Update 2018: Pain Management for the Correctional Nurse
According to the 2014 Report: The “State” of Pain in Michigan by the Advisory Committee on Pain and Symptom Management, at least 100 million adult Americans had chronic pain in 2011, and up to 34% of Michigan residents live with daily chronic pain. To put it in perspective, pain affects more Michigan residents than diabetes, heart disease and cancer combined. In 2012, 72% of the Michigan hospital admissions where pain was listed as either the primary or secondary diagnosis were due to chronic pain. Cancer and related pain accounted for only 5.2% of the total admissions for pain. In Michigan, 27.7% of residents surveyed in the 2013 Michigan Resident survey indicated that they accessed a health care provider for the treatment of chronic pain, and 25.2% stated that they had an acute or chronic pain condition for which they had not sought medical treatment.
Michigan continues to be a leader in the enacting of laws and policies that enhance patient pain management and positively influence patient pain care (2013 report: Achieving Balance in State Pain Policy: A Progress Report Card – Michigan grade A). The most common form of pain treatment in Michigan is prescription medications. The Michigan Automated Prescription System (MAPS) data for 2012 was used by the Centers for Disease Control and Prevention (CDC) to compute all US states and their prescribing practices, and Michigan ranked first in the most prescriptions written for pain medication with 107 painkiller prescriptions written per 100 residents.
There is a wide disparity in the amount and type of pain treatment provided in the community and in the correctional environment. The nature of incarceration makes some non-pharmacologic therapies that might normally be recommended difficult to support. Pharmacological treatments may also be very challenging in our environment. In this class, the pathophysiology of pain, the different types of pain, and the common medications used in the treatment of pain will be discussed. In addition, the role of the correctional nurse in pain management of the incarcerated patient will be discussed. This class satisfies the Michigan Board of Nursing’s criteria for a class in pain that is required of all nurses prior to re-licensure.