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Nurses spend less time than vets learning about pain


Veterinary students spend more time learning about pain management than nurse undergraduates, according to a nursing academic who wants an overhaul of training in the area.

Management of pain should be a basic human right, Eloise Carr told Nursing Times ahead of her inaugural lecture as a professor at Bournemouth University last week.

Professor Carr, who has spent more than 20 years researching pain management, called for nursing courses to spend more time teaching the subject.

Research by Professor Carr and a team from the British Pain Society found that, on average, nursing courses offer 10 hours of teaching on pain management, compared to more than 27 for vets. Midwives receive just six hours.

She told Nursing Times she understood there were lots of pressures on the nursing curriculum, but said she would like to see pain management have a similar profile to infection control.

“Nurses are with the patient 24/7 in hospital, so they’re in a really good position to know how their pain is and, if the prescription isn’t strong enough, they need to have the confidence to challenge that,” she said.

“I would like to see recognition that the management of pain is a basic human right. I’d like to see that belief included in the under graduate curriculum,” she added.

Prof Carr’s research has looked at barriers to better pain management. On a patient level, she said “stoical” British attitudes meant many patients just accepted pain.

“If we treated [pain management] like a public health issue and educated the public, they would become much better at asking for good pain management care,” she said.

At an organisational level she warned that trust protocols, such as requiring two nurses to check the dosage of an opiate before it was administered, could leave patients without relief unnecessarily.

She said: “This takes time and there isn’t any legal reason why you need two nurses to check.”


Is pain management given a high enough profile in nursing practice?

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Readers' comments (3)

  • OK, I have quite a few issues with this, not least of which Prof Carr has not experienced the reality of this as a nurse.

    Firstly I challenge the fact that nurses only learn about pain for 6 hours compared to 27 as vets. I am led to believe from this statement that this refers to classroom time. Nurses spend hours and hours, if not years learning about pain, observing for pain, listening to patients about their pain and generally using all their skills learnt whilst in PRACTICE on how to manage pain. Does practice not count for anything now or is it only properly taught if some highly paid professor can stand in front of a class for 27 hours and talk at people.

    Secondly, people are not animals. We have the power of speech and are able to communicate our needs, and those who can not we observe body language and facial expressions and rely on our own expertise and experience to recognise when a person is in pain. Vets do not have the luxury of having a patient who can talk to them and say where the pain is exactly. Or has this fact escaped the learned professor.

    Thirdly, "At an organisational level she warned that trust protocols, such as requiring two nurses to check the dosage of an opiate before it was administered, could leave patients without relief unnecessarily.

    She said: “This takes time and there isn’t any legal reason why you need two nurses to check.”" - Is she nuts? There is no way I would give any opiate drug without a second nurse checking it. There are two spaces in the Controlled Drug book requiring TWO signatures to confirm stock. It also is a safety measure for the nurse and the patient in light of the Shipman enquiry to ensure that nurses are not stealing CD's. It is also law to do this as NICE and the medicines council who regulate all hospital drugs and destruction of them require two signatures.

    This article has really wound me up and now I am totally annoyed for the rest of the day. Professor, get your facts straight and learn about the nursing and midwifery professions.

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  • What annoys me most about pain control is the prescription written as a variable dose PRN. I am a nurse and have also been a patient and had the higher dose overnight, and been told I may become addicted by day staff if I had anymore than the lower dose. This led me to believe, well draw your own conclusions.

    I also have pets, and when they have required pain relief, it has been consistent, and then reviewed to be lowered or withdrawn.

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  • I have over 30 years experience as a nurse in a variety of setting, and I am in total agreement with Prof. Carr. Nurses absolutely need more academic input on types of pain, physiology of pain, classes of analgesia, importance of pain management. We can't rely on custom and practice alone to achieve and maintain clinical excellence.
    I don't really know what I think about the issues regarding checking of CD, but nothing is set in tablets of stone, laws can be changed, and we must be open to different ways of tackling issues.

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