The Role of Nursing in Pain Management
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Nurse Practitioner and Certified Registered Nurse Anesthetist are advanced practice roles in which nurses functions with greater autonomy in a supervised or collaborative relationship with physicians. Rather than collaborating with physicians for orders prior to initiating changes in the pain management plan, advanced practice nurses collaborate with physicians when determining diagnoses and treatment plans, but maintain independent decision-making authority (Brown & Draye, 2003). Although the role of advanced practice nurses was first described in the 1960s, it is not unusual for these nurses today to find that the jobs they are considering may not have well-defined descriptions and roles. Nurses are embracing these challenges and opportunities that come with defining their advanced practice roles. Advanced practice nurses in many states are able to obtain prescriptive privileges for controlled substances. Prescriptive practice allows these nurses to fill a much-needed role in settings and locations where access to pain management specialists or health care providers with pain management expertise is limited. The role of advanced practice nurses has improved access to services for patients and specifically for patients in vulnerable populations such as minorities, those with low incomes, and the uninsured (Brown & Draye, 2003). Advanced practice nurses may specialize in pain management and fill roles within an interventional pain management clinic or multidisciplinary pain management center.
Sources of Medical Information
Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson in Legal Nurse Consulting Principles and Practices, 2019
Either an anesthesiologist or a certified registered nurse anesthetist (CRNA) provide anesthesia and patient monitoring during surgical procedures. Some states allow a certified anesthesiologist assistant (CAA) to provide anesthesia care for patients undergoing operative procedures. CAAs must meet certain educational criteria and pass a national exam (American Academy of Anesthesiologist Assistants, 2017). Sometimes the induction is performed by a CRNA or CAA with an anesthesiologist present, who subsequently leaves the OR suite to oversee another anesthesia provider.
Surgical Team Experiences
Akshaya Neil Arya in Preparing for International Health Experiences, 2017
In a similar fashion, one must familiarize themselves with the host team. Supply of specialist surgeons is extremely limited in many of the low-income countries and some countries have an explicit policy supporting non-physicians to perform surgery, and most of the anesthesia also may be provided by nurse anesthetists (Chu et al., 2009). Despite a lack of specialist training, these clinicians often have a great deal of clinical experience and expertise and are an invaluable source of information for a visiting trainee.
Intracardiac Echocardiography-Guided Device Closure of Non-PFO/ASD Shunts
Published in Structural Heart, 2018
Benjamin Acheampong, Jonathan N. Johnson, Donald J. Hagler, Allison K. Cabalka, Frank Cetta, Nathaniel W. Taggart
ICE studies were performed using the ACUSON AcuNav™ diagnostic ultrasound catheter linked to a Sequoia ultrasound-imaging platform (ACUSON Corp, Mountain View, CA). After local anesthesia, femoral venous access was obtained, which included an 8 or 9 French sheath for 8F AcuNav™ catheter or a 10 or 11 French sheath for 10 French AcuNav™ catheter, as well as additional vascular access as needed for hemodynamic assessment, angiography, and device placement. When feasible, patient comfort was managed by conscious sedation; general anesthesia was used for younger patients, those with significant procedural anxiety, and patients in whom TEE was also performed. Sedation and anesthesia were administered by a certified registered nurse anesthetist and supervised by an anesthesiologist. All patients received intravenous heparin (50–100 IU/kg) after vascular access. Additional heparin was administered as needed to maintain an activated clotting time above 200 seconds.
Cataract in children in sub-Saharan Africa: an overview
Published in Expert Review of Ophthalmology, 2018
Annie Bronsard, Robert Geneau, Roseline Duke, Lévi Kandeke, Ssali Grace Nsibirwa, Mildred Ulaikere, Paul Courtright
There are very few full-time pediatric anesthesiologists in SSA; this human resource gap has been one of the major challenges in routinely performing childhood cataract surgery at CEHTF. Since the surgical turnover time between patients is long and anesthesiologist time is limited, most CEHTF try to organize a number of children to have surgery on the same day. Early in the development of CEHTF, nurse anesthetists assisted in providing anesthesia, however due to national professional guidelines and with the maturation of the CEHTF, inclusion of an anesthesiologist as part of the CEHTF team has become the norm. Follow up of patients and examinations under anesthesia, often at secondary facilities, are mainly performed by nurse anesthetists under the supervision of an ophthalmologist.
Barriers and facilitators to postoperative pain management in Rwanda from the perspective of health care providers: A contextualization of the theory of planned behavior
Published in Canadian Journal of Pain, 2018
Gaston Nyirigira, Rosemary A. Wilson, Elizabeth G. VanDenKerkhof, David H. Goldstein, Theogene Twagirumugabe, Ryan Mahaffey, Joel Parlow, Ana P. Johnson
In 2010, 706 surgical procedures were performed per 100 000 Rwandans,24 and there were over 9000 road accidents, 25% of which were severe and resulted in major injuries that were fatal or required surgery.25 The improvement and expansion of health care in Rwanda has been the focus of a number of global health initiatives, employing collaborations with mainly academic institutions in developed countries (e.g., Rwandan Human Resources for Health,26 Canadian Anesthesiologists’ Society International Education Foundation27). Currently, institutional health care is provided through a decentralized system of five referral and 42 district hospitals, health posts, and a network of dispensaries, transfusion centers, and clinics. Surgery and perioperative care are exclusively provided at district and referral centers.28 There are two university teaching hospitals. University Central Hospital of Kigali (CHUK) is a 513-bed hospital located in the capital city of Kigali. University Teaching Hospital of Butare (CHUB) is a 420-bed hospital located in Butare in the southern province of Rwanda. In the operative setting, nurse anesthetists (NAs) or anesthesia technicians provide much of the anesthetic care due to the limited number of anesthesiologists in Rwanda (12 in 2010)24 and generally do so without the direct supervision of an anesthesiologist.
Related Knowledge Centers
- Anesthesia
- Surgery
- Advanced Practice Nurse
- Preanesthetic Assessment