The Nurse as Pain Educator, Part 2
An Interview with Gail M. Wilkes, RN, MSN, OCN
| Gail M. Wilkes, RN, MSN, OCN, is an oncology nurse practitioner, pain educator, and Clinical Instructor in Oncology Nursing, at Boston Medical Center, Boston MA. Ms. Wilkes has done research and has written on the topic of pain management education. This is the second of two "Spotlight" interviews with her. |
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Questions
1: You have had the opportunity to do some interesting pain education research and writing in your career. Can you tell us how this started?
 2: What about your research to evaluate better ways to teach health care providers about pain management?
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-------------------------------------------------------------------------------------------------------------------------- Evelyn Corsini:
You have had the opportunity to do some interesting pain education research and writing in your career. Can you tell us how this started? Gail M. Wilkes, RN, MSN, OCN: As an oncology nurse, I had developed a lot of experience treating cancer- related pain. I found that we could effectively provide pain relief to about 90% of our patients, but there were still the other 10% who were very hard to treat. Those were the situations when you had to adjust medications and remain very alert to the patient’s response. Since the nurse spends more time with the patient than any other health care provider, he/she naturally becomes expert in how to help the patient manage pain.
In 1990, I had the opportunity to work with Kathryn E. Lasch, Ph.D., a research scientist at the Health Institute at New England Medical Center, on a National Cancer Institute grant to develop culturally sensitive print materials for patients to improve their management of cancer pain. The grant also included research to explore the most effective way to teach nurses about pain management.
The project was fascinating. As part of our review of cultural differences in attitudes toward pain, we ran focus groups representing 11 different cultures. Here is an example of two culturally based sets of ideas about pain we found. We worked with a community of refugees from Cambodia in Lowell, MA. From that group I learned that Buddhists believe they need to suffer in order to experience nirvana, so they may not want to stop their painful suffering. With Latinos, I learned that some believe that whatever the doctor prescribed must always be right. If they still had pain after treatment they did not want to offend their doctors by complaining. The written material we developed was in the native language on one page, and in English on the facing page, so that the health care provider would understand the teaching points and could reinforce them.
EC: What about your research to evaluate better ways to teach health care providers about pain management? GW: While we know that effective means of pain management do exist, all studies show that pain is undertreated and that medical personnel have knowledge deficits and attitudinal barriers to pain management. As part of the same project with Dr. Lasch, we recognized that health care providers have a major responsibility to understand pain management, so we looked at the attitudes and beliefs about pain management among medical and nursing students and faculty. We found that there were deficits in knowledge about medications and other therapies, as well as a lack of curriculum and knowledgeable faculty and mentors to disseminate this knowledge. We concluded that it would be an important priority to increase the knowledge and understanding of the meanings of pain to health care students.
Educating other health care providers about pain management is a major part of my job now at Boston Medical Center. These efforts are well received, and the hospital is committed to continuing this effort.
References
Wilkes G, Lasch KE, Lee JC et al (2003) Evaluation of a Cancer Pain Education Module Oncology Nursing Forum 30(6): 1037-1043 (Nov/Dec 2003)
Lasch K, Greenhill A, Wilkes GM, Carr D, Blanchard R (2002) Why Study Pain? A qualitative analysis of medical and nursing faculty and students’ knowledge of and attitudes to cancer pain management J Palliat Med 5(1): 57-71
Lasch KE, Wilkes G, Montuori LM, Chew P, Leonard C, Hilton S (2000) Using focus group methods to develop multicultural cancer pain education materials Pain Manag Nurs 1(4): 129-38
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