title: Unlicensed staff members' experiences with patients' pain on an inpatient oncology unit: implications for redesigning the care delivery system.
abstract: Although unlicensed staff have routine contact with patients in pain, little research relates to their role with these patients. The purpose of this study was to describe the experiences of unlicensed inpatient hospital staff caring for cancer patients in pain. We sought to understand pain identification and communication practices, describe common practice situations, and identify training needs. We conducted 4 focus groups with unit secretaries, nurses' aides, and housekeepers (N = 24) on 2 inpatient oncology units at an urban, northeastern teaching hospital. Group processes were tape-recorded, transcribed, and analyzed using Atlas/ti software and content analysis. Analysis generated 5 issues related to pain in the daily practice of unlicensed staff: perceived function with pain, building relationships with patients, interpreting patients' pain, system issues, and job challenges and coping strategies. Unlicensed staff reported performing important functions related to pain, including alerting nursing staff to patients' pain, and providing psychosocial support. Participants shared difficulties of working with patients in pain and expressed interest in education on pain identification and course of illness. Findings provide insight into the role of unlicensed staff, and have implications for the educational preparation of this group as well as the nature of their participation in the care delivery system.
authors.affiliation: Yale University School of Nursing, 100 Church Street, New Haven, CT 06536, USA. dena.schulman-green@yale.edu
authors.forename: Dena
authors.initials: D
authors.lastname: Schulman-Green
authors.forename: Debra
authors.initials: D
authors.lastname: Harris
authors.forename: Ying
authors.initials: Y
authors.lastname: Xue
authors.forename: Diane B
authors.initials: DB
authors.lastname: Loseth
authors.forename: Cindy
authors.initials: C
authors.lastname: Czaplinski
authors.forename: Constance
authors.initials: C
authors.lastname: Donovan
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004645:Empathy; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006797:Housekeeping, Hospital / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008502:Medical Secretaries / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009511:New England; D009728:Nursing Assistants / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015404:Nursing Methodology Research; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D024382:Professional Role / Q000523:psychology; D036301:Qualitative Research; D020377:Self Efficacy