Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

Q: Should a placebo be given to a resident who is having pain when there is a doubt that their pain is real?

A: Our first responsibility as nurses is to advocate for our patient’s safety and well-being, including the right to effective pain management. That’s according to a new article I like titled “Controlling pain: Placebos: no place in pain management.”

It appeared in the online newsletter Nursingcenter.com and was written by Paul Arnstein PhD, RN; Kathleen Broglio ANP-BC, ACHPN, CPE; and Elsa Wuhrman MS, FNP, ACNP-BC.

We should preserve the integrity of professional nursing, the article’s authors assert.

“Your facility should have an evidence-based and regularly updated policy on appropriate placebo use,” they say. “Use this policy to advocate for your patient if you’re given an inappropriate prescription. If your facility doesn’t have a policy and procedure, report up the chain of command and involve the risk management department in the process.”

They suggest using non-pharmacologic pain management strategies while trying to resolve this order, all the while reassuring the resident.

As a nurse, remember that you shouldn’t “disclose any disagreement between healthcare team members at this point — it might undermine the patient’s faith in the team or the therapy that’s eventually provided.”

They suggest that to prevent this type of situation from recurring, completing an event report sometimes helps get the appropriate people discussing this matter.

Work with colleagues to develop a formal written policy restricting placebo use to approved research studies so that patients don’t suffer needless pain, the authors advise.

Please send your resident care-related questions to Sherrie Dornberger at [email protected].