Pain management education for nurses during new employee orientation

The management of pain is a topic under much scrutiny in the present healthcare climate. Research has shown that as a whole, pain is largely undertreated and mistreated. Studies have noted lack of education and knowledge of physicians and nurses in regard to pain as one of the barriers to effective management of pain. This study, guided by the Joint Commission for Accreditation of Healthcare Organization's new pain management standards and Watson's Theory of Human Caring, involved a pain management education session offered during the new employee orientation for nurses. A pretest/ post-test format was used as well as a follow-up survey 1-2 months after the educational intervention to determine knowledge and attitudes (Nurses' Knowledge and Attitudes Survey) and practices and barriers (Pain Practices and Barriers Survey) to effective pain management. Seventy-three nurses participated in the pre-test/post-test, and 28 nurses completed the follow-up survey. Although there was a 21% increase in knowledge on the post-test and retained knowledge of 15% over baseline on the followup survey, this did not translate into an increase in positive pain practices. Barriers to effective pain management most often cited were lack of knowledge of physicians, nurses, patients, and families, and fears of addiction, dependence, and tolerance to medications. When asked to indicate changes that would be most beneficial to aid nurses in developing effective pain management practices, the most common responses cited were education, pain protocols or algorithms, more time to spend with patients (related to lower nurse-patient ratios), and more access to non-pharmacological methods of pain management. The study findings indicate a need for the incorporation of pain management in education for practicing RNs on a continual basis, as well as in the nursing curriculum. Accountability for effective pain management should be established for healthcare providers as well as institutions offering healthcare.