healthcare careers

Fifty to 75 million Americans experience pain annually, including nearly half of those undergoing cancer treatment, according to some estimates. But pain is subjective; it cannot be documented by an X-ray or a blood count.

"It sort of forces you to walk in the gray while you're in a black-and-white system," explains Margaret Kellar, a clinical nurse specialist at Courage Center Chronic Pain Rehabilitation Program in Golden Valley (www.couragecenter.org).

"Pain management is so important for nurses and nurse practitioners," adds Amy Krenzer, a nurse practitioner at Twin Cities Pain Clinic in Edina (www.twincitiespainclinic.com). "It is considered the fifth vital sign."

Pain Management History

Medical practitioners in the United States began to take pain management seriously when the hospice movement began in the 1980s, according to Kellar, who began her career in hospice. Some health professionals consider patients who ask for help with pain to be drug-seekers, according to Krenzer. "The reality is they may not be getting the right kind of pain medication or enough of that medication," she says. "However, medication isn't always the best treatment for everyone. Treatments should be individualized."

The staff at Twin Cities Pain Clinic (www.twincitiespainclinic.com) helps patients manage pain through physical therapy, injections and medication, monitoring them for chemical dependency. "We try to get to the bottom of why they're having pain," Krenzer says. "Some patients we only see once and we can prescribe something that might work and we don't see them again. Most of our patients have chronic pain and come in once a month or every couple of months."

Chronic pain may also cause anxiety or depression. "Assessment of the patient's mental health is ongoing," Krenzer adds. "We often recommend seeing a psychiatrist or a psychologist."

Other Pathways To Pain Management