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From the front line – What a pain

Bethann Siviter on why community nurses need to appreciate the impact of chronic pain on patients' lives 

Recently, in the UK and US, guidance has discouraged the use of opiates in chronic pain management. An article in the New England Journal of Medicine said: People in chronic pain dont need pain treatment, they need to accept their pain and move on. Pain doesnt kill you.

There is widespread fear among people in the UK with chronic pain that services, already slim, will be further eliminated, and already GPs are limiting access to opiates. Its only pain.

Pain patients say they are often accused of being drug-seekers, attention-seekers or malingerers. They are accused of enjoying the sick role, using pain as a feeble excuse. Pain doesnt kill you.

But it does. The colleges and societies of medicine involved with chronic pain management have all come out

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Regular pain assessments, performed by nurses, may help evaluate quality of life among patients
Picture: iStock

Recently, in the UK and US, guidance has discouraged the use of opiates in chronic pain management. An article in the New England Journal of Medicine said: ‘People in chronic pain don’t need pain treatment, they need to accept their pain and move on. Pain doesn’t kill you.’

There is widespread fear among people in the UK with chronic pain that services, already slim, will be further eliminated, and already GPs are limiting access to opiates. ‘It’s only pain.’

Pain patients say they are often accused of being drug-seekers, attention-seekers or malingerers. They are accused of enjoying the sick role, using pain as a feeble excuse. ‘Pain doesn’t kill you.’

But it does. The colleges and societies of medicine involved with chronic pain management have all come out saying that chronic pain does stress the body, causing decline in health and more difficulty managing health than in those without a chronic pain condition. There are also the issues of quality of life, finance, access to health services, and the mental health impact of pain, isolation and stigmatisation of pain and pain treatments.

So, community nurses, what does this mean for you? Are your patients in pain? Do they get the treatment they need or just try to cope with untreated pain? Do they feel isolated and alone, misunderstood and uncared for?

But do you understand pain? Imagine the worst flu ever. All that achiness, fatigue and misery. Now imagine that’s all you can ever look forward to every day, and that’s not even severe pain. Or imagine neuropathy, hot glass pouring down your back or over your feet. Compassion and assessment, not judgement, is what’s needed. Oh, and appropriate medication helps too.

Regular pain assessment and a skilled nurse’s feedback on how pain is preventing independence in activities of daily living will help the GP appreciate the impact of pain on patients. That’s painless, isn’t it?


About the author

Bethann Siviter is an independent nursing consultant

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