Periop Nurses: Critical to Countering the Opioid Crisis

Perioperative nurses are frequently on the frontlines of the opioid epidemic, making you especially persuasive in advocating for policy changes – both in your facility and with legislators. Congress is currently considering several pieces of legislation to address the opioid epidemic. Your perspective, experiences, and stories can help shape policy. It’s well known that opioids commonly provided to surgical patients are often diverted, so your ability to provide insight into what happens before, during, and after surgery is valuable. What is working? What doesn’t work? What barriers do you face?

Providing a background on the perioperative nurse role is in the operating room and in patient safety frames the conversation with legislators. For example, with the rapid increase of public awareness around the dangers of opioids, it is not unusual for patients to request that opioids be avoided.  Discussing pain management options, including multimodal analgesic options and non-pharmacologic approaches with surgical patients before procedures has been successful. It is the perioperative registered nurses who are responsible for ensuring a patient’s wishes are followed in the OR and communicating them when transferred to postoperative recovery.

Uncertainty about whether patients are forthcoming about their opioid use as you prepare a patient for surgery and recovery causes concern and complicates the planning process. You can share these instances, as well as your experience encouraging physicians to consider non-opioid options. These stories help your legislators understand the complexity of the opioid crisis and our need for comprehensive policies addressing it. Perhaps the fact that many insurance companies often don’t cover CAM therapies, which often means there are additional costs for patients to choose non-opioid pain management options, has been a barrier to decreasing opioid use in your experience. There are many experiences you can share with your members of Congress; these are just a few suggestions.

Addressing the opioid epidemic needs to be multifaceted; there is not one bill that will fix it. In June, the U.S. House of Representatives combined multiple proposed opioid crisis bills into one large package, the SUPPORT for Patients and Communities Act (H.R. 6). Within this package, there is a provision that would grant Nurse Practitioners and Physician Assistants permanent authority to prescribe Medication-Assisted Treatment (MAT) as treatment, while the other three Advanced Practice Registered Nurse (APRN) professions (Certified Nurse-Midwives, Clinical Nurse Specialists, and Certified Registered Nurse Anesthetists) would have this authorization for five years. Additionally, it would also require a study of the efficacy of providing MAT by all providers, including physicians. It now moves to the Senate.

The nursing community, including AORN, is supportive of legislation that would grant and extend nurses the ability to prescribe life-saving treatment for opioid addiction. We urge you to ask your Senators to also support this legislation and personalize your request by sharing your perspective and experiences from being in the center of the opioid epidemic. Additionally, you can also request a meeting with the offices of your Senators to discuss your experiences in dealing with the opioid crisis. For more information on how to request a meeting with your Senators, contact Danielle Glover, Associate Director of Government Affairs.