Nurse Role in Pain Management
Recommendation 4.0 (Across All Settings)
➤ The nurse should participate in ensuring care coordination and meeting
patient and family needs. Where permitted, appropriately trained
nurses may prescribe medicines, including controlled medicines. Nurses
should be trained to assess patients' palliative care needs, including
pain control assessment and evaluation (as well as other knowledge
and skills described in recommendations under Palliative Care Models
recommendations), make recommendations, and communicate needs to
adequately trained health care providers who are permitted to prescribe.
(Strong Recommendation; EB-I)
Spiritual Care
Recommendation 5.0 (Across All Settings)
➤ Spiritual care provided by appropriately-trained providers should be
available in all settings, whether locally or by referral. In addition to
providing direct patient care, spiritual care providers may advise and
support the care team to support the patients and their families. Nurses
or counselors may be trained to assess the spiritual needs of patients
and their families. Providers should be observant of and sensitive to
the religious norms of patients and families. (Weak Recommendation;
FC-Ins)
Social Work/Counseling
Qualifying Statement
➤ The psychosocial needs of patients and their families should be
addressed in all settings and across the cancer care continuum. This
role can be addressed by social workers, mental health professionals,
or community health workers with training in the needs of palliative care
patients and the special approaches required in this population. The
role of the social worker/counselor becomes more critical in patients
with advanced illness or when curative therapies are not an option,
as is often the case in limited-resource settings. Collaboration with
counselors/social workers can assist communication between patients
and clinicians, when available.
Recommendation 6.1 Basic
➤ When staffing is limited and specialized counselors are not available,
physicians and/or nurses may play this role. They should receive the
training to provide psychosocial care and be given enough time with the
patient to allow them to provide it. (Weak Recommendation; FC-Ins)
