A critical examination of advanced practice nurses\u27 prescribing practices for patients with chronic nonmalignant pain

Very little attention has been given to chronic nonmalignant pain in the nursing literature. Although there has been increasing debate concerning prescribing practices among physicians for this population, little if any understanding exists about advanced practice nurses (APRNs) in this context. This study critically examined subjective factors that influence the prescribing practices of advanced practice nurses for patients with chronic nonmalignant pain. The study was grounded in the critical tradition of Habermas and the emancipatory theory of Freire and used a critical methodology. Greipp\u27s Model of Ethical Decision Making in the Management of Chronic Pain served to guide the study as well. Data were collected through semi-structured interviews with participant APRNs. Critical analysis of the data revealed that prescribing decisions by APRNs for patients with chronic pain were characterized by a conflict of interests in which the patient\u27s best interests were given a low priority. This conflict, which is socially and politically created and maintained, renders these nurses unlikely to fulfill their ethical responsibility to the patient.