Pain Resource Nurses: Believing the Patients, Believing in Themselves

Sandra Holley

Susan C. McMillan

Susan J. Hagan

Polly Palacios

Deborah Rosenberg

ONF 2005, 32(4), 843-848. DOI: 10.1188/05.ONF.843-848

Purpose/Objectives: To describe the experience of being a pain resource nurse (PRN), discuss the influence of the PRN's role on colleagues and patient care, and explore barriers to the PRN role.

Design: Qualitative, exploratory.

Setting: A Veterans Administration hospital in the southeastern United States.

Sample: 12 nurses who received advanced training in pain assessment and management attended focus groups approximately one year after assuming the PRN role.

Methods: Two focus group sessions, each with four to eight nurses. Each nurse was asked to describe her experience. Interviews were transcribed verbatim. Data were analyzed using Spradley's domain analysis for discovering processes and themes from the transcribed data.

Main Research Variables: The experience of being a PRN, the influence of the PRN on staff and patients, and barriers to the role and pain management.

Findings: The key processes that described the PRN experience were Believing the Patients (i.e., an awareness that nurses must have to effectively manage patients' pain) and Believing in Themselves (i.e., the PRNs gained authority as experts in pain management, accepted the responsibility of being champions in pain management, and gave themselves permission to make patients comfortable).

Conclusions: The pain-training course the PRNs received enabled them to practice as confident, credible, and empowered professionals. The awareness that they acquired during the course and the year of practice allowed the PRNs to be patient advocates, role models, and educators.

Implications for Nursing: The findings of this study indicate a high level of nurse satisfaction with the PRN role. Nurses with an interest and specialized knowledge in pain assessment and management at the unit level may greatly improve patient outcomes.

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    Chiu, L.H., Trinca, J., Lim, L.M., & Tuazon, J.A. (2003). A study to evaluate the pain knowledge of two sub-populations of final year nursing students: Australia and Philippines. Journal of Advanced Nursing, 41, 98-108.

    Dalton, J.A., Carlson, J., Mann, J.D., Blau, W., Bernard, S., & Youngblood, R. (1998). An examination of nursing attitudes and pain management practices. Cancer Practice, 6, 115-124.

    de Rond, M.E., de Wit, R., van Dam, F.S., van Campen, B.T., den Hartog, Y.M., & Klievink, R.M. (2000). A pain monitoring program for nurses: Effects on nurses' pain knowledge and attitude. Journal of Pain and Symptom Management, 19, 457-467.

    Erkes, E.B., Parker, V.G., Carr, R.L., & Mayo, R.M. (2001). An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients. Pain Management Nursing, 2(2), 47-53.

    Ferrell, B.R., Grant, M., Ritchey, K.J., Ropchan, R., & Rivera, L.M. (1993). The pain resource nurse training program: A unique approach to pain management. Journal of Pain and Symptom Management, 8, 549-556.

    Ferrell, B.R., McGuire, D.B., & Donovan, M.I. (1993). Knowledge and beliefs regarding pain in a sample of nursing faculty. Journal of Professional Nursing, 9, 79-88.

    Fisch, M.J., & Cleeland, C.S. (2003). Managing cancer pain. In R.T. Skeel (Ed.), Handbook of cancer chemotherapy (6th ed., pp. 650-673). Philadelphia: Lippincott Williams and Wilkins.

    Fothergill-Bourbonnais, F., & Wilson-Barnett, J. (1992). A comparative study of intensive therapy unit and hospice nurses' knowledge on pain management. Journal of Advanced Nursing, 17, 362-372.

    Howell, D., Butler, L., Vincent, L., Watt-Watson, J., & Stearns, N. (2000). Influencing nurses' knowledge, attitudes, and practice in cancer pain management. Cancer Nursing, 23, 55-63.

    Joint Commission on Accreditation of Healthcare Organizations. (1999). Joint Commission focuses on pain management. Retrieved November 17, 2003, from

    Kravitz, R.L., Delafield, J.P., Hays, R.D., Drazin, R., & Conolly, M. (1996). Bedside charting of pain levels in hospitalized patients with cancer: A randomized controlled trial. Journal of Pain and Symptom Management, 11, 81-87.

    Lebovits, A.H., Florence, I., Bathina, R., Hunko, V., Fox, M.T., & Bramble, C.Y. (1997). Pain knowledge and attitudes of healthcare providers: Practice characteristic differences. Clinical Journal of Pain, 13, 237-243.

    McCaffery, M., & Ferrell, B.R. (1992). Opioid analgesics: Nurses' knowledge of doses and psychological dependence. Journal of Nursing Staff Development, 8, 77-84.

    McMillan, S.C., & Tittle, M. (1995). A descriptive study of the management of pain and pain-related side effects in a cancer center and a hospice. Hospice Journal, 10(1), 89-107.

    McMillan, S.C., Tittle, M., Hagan, S., & Laughlin, J. (2000). Management of pain and pain-related symptoms in hospitalized veterans with cancer. Cancer Nursing, 23, 327-336.

    McMillan, S.C., Tittle, M., Hagan, S., Laughlin, J., & Tabler, R.E. (2000). Knowledge and attitudes of nurses in veterans hospitals about pain management in patients with cancer. Oncology Nursing Forum, 27, 1415-1423.

    Miaskowski, C., Dodd, M.J., West, C., Paul, S.M., Tripathy, D., Koo, P., et al. (2001). Lack of adherence with the analgesic regimen: A significant barrier to effective cancer pain management. Journal of Clinical Oncology, 19, 4275-4279.

    National Cancer Comprehensive Network. (2005). Clinical practice guidelines in oncology: Adult cancer pain. Retrieved May 25, 2005, from

    O'Brien, S., Dalton, J.A., Konsler, G., & Carlson, J. (1996). The knowledge and attitudes of experienced oncology nurses regarding the management of cancer-related pain. Oncology Nursing Forum, 23, 515-521.

    Paice, J.A., Mahon, S.M., & Faut-Callahan, M. (1991). Factors associated with adequate pain control in hospitalized post surgical patients diagnosed with cancer. Cancer Nursing, 14, 298-305.

    Plymale, M.A., Sloan, P.A., Johnson, M., Lafountain, P., Snapp, J., Vanderveer, B., et al. (2001). Cancer pain education: A structured clinical instruction module for hospice nurses. Cancer Nursing, 24, 424-429.

    Portenoy, R.K., & Kanner, R.M. (1985). Patterns of analgesics prescription and consumption in a university-affiliated community hospital. Archives of Internal Medicine, 145, 439-441.

    Portenoy, R.K., & Lesage, P. (1999). Management of cancer pain. Lancet, 353, 1695-1700.

    Spradley, J.P. (1979). The ethnographic interview. New York: Harcourt Brace Jovanovich.

    Vortherms, R., Ryan, P., & Ward, S. (1992). Knowledge of, attitudes toward, and barriers to pharmacologic management of cancer pain in a statewide random sample of nurses. Research in Nursing and Health, 15, 459-466.

    Watt-Watson, J., Stevens, B., Garfinkel, P., Streiner, D., & Gallop, R. (2001). Relationship between nurses' pain knowledge and pain management outcomes for their postoperative cardiac patients. Journal of Advanced Nursing, 36, 535-545.

    Weissman, D.E. (1988). Cancer pain education: A call for role models [Editorial]. Journal of Clinical Oncology, 6, 1793-1794.

    World Health Organization. (1996). Cancer pain relief (2nd ed). Geneva, Switzerland: Author.

    Zalon, M.L. (1999). Comparison of pain measures in surgical patients. Journal of Nursing Measurement, 7, 135-152.