Remembering Margo McCaffery’s Contributions to Pain Management
Former ONS member Margo McCaffery, RN, MS, FAAN, was a leader and pioneer in pain management for nursing. Through her work, she helped to identify and treat patients with acute and chronic pain in a number of healthcare settings. McCaffery’s 1968 definition of pain was simple (http://www.worldcat.org/title/nursing-practice-theories-related-to-cognition-bodily-pain-and-man-environment-interactions/oclc/1185286)—“It’s whatever the experiencing person says it is, existing whenever and wherever the person says it does.” Her words have become a touchstone for clinicians addressing and treating patients in pain.
McCaffery passed away on January 8, 2018, leaving behind a legacy of work that honed the medical understanding of pain management. She continually detailed how nurses play an integral role in managing patients’ pain and why their role is critical to successful outcomes and improved quality of life.
McCaffery’s Impact on Pain Management in Oncology Nursing
As many as 20%–50% of all patients with cancer experience some form of pain (https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-hp-pdq). Because of treatments and complications from diseases, patients report acute and chronic pain on a regular and recurring basis. The pain associated with cancer can extend far beyond the initial diagnosis and treatment. Because of pain’s prevalence in cancer care, oncology nurses must be well-versed in pain management interventions and the importance of addressing symptoms associated with the disease.
The ONS position statement on cancer pain management (https://www.ons.org/advocacy-policy/positions/practice/pain-management) draws closely from McCaffery’s work, noting that “pain assessment includes the use of evidence-based, reliable assessment tools with a goal of capturing and documenting patient-reported pain outcomes. Patient self-report is the standard of care for evaluating pain.” McCaffery championed patient-reported models addressing pain, including the 0–10 scale commonly used in practice.
During McCaffery’s time as an ONS member, she contributed to a number of special interest groups (SIGs), including the Pain Management SIG, Hospice SIG, and HIV/AIDS SIG. In her career, she worked as a consultant, starting in 1970, speaking to groups and leading workshops on pain management throughout the United States and internationally. For 15 years, she served on the World Health Organization’s Expert Committee on Cancer Pain. She was a founding member of the International Association for the Study of Pain and a long-standing member of the American Nurses Association, Sigma Theta Tau, American Pain Society, and American Society for Pain Management Nursing. McCaffery also worked on the pain management guidelines for organizations such as the Agency for Healthcare Research and Quality, the American Pain Society, and the World Health Organization. She wrote and contributed to numerous publications, including the books Pain: Clinical Manual for Nursing Practice, Nursing the Patient in Pain, and Pain Assessment and Pharmacologic Management.
For most oncology nurses, patients experiencing pain is a common reality. In the era of opioid crisis (https://www.ons.org/sites/default/files/ONS_Statement_on_Opioid_Crisis_Dec_2017.pdf) and pharmaceutical regulations, combatting pain is harder than ever. Thanks to McCaffery’s contributions and tireless work in the field of pain management, nurses have better ways of understanding a patient’s suffering and new interventions to alleviate symptoms, improve outcomes, and increase overall quality of life.