title: Managing cancer and noncancer chronic pain in critical care settings. Knowledge and skills every nurse needs to know.
abstract: Nurses and physicians caring for people with all types of pain are responsible for providing effective pain management in all clinical settings. Although the principles for managing all types of pain are similar, people with chronic pain have special needs to sustain optimal analgesia in critical care settings. Nursing practice must be guided by national standards, guidelines, and recommendations for managing chronic and acute pain. Pain assessment, reassessment, and follow-up; titration of medications to individual responses; aggressive management of side effects; prevention of pain; and routine evaluation of the effectiveness of the plan are basic skills for all health professionals. Every person's baseline level of pain must be determined, and preexisting interventions for pain relief must be maintained to assure continuity of care. Chronic pain complicates clinical problems and could have a profound effect on patient outcome. Managing chronic pain improves function, outcome, and quality of life. The knowledge, skills, medications, nondrug interventions, and technology are available to manage nearly all types of pain. Pain relief is a responsibility of all health care professionals. Our patients deserve our best efforts to optimize their comfort, and we must be accountable.
authors.affiliation: Curtiss Consulting, Greenfield, Massachusetts 01301, USA. ccurtiss@shaysnet.com
authors.forename: C P
authors.initials: CP
authors.lastname: Curtiss
authors.forename: P J
authors.initials: PJ
authors.lastname: Haylock
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002908:Chronic Disease; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000451:nursing*; D009730:Nursing Assessment; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000451:nursing*
chemical_list: D000701:Analgesics, Opioid