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April 13, 2006 • Volume 14 Number 15

Assoc. Prof. Paul Arnstein (CSON): "There are some 30 to 50 percent of American adults living with persistent pain yet 90 percent of pain is treatable."

Nursing and Pain Management

Connell School's Arnstein a pioneer in increasingly vital area of health care

By Kathleen Sullivan
Staff Writer

Boston College is home to a pioneer in a growing specialty area of nursing practice: Assoc. Prof. Paul Arnstein (CSON), one of the first nurses in the United States to be certified in pain management.

Arnstein, who holds a doctorate in nursing from Boston College, earned certification from the American Nurses Association after taking the first exam ever offered for pain management, which involves the effective evaluation and treatment of pain. He was one of only 368 nurses nationwide to successfully demonstrate a working knowledge of pain management across the life span and for different types of pain: acute, chronic and terminal disease-related.

Pain management has been the focus of Arnstein's professional career for more than a decade. His studies have focused on pediatric post-operative pain, post-operative pain following joint replacement surgery, and outcomes for unpartnered, elderly heart attack patients. He has been published in the American Journal of Nursing and the international research journal Pain, among other publications. Arnstein also has served in a leadership capacity for several professional organizations that focus on pain management.

Small wonder that Arnstein is praised for his key role in efforts to have pain management officially recognized as an area of specialty in nursing. Colleagues say his research and advocacy emphasize the need to better evaluate and treat people with pain and to acknowledge the importance of pain management in health care settings.

They also cite his development of the "Understanding and Managing Chronic Pain Program" to help patients learn the skills to control pain, improve function, restore hope and improve their quality of life. The program has been clinically tested and become an international model for pain management.

"The management of pain is a major component of nursing practice and the students and faculty members in the William F. Connell School of Nursing are most fortunate in having Paul here," said CSON Dean Barbara Hazard. "He is recognized nationally for his expertise in the management of pain."

Said Arnstein, "There are some 30 to 50 percent of American adults living with persistent pain yet 90 percent of pain is treatable.

"It's a public health problem," says Arnstein, pointing to National Institutes of Nursing Research data that claims pain costs the US more than $100 billion per year in medical expenses and lost productivity.

Most cases of pain result from surgery, trauma or cancer, says Arnstein, who also notes the impact of health care advances: As medical science has developed cures and treatments for once life-threatening illnesses, adults are thus living longer and facing the daily pain associated with aging and chronic conditions. Many surgeries are now performed as day surgeries, he says, requiring patients to manage their pain alone at home.

"Pain treatment considers both the physical and emotional experience of pain," Arnstein said. Medications - ranging from controlled substances like Percocet to non-opiates such as Tylenol, and coanalgesics - are just some of the resources used in pain treatment. Treatment can also involve massage, acupressure, relaxation techniques and heat, for example. Arnstein says it is usually "a combination of approaches that results in the maximum function with the minimum of pain."

The recognition of pain management as a specialized area of health care is a fairly recent phenomenon. The federal government issued the first clinical practice guidelines on pain management in the 1990s, and the American Nurses Association recognized pain management as a specialty within the practice of nursing only last year.

Arnstein says he hopes the new pain management in nursing certification will bring further recognition to the importance of formalized pain management approaches in hospitals, hospices and nursing homes.

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