Pain specialist calls for more scope for nurses

Prince Edward Island's pain specialist says he wants to see a wider scope of practice for the province's nurses when it comes to pain management.

I could see being able to support Islanders closer to home in their communities with the collaboration and assistance of family doctors.- Dr. Desmond Colohan

Dr. Desmond Colohan will be retiring this fall, and says he will be leaving behind a large gap in pain management services. 

He would like to see nurse practitioners and registered nurses with extra training be allowed to write prescriptions for opioids. Nurse practitioners are currently not allowed to write prescriptions for those drugs, which are a mainstay in managing chronic pain.

"My suggestion is maybe we can start out by having them be able to write out renewal prescriptions on stable opioid dosing that's been prescribed and monitored by a physician over time and stay away from either new prescriptions of opioids or even up-dosing of opioids," said Colohan. 

Colohan has also made proposals to Health PEI over the last several years about setting up primary pain clinics across the Island, managed by nurse practitioners.

"I could see being able to support Islanders closer to home in their communities with the collaboration and assistance of family doctors in those areas who are busy enough already," said Colohan.

He would like to see a collaborative model where doctors would only act as supervisors, and a full-time pain specialist could be used for consultation. 

Colohan, who is also the medical director for West Prince, says he has proposed these changes to Health PEI, but so far there are no plans to move forward. 

"It was not a flat out no, we're not going there ... there's a major focus at Health PEI on chronic disease management. In reality it doesn't appear that pain is yet recognized as a chronic disease. Not only here, but in a lot of places," said Colohan. 

When Colohan retires he will leave behind about 40 patients with severe pain issues, many requiring the use of opioids.

"Medical services has been well aware of this issue. They have been all along. And they've been supportive, they just haven't got a solution for the problem, and we're meeting again in a couple of weeks."

Colohan is hopeful the province will find a doctor who specializes in pain management to fill his position. He says he would be happy to act as a mentor for someone until they are trained properly.