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Ordering Off the Menu

Ordering Off the Menu

Twenty-five units at The Johns Hopkins Hospital adopt a pain control menu.

Making sure patients are comfortable is an important step toward helping them get better, says Suzanne Nesbit, a clinical pharmacist and pain management specialist at The Johns Hopkins Hospital.
That’s why she and pain resource nurse Roberta Norris have developed a way to put key elements of pain management right into patients’ hands.

The Pain Control and Comfort Menu is a list of common items that help patients relax, rest and pass the time during an inpatient stay. As if they are ordering from a restaurant menu, patients or family members can ask staff members for pain and stress relievers, such as cold packets, warm blankets and even a visit from a therapy pet.

Also on the list are hair and skin care products that help patients feel more like themselves. The departments of Service Excellence and Nursing provide many of the menu’s items.

“This isn’t a substitute for medication,” Nesbit says. “It’s more of a complement to it.” She points out that many of the items on the menu have been available for years, but this listing gives patients choices and a sense of control over their pain.

For decades, managing pain has been an important part of care at The Johns Hopkins Hospital. James Campbell, pain medicine pioneer and one of the founders of the Blaustein Pain Treatment Center, called pain “the fifth vital sign.” Twenty years ago, Campbell started a national campaign to make pain a component in the routine assessment of a patient’s condition.

“If pain were assessed with the same zeal as other vital signs are, it would have a much better chance of being treated properly,” Campbell said in a 1996 address to the American Pain Society.

Today, physicians and nurses regularly ask patients about their pain from the beginning to the end of their hospitals stays. The new menu, developed by the hospital’s Pain Management Committee, includes the color-coded universal pain-rating scale that ranges from zero to 10. It also has a section that helps patients describe their pain, using words like dull, aching, tender, shooting and radiating.

The menu is now available to patients on 25 units in The Johns Hopkins Hospital, and Howard County General Hospital has introduced its own version. “Our goal is to have it become systemwide,” Norris says.

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