Introduction

Pain relief trends to remain a low priority in many clinical settings for physicians and nurses. This is true despite that fact that pain is prevalent, pain is the primary symptom that brings most patients into a healthcare setting, and pain is a universal experience. Pain is often a direct consequence of many healthcare treatments. The most vulnerable populations, including minorities and children, often experience the poorest pain management.

Cultural diversity is the reality of the millennium as the United States is becoming the most ethnically diverse society in the world. The needs and responses of many different racial and ethnic groups are competing for recognition, and health care professionals must learn how to meet the health care needs of this multicultural society. Cultural concepts in the context of this social change are explored as they relate to pain management. Concepts of heritage consistency, traditional health beliefs, and traditional health-promoting behaviors as they relate to pain management are explored in this MCS assignment.

Objectives

• To identify and discuss issues involved in inadequate pain management.
• To list the basic principles of pain management
• To understand the ethical, cultural and political issues surrounding pain management.
• To describe the professional responsibility of the physician in the management of pain.

Preparation

• Use the readings to familiarize yourself with issues of pain management.
• Answer the study questions and come prepared to discuss your answers in session.
• Suggestions for Written assignment:
• Use one of the study questions or the case for the week as a basis for a position paper.
• Use the same questions as the basis of a letter to the editor or opinion paper.
• Review one of the study guide readings or a reading from your own research.
• Write about your own experience or the experience of a family member or friend coping with pain.

Process

Class today begins in lecture. Carolyn Santora, RN MS and Dr. Jack Coulehan will review basic principles of pain management and barriers to adequate pain management. Your test results, as a class, will be presented and contrasted with historical data of SBUH health care practitioners. Following this presentation we will adjourn to section and discuss your personal reflections and experiences with pain, and how your culture and social background influence your personal experience with pain. How might this influence your treatment of patients?

Study Questions

1. What are the risks/benefits of placebo use in the context of pain management.
2. For patients with a history of narcotic abuse or with drug seeking behavior, might placebo use be a beneficial therapeutic modality?
3. What circumstances would allow for the ethical use of placebo therapy for pain?
4. What is your position as an ethical professional regarding the current state of pain management in the medical community? Please utilize the Attributes of Professionalism as a basis for your discussion.