Management of Breakthrough Pain in Cancer Patients - Episode 4

Role of the Oncology Nurse in Breakthrough Cancer Pain

In the management of breakthrough cancer pain, oncology nurses play a multifaceted role that involves patient education and assessment.

In many cases, patients will only discuss their pain with a nurse, since they feel more comfortable in this setting. As a result, it is important for nurses to relay this information back to the treating physician, since it may impact treatment, Jeri L. Ashley, RN, MSN, AOCNS, CHPN, notes.

All pain assessments should be conducted in an unbiased fashion that is focused on physical assessment and poignant questions, Ashley asserts. The assessment should consider suffering, cultural issues, spiritual issues, and other measurable dimensions of pain.

In most situations, nurses spend the most time with patients and are integral in the patient education process. However, before nurses can educate a patient on the correct use of rapid-onset opioids for breakthrough pain, they must first build a rapport, Ashley states. Once a rapport is established, the next goal is to ascertain possible apprehensions or potential for misuse and abuse. Finally, nurses must conduct reassessments, since it is a vital part of effective pain management, Ashley notes.

Regarding pain medication abuse and misuse, Ashley and Marc Rappaport, DO, believe the utilization of questions aimed at establishing the likelihood of opioid abuse are critical, because even in oncology settings, physicians should remain aware of the potential for misuse and addiction.