What is it really like working in Pain Management? Do you have misconceptions about the specialty?
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- Опубліковано 15 тра 2024
- Could you be wrong about what you think it is like to work in Pain Management? Is Pain Management a terrible specialty or do people actually enjoy it? In this video, I interview a Pain Management PA who tells us what it's really like and why you should consider working in Pain Management. Discover what APPs actually do in Pain Management, what the work life balance is like, and what the pros and cons are of working in this specialty.
Timestamps
00:00 Intro
01:53 Type of patients seen in Pain Management
03:47 Misconceptions about Pain Management
04:52 Managing patient expectations
05:18 Diagnosing in Pain Management
06:08 Are opioids a big problem in Pain Management?
07:35 Treatment options in Pain Management
09:15 Injections APPs do in Pain Management
10:15 APP autonomy in Pain Management
10:52 Work settings in Pain Management
11:39 Work life balance in Pain Management
12:24 Best personality traits for working in Pain Management
15:30 Patient count in Pain Management
16:10 Surprises in Pain Management
18:08 Other challenges of working in Pain Management
18:52 Best rotations for Pain Management
19:25 Resources for working in Pain Management
20:09 Is Pain Management new grad friendly?
20:30 Why you should consider working in Pain Management
Thanks for watching and don't forget to SUBSCRIBE! 👍👍👍👍👍❤️❤️
Until you suffer from chronic pain you have no idea…. That’s all I have to say.
This!
I agree , and you'll do everything you can to be pain free
This lady is being paid big bucks for doing nothing for people who have real daily pain!! I definitely went to college for the wrong thing. Gabbapentin is on the verge of becoming a controlled substance as it is very addictive. Also SSRNI’s especially Cymbalta are some of the most addictive meds on the planet. Trying my best to get of Cymbalta and can’t due to the withdrawal symptoms. Brutal!!
i scribe for a doctor in pain management every so often. this lady has it 100% right. most patients are lovely, and very nice. generally they dont want opiates. you'll have some that are miserable, but it's due to their symptoms or mental health. I think the worst/most exhausting part is continuing worker's compensation cases that are dead end, and having the patients on opioids forever. These patients come in every four weeks for these visits, and there is not much that WC insurance will often approve other than these treatments.
Yes, sometimes worker's comp can be very frustrating to work within the system! I think scribing is a great way to learn and understand charting, which is a significant part of being a provider. Thanks for watching and commenting!
This is a serious problem for people with chronic pain. The CDC falsely conflates the long-term need for strong pain medication (opioids) with addiction. When they don't take the pain meds, the pain comes back. Duh! This does not mean they are addicted. There are many people who will need to be on opioid medication for pain management FOR THE REST OF THEIR LIVES, and not just cancer patients. They are not 'drug-seekers'. If a person is in severe pain, they will be "addicted" to ANYTHING that relieves that pain, whether drugs or other modalities or a combination. There is no need for these people to 'get off' their pain meds or to switch to something 'lighter'. Give them whatever works for their pain, and it's up to THEM to tell you what works and what does not.
I had a doctor try and change what has been working for me for years after a de-gloving of my finger from a truck and trailer accident. He did not take into consideration me just stopping a pill cold turkey over night just doesn't work. He didn't give me any way to do it without being harmed.
I had polio 74 years ago. I live in pain from post polio muscle issues but opioids allow me a quality of life that gets more tenuous every month because I never know when some do-gooder, frightened doctor, politician or government bean counter is going to get me cut off. I have no cartilage in my “good”leg. Due to my gait my back and ankle is a mess with arthritis as well. So when I hear about someone going out in their back yard and putting a gun in their mouth I wonder if that’s going to be my fate one day. Who will be the author of my death by not treating my suffering?
I feel the EXACT same way. If something doesn’t change soon, I am going to make my final plans and leave this world. I am absolutely f**king DONE with these spineless f**king prick doctors.
You’re not alone. I’ve suffered from rheumatoid arthritis for 23 years and now all of a sudden I’m being sent to a pain management clinic. Needless to say at 63 years old I’m more than angry.😡😡
Patients with chronic pain have "mood symptoms" because pain makes you miserable. People who feel better taking antidepressants were probably depressed. Weird how that works.
I understand your thoughts, but the brain is very complex. It can get stuck in certain neuron driven pathways. Medications like SSRIs can help disrupt those pathways, thereby helping relieve pain. So, no “ mood medications” are not just given in pain management for depression, although treating underlying depression certainly helps. So, we as providers hope that people would be open to those treatments. Thanks for watching and commenting!
@@TheMedicineCouch so what about when an SSRI doesn't do a thing it has never been proven to be capable of doing? Anti seizure medications, yeah? They haven't been proven to do those things either. People are very rarely in pain because they're depressed. They are however depressed because they're in pain. The depression isn't underlying, it's a symptom of something that isn't being treated. People who are in pain are open to "treatments" that have never been shown to treat pain, but providers don't seem to be open to accepting that their "treatments" aren't working because nobody ever said they would.
@@TheMedicineCouch and I never called SSRIs "mood medications." Just FYI.
@@mydogeatspuke Personally I have severe PTSD from how I was treated from the "specialists", who wanted me on the max dose of Pregabalin for more than 2 years REGARDLESS OF SIDE EFFECTS, and insisted that I HAD to be on Cymbalta (under 50 age group) which of course "is not addictive, causes no side effects past day 3 and you can stop at any time at will", REGARDLESS of having had serotonin syndrome with a full blown seizure from SNRIs, which of course the "specialist" downplayed, normalized and ultimately dismissed, handing me the script in under 15 minutes in total. The anesthesiologist called me an addict because she claimed that my codeine script was too low to do anything for pain (indeed it barely put a dent but it was the only thing that had an effect on the pain levels), and insisted that I "liked them" for the euphoria and I was too young to get any treatment, "cause I would most likely have that pain for my whole life"
I was considering going to pain management. but after watching this video I figure I have no hope in getting the care I need by going to them.
I don't understand what in this video would have turned you away from pain management?
@TheMedicineCouch Most of your patients do not get opiates, which are FDA approved, and proven to help with chronic pain, with few side effects. CDC has re-written their guidelines (not law) yet doctors are still in jail, still afraid of being taken to jail, or having their license taken. Fewer than 3% of patients on opiates become addicted. Most do become dependant.
Personally I am tired of being a guinea pig and being put on many meds with horrible side effects, (Gabapentin, buponorphine, injections, etc) when I only require 50 mme equivalent of opiate therapy to keep a quality of life, along with 6 motrin 600s a day and that allows me to keep being employed and keeps me a tax-paying citizen. Opioid therapy keeps me off the couch, and allows me to be physical in a way that no other meds have been successful. Thank you for the video!
@@TheMedicineCouchI am not against other forms of medicine, which can be very helpful for some! I am just noticing a sharp decline in quality of life for those who can no longer access opioids, due to the opioid crisis which is a fentanyl crisis, not a prescription drug crisis. Thank ya for listening!
Not all are the same. I’ve been managed with opioids for years as well as injections as needed. I also have implants. I hope you find a clinic that’ll help you.
I’ve been treated with opioids for years and also have a pump and SCS, as well as injections, nerve blocks, and RFAs. I also have painful autoimmune immune diseases and I thank God for the multidisciplinary care and professionalism I get from my clinic.
Helpful, thank you. Great video. It cleared up some of my misconceptions and preconceived notions about working in pain management. N.S. FNP-BC
Great! I’m glad it was helpful to you. Thanks for watching and commenting!
Very insightful and informative. I have a new patient appointment with pain management. I had no clue what to expect.
Glad you liked it. Best wishes for your upcoming appointment!
Well, I’m about 1 month in working in pain management and I can tell you that everything she said was spot on. That’s exactly how it is and her advice is excellent.
Great to hear! Thanks for watching and thanks for sharing your experience with us.
Drug seekers really ruin access to medicine for those of us who really need it. It irritates and worries doctors and pharmacists. Politicians pass rules and laws making access more burdensome. Patients get treated with suspicion. Their problems sometimes end up untreated or undertreated.
Yes, it is a genuine problem in healthcare. However, while it is very frustrating, we also have to remember that anyone can become addicted to these medications and the addiction drives their behavior.
The CDC use to rate hospitals on how well they treat pain, now they want to shut us all out. I've had 4 tricuspid valve replacements. I was prescribed opiates, I never finished a bottle, before I was back to work. I didn't become addicted. My heart doctor didn't write heavy, I was very young, for the first 2 open heart surgeries. She knew I had no family, and wrote me 15 pain pills at a time. I only had them refilled once.
@@TheMedicineCouch I have been on opioids for eleven years and I show no signs of addiction. I have been taught that the addiction rate is 8 percent.
@@TheMedicineCouchit is a shame people such as yourself go right to addiction! Yep everyone is drug seaking. Just for the high. People get sick of being judged by the medical profession! There’s a huge difference between being addicted and being dependent! Not sure if you know what pain management people have to go through to get their monthly prescriptions? But it’s unbelievable. Eventually people will hat are addicted show clear signs of addiction. I refuse to live with no quality of life due to pain. I do not abuse I do not get any high from the medications. I never run out. I pass every UA. I also do other things such as injections, tens unit, braces and other forms to control my pain. But honestly the medical profession really show how judgmental they are! Idk if you’re in the medical profession. And I really don’t care. What I do care about is how judgmental people like you are. My dad is fused from the mid back to tailbone. I stopped going to pain management due to judgmental people such as yourself. He has zero quality of life. He is at time in so much pain others can see it in his face.
@@TheMedicineCouchI have no choice but to take opioids so I can make a living and take care of my wife and two daughters. Without them I could not work. I have been taking a moderate amount, 40mg a day for 16 years never more but often times, (whenever possible) less. I’m fully aware how dangerous opioids are and I respect them immensely and treat them cautiously because they are not something to mess around with. I have severe pain and it is essential that I take them to survive and trust me for years and years my doctors and I had exhausted every avenue possible before landing on opioids.
If I was to over take my medicine to get high that means I would run out early before my 30 days were over and I wouldn’t be able to work and I would let myself and family down. But it’s difficult to manipulate my dose so I don’t increase my tolerance or lose the efficacy. It’s hard what I do but I have no choice. Most people shouldn’t be on opioids long term unless their pain is very severe and debilitating and they have no other options.
This is so very helpful. Interviewed for a pain mgmt position and really like the philosophy of the specialty! I totally agree that MH plays a huge role in pain management! Thank you!
Glad you liked the video! Let us know if you end up in pain management.
@AnimalLover12321 I have to disagree. From personal experience, clinicians always that view, that my pain could be minimized if I did some sort of, by the way very expensive for me but very helpful economically for a mental health clinician, mental health treatment. I actually had learned and had been using relaxation exercises a few years before my pain started - to deal with anxiety. Every time I see a new pain professional the idea of learning relaxation exercises comes up. Why, because I never both telling them that I already know and use relaxation exercises and it doesn't help pain. It helps me deal with mild pain, in other words, helps me not to become anxious about it and remain calm and not run to the emergency room for mild pain. But it does nothing for serious, nagging pain. In fact it makes it worse. I find distraction works for mild to moderate pain. For example I do something I really enjoy, or watch a movie, or listen to music. But once pain reaches a certain level, it becomes impossible for me to even pay attention to a movie. I just have to sit down or lie down and endure the pain. Relation exercises have enabled me to control the anger and the hatred that arises when clinicians don't take my pain seriously or prescribe sufficient opioids. So I can go on and endure the pain without wishing to harm them. My belief system does the same thing, that is, while instinctively I want to be angry at clinicians, I am able to refrain from being angry, because I know in most cases it won't help. I am a single individual trying to deal with the "group-think" of health care professionals, their reliance on a professional consensus that is not necessarily based on science, that may be based on their educated guess instead. Pain turned me into a vegan by the way. Once I began experiencing pain, I no longer had the heart to participate in the system of raising, enslaving, and slaughtering animals. I just look at a baby cow that might be on its mother's breast, just like my child was on his mother's breast, and I can't agree to participate in the animal husbandry - treating animals like they are animals one might say. They are not. You can see they love their children same as we do.
Do pain specialist talk about inflammation,due to starchy, sugar diet, chronic arthritis in lot of joints? And why did big pharma push oxycodone on older folks,invent the 5th vital sign at the same time??? really would like to know
I do wish medicine in general focused more on how our diets affect our health! I think we're missing a big component there.
A proper diet really helps keep your pain under control. However, you're paying has to be under control before you can do it. l everything in my life is wrong for my pain. But I don't get the pain relief i need, so I can do it right.
I have really deteriorated these past few years. And I don't know how much longer I will be around. But I know we're I'll go when I die. And I know I'll be pain-free!🎉❤🎉
I got new 1 who decided ut was smart idea to take me off something that was working now put me on something that cause me now to not be able to see , puking every 30 min and shittin blood and due to my spinal condition i can even walk and ended up having to physically crawl get absolutetly 0 sleep and end up screaming in pain for 24/7 and to be gas lit
Anyone that can be healed by SSRIs or therapy aren't in chronic intractable pain. I'm sure, for me, the pain is not in my head, it is in my back!😂
Your Spot on right!
This was very helpful, thank you both.
So glad to hear you found it helpful! Thanks for watching!
I have been an NP for 30 years, and I just started a new position in pain management. I would say the most important thing is to have an idea of how you view pain and pain treatment and then make sure you find a practice with similar beliefs. Not all pain management practices are the same. Some are purely medication focused and others use multiple modalities and interventions.
Yes! Excellent point. When we interview for positions, we have to remember we are interviewing the practice as well! It is so important to make sure we match our style of practice and our values align with any potential employer, otherwise it will likely be a disaster. Congrats on such a long career and thank you for sharing your wisdom here in the comment section!
Be careful one car accident or fall and you can become dependent. Scary 😟
Yes, people need to understand that opioid medications should only be taken when absolutely necessary and with much thought.
So why doesn't anyone regulate cigarettes being sold or alcohol since they "care" about addiction and oeoples health so much?
I have had metal rods and plates installed in my back and asked five doctors for help one sent me to a pain specialist and prescribed me some kind of happy pills that had nothing to do with the muscle and nerve pain i have ,buncha dam quacks ,been 4 years of hell so far
Assuming that it's correct that requests for pain medicine from patients may have decreased, the amount of overdoses due to pain medicines has literally doubled and then some. Is it naive to think there is a correlation here?
Meaning that people are getting their drugs from the street instead? There is definitely a massive problems with drugs like Fentanyl being sold illegally, and many of the overdose deaths are coming from laced street drugs. The way the whole opiate crisis has been handled, and is still being handled, is sad. Providers were on the hot seat for not controlling pain enough and were pushed to prescribe opiods and now being threatened with disciplinary actions and lawsuits because people became addicted. It's a tough situation all around.
@@TheMedicineCouch you are right it has been mishandled quite a bit. People have outright taken their lives from being left with lack of pain care, as all doctors have been scrutinized so harshly for prescribing opioid medications or patients with pain are deemed as drug seekers. Pain is such a taboo topic now.
In my opinion, yes I think the unrealistic guidelines for treating pain, especially intractable pain, have driven some to the street. Some that would have never done so otherwise. I'm not saying it's right to buy street drugs as we all know that it is dangerous beside illegal, but when an individual is in severe pain 24/7 it can cause one to do things they would not have done under different circumstances.
I think if opioid treatments are going to be as limited as they are new options need to be just as available for insurance companies to cover as they do with the medication. It's just inhumane to leave people suffering like they have. Maybe the new guidelines will help but I fear the damage has been done.
@@milluh Well, pain is a very difficult thing. It is both psychological and physical. However, sometimes when we suggest some of the non-medication ways to relieve pain, people think we are dismissing their pain, which then compounds the problem. Pain is such an integral part of the human animal and everyone experiences it so differently, that it really is very complex. I feel there is quite a bit of research in that area, so I sincerely hope we get some more treatment options soon.
@@TheMedicineCouch my pain comes from from being opened four times for open heart surgery. My doctor tells me, I cannot see where the pain is coming from.
The question is where is the fentanyl is coming from? Its not a bathtub drug? Too me, that leaves a lot of unanswered questions.
Too many are shortsighted and assume everyone is a drug seeker. It's awful to be close-minded.
I understand the sentiment, but as medical providers we have been “played“ by many people looking for drugs. Also, many providers have become leery of prescribing narcotics because we are scrutinized so much and our licenses are on the line. We’ve worked many years and spent hundreds of thousands of dollars to go to school, so hopefully you can understand our concern over losing our licenses and our careers. It’s a very unfortunate situation for providers, but also for the patients who genuinely need help!!
@@TheMedicineCouch I do understand, I've had 4 open heart surgeries, and my doctors didn't subscribe a lot of pain pill. However, now I'm have a lot of spasms and pain under my ribs. It's very painful.
@@TheMedicineCouch You said yourself that not many patients ask for opioids. CDC guidelines have been revised, and I hope chronic pain patients get the treatment they need, before it's too late. The opioid epidemic directly caused a huge uptick in overdoses from being so desperate for relief that they too, end up going to the streets and dying of fentanyl poisoning, or from taking their own lives. Pain is all consuming and awful. Do no harm. Few patients become addicted. Dependant, yes. Chronic pain patients do not expect to be completely free of pain but do need to be medicated enough to function. Thank you!
@@Killmaisy The CDC revision was pretty mild and many patients are complaining that they still can't get opioids. They did drop the 90 MME limit though, and that has helped some patients with severe pain to get more relief. I think that in time, more patients will be helped.
I would LOVE to not have to take opiods just to function. My pain never goes away, it just gets to a tolerable level. Have had 9 knee surgeries, 1 replacement, 1 revision and facing a replacement on my other knee. Add in my spinal cord was compressed to 5mm at the C6-7 level and 8 at the C5-6 level. Surgery relieved that issue but have other compressions down to 8-9mm in the rest of my cervical area.
My legs go numb down to the knee, shooting pain into my feet and a blown disk at L4-5 but not doing surgery...yet.
I have a great Pain Mgr that adjust meds as needed, have tried ER morphine, ER Norco, started to have issues but was open with the Dr so I am now on methadone which nearly eliminates the "need" for meds and also 5mg percoset. Doesn't get rid of the pain, but makes it so I can function. Have had the injections, RFA's, and they helped short term.
Wrong, many patients with chronic pain for years know their diagnosis, condition, treatments, interventions, etc., as well as, or better, than most providers.
Pain management and all the rules and urine testing has made more people addicts because they treat them like scum and they get kicked out 😊
Depression meds do not help pain at all,
They do help some people.
Along with yoga , meditation and wishful thinking 🤔
Why are ya'll so worried about giving pain meds to people who really need it when there are way worse drugs on the street, go help them.
Why not use opioids, they work. What is the big deal.
The entire vocabulary set is opiates bad. This is a nice way to say no oxy.
How about women giving birth with no pain meds and just using meditation to think the pain away
When my pain doctor passed away, I wrote a song in his memory and still cry missing him some days. He changed my life and saved it, and I have a much better quality of life because of him. Now I’m working with another amazing pain doctor, and I am so thankful to have a doctor who isn’t terrified of prescribing the right medications for chronic pain❣️❣️❣️❣️❣️❣️ Also, a wise man once taught me that all pain is in the mind ❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️💖❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️
I am so happy to hear that you have had great pain, medicine, providers, who have the rest your life!
Apparently you do not have legitimate physical pain if you think it’s all in one’s mind!!Just because you are mental don’t label everyone else as mental.
I was denied pain medication for the worst injury of my life. When I wound up in Pain management, all I got was Gabapentin. GABAPENTIN. For a 5 inch laceration to my hand. My doctors kept me in agony for three months for a subacute injury that could have been handled with Percoset. I curse them and I wish to god I could sue them. I would like to make denying a patient pain medication an actionable offense, both civil and criminal.