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This position statement was archived on 11/7/2012. AMSN prefers to endorse the position statements of the Hospice and Palliative Nurses Association (HPNA) and the American Society of Pain Management Nurses (ASPMN).

IT IS THE POSITION OF AMSN THAT:

• Pain management should be a priority of care for every patient, with freedom from pain as a basic human right.
• Pain management is a collaborative effort between the caregiver and the patient that must include consideration of the patient's individual needs in selecting the most appropriate intervention. The nurse should promote understanding of pain management measures.
• The patient's self-report is the most reliable indicator of pain. If the patient is unable to describe pain (e.g., due to cognitive impairment), the nurse should anticipate pain with procedures or conditions that are known to cause it (e.g., hip fracture) and intervene appropriately.
• Reassessment of pain is needed after intervention or change in the treatment regimen. The medical-surgical nurse should encourage the patient to report inadequate pain management, and should in turn immediately report this finding to the physician.
• Analgesics should be administered regularly, with around-the-clock dosing used as indicated to optimize pain management.
• Analgesic side effects should be identified and treated aggressively for patient comfort.
• Full and effective doses of analgesia are indicated for effective pain management in the dying patient. Increasing the dose of medication to achieve adequate symptom control, even at the expense of life, is justified ethically.
• Placebos should not be used for assessment or management of pain of the medical-surgical patient. To protect the patient and nurse from moral, ethical, and legal compromise, use of placebos should be limited to approved clinical trials in which informed consent is obtained.
• The medical-surgical nurse should be knowledgeable regarding signs of tolerance, addiction, pseudoaddiction, or dependence, and should respond appropriately to ensure effective pain management.

OVERVIEW:

Care of the patient with pain is a rapidly expanding science that utilizes pharmacology, technology, and complementary therapies to provide safe, comprehensive treatment. Optimal pain management promotes healing, comfort, and a feeling of well being. Effective pain management permits performance of critical activities, improves quality of life, and reduces the length of hospital stay.

Pain medicine is a sub-specialty of medicine concerned with the treatment of acute and chronic pain. Modern pain medicine is individualized, holistic, and multidisciplinary, using a wide variety of medications, interventional procedures, and psychosocial interventions.

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