The impact of the nurse-physician relationship on barriers encountered by nurses during pain management.

The aim of the current investigation was to examine the barriers encountered by Tasmanian registered nurses when attempting to provide optimal pain management. The impact of nurse satisfaction with their professional relationship with physicians during pain management on the types of barriers encountered was also examined. A total of 1,015 registered nurses completed a 21-item survey that examined the types of barriers encountered during pain management. In addition, data were gathered on nurses' satisfaction with their professional relationship with physicians during pain management. More than one-third of the respondents indicated that they had encountered at least one type of barrier to providing optimal pain relief, including insufficient cooperation by physicians and inadequate prescriptions of analgesic medications. Nurses who did not feel adequately consulted by physicians were significantly more likely to encounter barriers such as insufficient cooperation by patient's physicians and inadequate prescription of analgesic medications. The barriers to effective pain management encountered by nurses were affected by their relationship with physicians. Education, for both nurses and physicians, concerning the role of the nurse in the workplace will help to ensure that nurses encounter fewer barriers during pain management. Optimal pain management practice will result if guidelines for dealing effectively with barriers are tailored to the specific type of institution and the unit within those institutions. Copyright 2003 by the American Society of Pain Management Nurses