Takeaway
Pain and suffering are ubiquitous. Observing approaches and practices in the U.S. highlighted for me the importance of open dialogue, patient empowerment, and multimodal approaches.
Lifelong Learning in Clinical Excellence | October 2, 2024 | 1 min read
By Amani Algubari, MD, Farwaniya Hospital, Kuwait & Amy Yu, MD, JHM
It was my first day stepping into a hospital in the U.S. and seeing an interaction between a patient and clinician. The interaction was with a pancreatic cancer patient who was undergoing neoadjuvant chemotherapy. What stood out to me the most was that the doctor dedicated the majority of the interaction discussing pain management strategies with the patient and engaged a palliative care specialist to ensure effective pain relief while minimizing side effects.
During my time observing at Johns Hopkins, I reflected on the differences in pain management practices between back home Kuwait and the U.S. Here are a few key takeaways that I believe could be incorporated into the practices at my home hospital.
1. Encourage open dialogue.
I’m accustomed to asking about pain using the “SOCRATES” method: site, onset, character, radiation, associations, timing, exacerbating factors, and severity.These questions are used as a diagnostic tool; however, I’ve learned the importance of delving deeper into the patient’s narrative. Beyond the diagnostic checklist, it’s crucial to understand how pain impacts their daily life.
2. Acknowledge the patient’s pain.
Validating their experience creates trust in the management approach you’re providing.
3. Empower patients.
Explaining the risks and benefits of each pain management method can foster trust. This helps to create a plan together, enhancing comfort and mitigating the risk of overuse of pain medications.
4. Use multimodal approaches.
5. Opioid overuse and underuse.
A significant difference in the pain management approach between Hopkins and my home hospital is the use of opioids. In Kuwait, they’re rarely ever used even in cases of severe pain. This difference allowed me to clearly see the advantages and disadvantages of these medications. Implementing a strategy where opioids are used when needed, and not completely avoided due to the fear of their risks, and then discontinued at the earliest opportunity, seems to be the best approach.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.