Our goal, as part of the multidisciplinary team, is to help patients who have pain issues, treat them compassionately, treat them effectively, minimize the burden to the patient, minimize the burden to the family, maintain functional independence and help prevent damage to the community at large. Across the country, nurse practitioners have a variety of prescription privileges available with regard to treating pain. Some of those have to do with the amount of medication prescribed. Some have to do with the types of medication prescribed. That changes on a state by state basis, so it’s important to pay attention to what’s going on in your state, so we can adjust patient treatment to what we have the ability to do.
A nurse practitioner may encounter a number of complexities in treating a pain patient; it could be the magnitude of the dose that they’re taking, say in terms of morphine equivalent, and whether the nurse practitioner can prescribe that. It could relate to side effects and the need to change medications. It could be the patient’s social situation and the potential for substance abuse from elsewhere in the patient’s household. And it is important to keep costs in mind when you’re treating patients with chronic pain issues, and to use best practices to make sure that patients are receiving appropriate care and not wasteful care.
I would encourage physicians who work in pain management to work very closely with their nurse practitioners and physician assistants to be able to reach out to more people, because there just simply aren’t enough pain specialists in the country. There are not enough to go around. We have to be able to reach out to educate nurse practitioners and physician assistants to be able to more effectively evaluate and treat pain.