"Nurses: Pain affects everything else"

September 14, 2009 -- Today United Press International (UPI) issued a short item about the pain management research of Johns Hopkins nurse scholars Gayle Page and Sharon Kozachik. The main idea is that the nurses have "determined through research that pain management is not only a matter of compassion, but a medical necessity for patients to heal"--a statement that could as easily be made about the profession of nursing, which many decision-makers see as being more about compassion than life-saving. The piece includes short quotes by both scholars. Page says pain is an "exquisite stressor" because it affects so many components of wellbeing, from sleep to the ability to heal. Kozachik describes the challenge of finding the point at which pain is adequately managed--a line that is vital to clinical care. The piece notes that the research relies on animal studies; it does not explore the ethical issues involved. The item might have described more of the specific effects of this research on patient outcomes and costs, and told readers that Page and Kozachik are leading scholars with doctorates. But on the whole, the piece is a good example of press coverage of nursing research, coverage that remains rare. Indeed, though the UPI item (presumably the result of a September 11 Hopkins press release) was noted on a few health-oriented web sites, we saw no other mainstream press coverage. We commend UPI and Hopkins for their efforts to inform the public about the value of nursing research.

The UPI item was headlined: "Nurses: Pain effects everything else." It explains that "two U.S. nurses" have determined that healing requires pain management. Page, "of the Johns Hopkins University School of Nursing in Baltimore, calls pain an 'exquisite stressor' affecting mood, sleep, the abilities to heal, and to fend off infection and illnesses." Page and Kozachik are "studying laboratory animal models" to clarify the effects of pain on body systems. The item quotes Kozachik:

There's a fine line to walk between pain that's managed and pain that damages. The challenge inherent in our research is to identify those tipping points so we can avoid them in our clinical care of patients in pain.

The article closes with an indirect quote from Page, who says that "the distance from the research bench to the bedside is closer than some may think and [our] animal studies are showing the mechanisms of pain and the body systems make pain management key in improving human health."

This short item sends a great message not only about the importance of pain management, but about the importance of nursing research. The piece identifies the two scholars as "nurses" at the nursing school of a major university, which is critical; it could easily have simply called them "Hopkins researchers," and readers probably would have assumed they were physicians or biologists. Perhaps part of what made the story newsworthy was the perceived novelty of nurse researchers, but we won't be picky about what it takes to improve public understanding of the profession. In a short space the item also conveys some basic information about the nurses' work, and it gives them several opportunities to act as experts on the subject.

On the down side, the piece might have explained in a little more detail just what a difference effective pain management can make for patients, as the Hopkins press release does. Can pain mean the difference between life and death? Between a full recovery and something less? Between a six-month recovery and a two-month recovery? What are the cost implications of those differences?

The piece might also have made clear just how advanced these two nurses are -- they are both Hopkins professors, scholars with doctorates and many professional publications. Gayle Page is a global leader in pain research who has spearheaded important research in the field for two decades. Sharon Kozachik has studied pain, sleep, and symptom management, and she is responsible for a stream of relevant publications over the last decade. The research the UPI item is describing is focused on aspects of health care that have long been at the core of nursing practice. And this project appears to be funded by the National Institute of Nursing Research, which is part of the National Institutes of Health--a greatly underfunded part, but a part nonetheless.

In any case, we commend UPI for publishing this helpful example of the critical work of nursing scholars, and the Johns Hopkins School of Nursing for making an effort to publicize that work.

See the UPI article "Nurses: Pain affects everything else" that was posted September 14, 2009.