Poor Assessment of Nursing Home Residents’ Pain — What Can Be Done?

A recent study sought to find out whether relatives and caregivers (proxies) understood residents’ pain well enough to assist in pain assessment and to discover what factors affected their judgments of pain. The findings showed, however, that their reports didn’t consistently match the pain ratings of nursing home residents themselves.

It’s particularly difficult to assess pain in cognitively impaired nursing home residents. This means that there’s a lot of suffering that goes untreated. This AJN article in the December issue discusses the findings of a new study on the topic and offers some recommendations we obtained from the study authors. Here’s another excerpt:

The authors suggest that pain management in nursing homes could be improved through caregiver education, including the implementation of pain assessment education in combination with treatment. They recommend basic training for nurses and nursing assistants on pain, pain behavior, and pharmacologic and nonpharmacologic pain treatment, such as “massage, applying warmth, mobility[, and] distractions with music or story telling.” They also suggest that “treatment effects could be determined more easily using a pain observation scale.”

So check out the article, and also let us know what else can we do to more accurately assess the pain of nursing home residents.

Bookmark and Share

Nursing Yet Again the Most Trusted Profession. So What?

By Shawn Kennedy, MA, RN, interim editor-in-chief

I was catching up on my reading over the weekend and came across a press release issued December 9 by the ANA (American Nurses Association). It noted that “[f]or the eighth consecutive year, nurses have been voted the most trusted profession in America according to Gallup’s annual survey of professions for their honesty and ethical standards. Eighty-three percent of Americans believe nurses’ honesty and ethical standards are either ‘high’ or ‘very high.'”

Laudable for sure, but I keep wondering: does this matter to anyone but us? In the past eight years, has this designation helped nurses get to the policy table? Has it made key decision-makers realize that in addition to being trustworthy, nurses are also smart, skilled professionals who can be the key to cost-effective, quality care?

It’s really amazing (in an appalling sort of way): the groups among those with the lowest trust ratings—politicians and lawyers—dominate when it comes to making key decisions about health care (and about everything, actually). And we wonder why things are the way they are?

Bookmark and Share

And You Thought PE Was Another Name for Gym Class

By Jacob Molyneux, senior editor

The template goes something like this: Start with a legitimate quality-of-life issue — like fitful sleep or shyness — that does not yet have its own prescription medication and is debilitating to a few people a lot of the time. Next, position the quality-of-life issue as a medical condition with symptoms so common it covers vast numbers of people who had previously not identified themselves as having a health problem, or who thought they were just experiencing an occasional and normal annoyance.

According to the rest of this article in the NY Times, the latest disorder about to enter our dictionary of accepted medical conditions is premature ejaculation (PE). Several companies are developing treatments in the form of pills or aerosol sprays. The net of nonspecific symptoms seems to have been cast fairly wide—a representative of one drug company is quoted as saying that one in three men have this condition. 

Celebrities may soon be confessing that the anxiety occasioned by PE has led to ruined marriages, depression, drug use, and even the use of prostitutes. The ironies of the media campaign to push the term PE into our medical lexicon are worth considering as our legislators debate health care reform provisions and the crisis of rising costs. Medical bankruptcy is on the rise. Many cannot afford medications they need for serious conditions like heart disease and diabetes.

It may be premature to suggest it, but it seems likely the pharmaceutical companies expect health care reform legislation […]

Required Reading: Nurses as Champions of Patient Safety

Photo from otisarchives4, via Flickr

By Diana J. Mason, PhD, RN, FAAN, editor-in-chief emeritus of AJN. Mason is a member of the National Advisory Committee of Kaiser Health News.

I was delighted to see Kaiser Health News publish a superb commentary by nurse researcher Mary Naylor and health economist Mark Pauly on why nurses are the key to patient safety and quality, the barriers that interfere with nurses being these sentinels, and what can be done to address these barriers. It should be required reading by all policymakers, CEOs of health care organizations, and trustees.

Bookmark and Share

2018-03-13T10:44:44-04:00December 11th, 2009|career, nursing perspective, nursing research|1 Comment

What We Heard from the Leaders of the New National Nursing Union

By Shawn Kennedy, MA, RN, interim editor-in-chief

As we noted earlier this week, several major nursing unions have united to form a “superunion.” The National Nurses United (NNU) brings over 150,000 nurses together by combining the California Nurses Association (CNA)/National Nurses Organizing Committee (NNOC) with the Massachusetts Nursing Association (MNA) and some members of the United American Nurses (UAN).

There are three co-presidents: Karen Higgins (from the MNA), Jean Ross (from the UAN), and Deborah Burger (from the CNA/NNOC).

Ross told me this:

  • The CNA/NNOC will cease behaving as a national union and, like the MNA, be a state union; both will be affiliates of the new NNU.
  • The UAN will cease to exist as a national union; those state associations that were members will automatically be members of NNU, unless they decide not to.
  • NNU will focus on health care reform, will advocate for a single-payer system, and will seek to organize all non-union staff nurses in the country

Ross had this to say as well: “People in this country have been waiting for a long time for nurses to come forward to make true health care reform a reality.”

Co-President Deborah Burger told me that NNU will pursue the main objectives of a “massive organizing campaign to organize all nurses nationally” and an aggressive “social justice” agenda focused on advocating for a single-payer health care system. They will also work for passage of federal staffing ratios legislation introduced by Senator Barbara Boxer.

Said Burger, […]

Go to Top