My Working Day: Caroline McGrathis advanced nurse practitioner in pain management, the first role of its kind in Ireland
My role as advanced nurse practitioner (ANP) in pain management has evolved as a result of emerging healthcare needs and is an advancement of the interdisciplinary approach to pain management.
This role is the first of its kind in Ireland but research from the US, Canada, UK and Scandinavia indicates clearly that the ANP in pain management's contribution to positive outcomes include collaboration and co-ordination of pain management services and a heightened awareness of pain and its management. In Portiuncula Hospital, my role increases accessibility to the service for all patients requiring intervention.
Pain is the most common complaint which compels people to seek medical advice. It is a phenomenon which pervades every facet of the healthcare environment. Pain medicine is concerned with the prevention, evaluation, diagnosis, treatment and rehabilitation of painful disorders. Chronic pain is reported in one in seven (13 per cent) adults in Ireland.
A typical working day is hard to describe as there is enormous variety and flexibility within the role. I work Monday to Friday, 9.30am to 5.30pm. Mornings start with checking phone messages, referral letters and e-mails.
Our service receives about 120 calls per week ranging from patients needing urgent access to the service to problems with medication titration or requests for information regarding their pain. Referral letters are triaged and discussed with the consultant in anaesthesia and pain medicine.
Phone calls to patients regarding problems, information or results are generally made at this time. Next stop is a visit to each ward to link with medical and nursing staff and to check on the progress of pain service patients.
This daily visit has many benefits. It keeps the personal touch in the role, facilitates timely assessments and interventions for any pain problems, assists in the provision of pain management education in the clinical setting and also keeps me connected to the real world of clinical practice.
In our chronic pain clinics, approximately 35-40 patients are seen. Prior to these clinics, I review each chart to ensure that all the relevant information is available. This chart review has enabled our clinic to be more efficient and productive with less waiting time all round.
The most difficult part of my job is the paperwork! However, accurate documentation and record-keeping ultimately eases the patient's journey through the healthcare system, and facilitates auditing to improve practice.
The easiest part of the job is face-to-face patient care. I still enjoy it and gain tremendous personal and professional satis- faction from it. The people I work with make it easy, too. At Portiuncula, we have a great multidisciplinary pain team who are united in the focus to achieve optimal pain management for all.
To improve the service, I asked patients in a recent survey what we need to do. In response to their demands, we are actively working at reducing waiting times. I would like to see more pain management programmes available to patients suffering from chronic pain. Also, the imminent advent of nurse prescribing will improve pain management services. Pain management is a basic human right and failure to relieve it is neither clinically, professionally nor humanitarianly justifiable.
In conversation with Michelle McDonagh