improve pain outcomes,” said Katie Barwig, MSRN.
When and who to consult
Several teams are available to reach for support and consultation for your specific patient:
- Adult and Pediatric Acute Pain Service (APS) if the patient could benefit from post-operative pain management, an epidural or peripheral nerve block.
- Palliative Care Consultation Service (PCCS) if the patient has a life-limiting illness (in the next few years), acute life-threatening illness, cancer-related pain or is followed in a U-M Health palliative care clinic.
- Addiction Consult Team (ACT) (pager number 60004) if the patient has opioid use disorder (OUD) on assessment, a history of OUD now with worsening pain, or may benefit from buprenorphine or methadone initiation/management for OUD.
- Pediatric Pain Nurse APS Consult (pilot) if the patient is in Children’s & Women’s hospitals (C&W) and you would like to have a review of the patient’s pain treatment plan or would like to learn how to deliver new non-pharmacologic pain management strategies for your patients.
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