The Nurse’s Role in Integrative Pain Management

by Susan Luck

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This week I was invited to present a live web conference on “Holistic and Integrative Modalities for Pain Management” for the Visiting Nurse Association of America (VNAA), a national association that represents hospice and home care nurses.  To be invited to speak on this topic clearly indicates the interest in these practices for patients who are in pain in all settings and the need to address this critical issue in health care.

The Institute of Medicine (IOM) delivered its national strategic document on the massive issue of pain on June 29, 2011, “Relieving Pain in America: A Blueprint for Transforming, Prevention, Care, Education and Research”.

Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the IOM in examining pain as a public health problem, as pain is the most common reason for physician consultation in the United States.

In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America.

What about all of the nurses who are already using holistic and integrative nursing modalities as part of patient care and for pain management? Nursing already has a model of care that needs to be understood and included when health policy analysts seek solutions on how to implement supportive, non-invasive, cost effective practices for pain management.

It is well documented that in hospitals and diverse health care settings, nurses are increasingly integrating a variety of healing modalities into patient care for anxiety, stress, to lower pain perception and for pain management. These include energy-based practices such as Therapeutic Touch, Massage, Reiki, and Healing Touch. Nurses increasingly study and integrate mind/body techniques including relaxation exercises, guided imagery and mindfulness practices- often for their own self-care to relieve the stresses that they experience professionally and personally, which then translates into higher quality care for their patients.

There is a growing body of research on these nursing interventions to decrease pain, lower inflammatory processes, induce the relaxation response, and support the healing process (See References below).

Why aren’t nurses taught these skills and tools in their nursing education, and supported to integrate these non-invasive healing strategies as part of nursing care?

While the demand by consumers continues to grow, how will these nursing modalities be included in clinical or policy strategies?

As nurses, how can each of us increase our visibility and seek opportunities to demonstrate our work as we continue to study and develop new skills, participate in research, and impact healthcare policy?

What modalities do you practice for your own self-care and to offer to your patients?

References:

  1. Apostle-Mitchell M. & MacDonald G. (1997).  An innovative approach to pain management in critical care: therapeutic touch.  Off J Can Assoc Crit Care Nurs. Fall;8(3):19-22.
  2. Cutshall S.M., Wentworth L.J., Engen D., Sundt T.M., & Kelly R.F. (2010).  Effect of massage therapy on pain, anxiety, and tension in cardiac surgical patients: a pilot study.  Complement Ther Clin Pract. May;16(2):92-5.
  3. Garland E.L., Gaylord S.A., Palsson O., Faurot K., Douglass Mann J, & Whitehead W. (2011). Therapeutic mechanisms of a mindfulness-based treatment for IBS:  effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med, Dec 8.
  4. Fadel Zeidan, Ph.D. (2012).  Meditation Can Provide Greater Pain Relief Than Powerful Medication.  Journal of Neuroscience, April 9, 2012. 
  5. Umbreit A.W. (2000).  Healing Touch:  Applications in the acute care setting.  AACN Clinical Issues. Feb; 11(1): 105-19.
  6. Zeidan F., Martucci K.T., Kraft R.A., Gordon N.S., McHaffie J.G., & Coghill R.C.  (2011).  Brain mechanisms supporting the modulation of pain by mindfulness meditation.  J Neurosci. Apr 6;31(14):5540-8.


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As Co-Founder of the International Nurse Coach Association for over a decade, Susan has been teaching and developing coaching program and currently through the Integrative Nurse Coach Academy. She is Board Certified in Health and Wellness Coaching, Holistic Nursing, and Clinical Nutrition. Susan has authored several chapters on Nutrition and Environmental Health for Holistic Nursing, Integrative Nursing, and Nurse Leadership textbooks. She has co-authored Nurse Coaching and Self-Assessment chapters in; Holistic Nursing: A Handbook for Practice, 7th edition (2015-2020) and is co-author of the award winning book (ANA Gold Seal, 2015) Nurse Coaching: Integrative Approaches for Health and Wellbeing (2015) and The Art and Science of Nurse Coaching, an ANA Publication (2013), that led the way to establishing the standards for practice in the emerging Nurse Coach role. For the past 20 years, she has been the Nurse Coach and Nutrition consultant for Special Immunology Services at Mercy Hospital in Miami and is currently the Director of Nurse Coaching at Rezilir Health in Hollywood, Florida. Susan continues to integrate lifestyle health and wellness education into diverse communities, bringing her expertise and passion as a nurse, clinical nutritionist, and medical anthropologist. She has developed and implemented integrative health initiatives for diverse community organizations including the Yellow Courtyard, Integrative Health Symposium, Urban Zen, New York Open Center, The Lower East Side Girls Club, Kripalu, Omega Institute, and the University of Miami and Florida Atlantic University. As a concerned global citizen, Susan is the founder and education director of the Earthrose Institute, a not-for-profit organization dedicated to environmental health education and advocacy. She maintains a private practice as an Integrative Nurse Coach with a focus on nutrition and the environment.

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2 Responses

  1. Susan, thank you for your tireless efforts to speak out. I would add presence, listening, and empathy as important tools to use with people experiencing pain. These tools are part of every nurses practice, and were enhanced for me through my Integrative Nurse Coach education. As I touch and listen I can’t tell you how many patients tell me they have never really been listened to or had a chance to tell their story.

  2. Susan, it is so important for others to understand the roles nurse’s play in helping patients manage their illness, pain and work toward healthy lifestyles. Thank you for your tireless work in putting voice to nursing care.

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