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Role of the Oncology Nurse in Breakthrough Cancer Pain

Panelists: Charles E. Argoff, MD, Albany Medical Center; Jeri L. Ashley, RN, Baptist Memorial; Vitaly Gordin, MD, Penn State Hershey; Jeffrey A. Gudin, MD,
Published: Tuesday, May 06, 2014
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Oncology nurses play a multifaceted role in the management of breakthrough cancer pain, which includes patient education and assessment. In many cases, patients will only discuss their pain with a nurse, since they feel more comfortable in this setting. It is important for nurses to relay this information back to the treating physician, since this information may impact treatment, Jeri L. Ashley, RN, notes.

All pain assessments should be conducted in an unbiased fashion that is focused on physical assessment and poignant questions, notes Ashley. The assessment should consider suffering, cultural issues, spiritual issues, and other measurable dimensions of pain, Ashley states.

In most situations, nurses spend the most time with patients and are integral in the patient education process. However, before nurses can educate a patient on the correct use of rapid onset opioids for breakthrough pain, they must first build a rapport, notes Ashley. Once this has been established early on, the next goal is to ascertain possible apprehensions or potential for misuse and abuse. Finally, nurses must conduct reassessments, since it is a vital part of effective pain management, Ashley notes. 

In regard to pain medication abuse and misuse, Ashley and Marc Rappaport, DO, believe the utilizations of questions aimed at ascertaining the likelihood of abuse are critical, even in oncology. Even in this setting, physicians should remain aware of the potential for abuse and addiction.
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For High-Definition, Click
Oncology nurses play a multifaceted role in the management of breakthrough cancer pain, which includes patient education and assessment. In many cases, patients will only discuss their pain with a nurse, since they feel more comfortable in this setting. It is important for nurses to relay this information back to the treating physician, since this information may impact treatment, Jeri L. Ashley, RN, notes.

All pain assessments should be conducted in an unbiased fashion that is focused on physical assessment and poignant questions, notes Ashley. The assessment should consider suffering, cultural issues, spiritual issues, and other measurable dimensions of pain, Ashley states.

In most situations, nurses spend the most time with patients and are integral in the patient education process. However, before nurses can educate a patient on the correct use of rapid onset opioids for breakthrough pain, they must first build a rapport, notes Ashley. Once this has been established early on, the next goal is to ascertain possible apprehensions or potential for misuse and abuse. Finally, nurses must conduct reassessments, since it is a vital part of effective pain management, Ashley notes. 

In regard to pain medication abuse and misuse, Ashley and Marc Rappaport, DO, believe the utilizations of questions aimed at ascertaining the likelihood of abuse are critical, even in oncology. Even in this setting, physicians should remain aware of the potential for abuse and addiction.
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