Practicing as a Pain Management Specialist NP at the Royal Brisbane and Women’s Hospital and in her own private practice in Brisbane and North Brisbane, Melanie Proper helps her patients learn how to live their best life with pain. She believes that people need empowerment and evidence-based knowledge to manage their health. Being a NP, applying highly developed knowledge, nursing values and skills has allowed her to support that individualised care achieving positive outcomes. Melanie passionately assists her patients in managing the challenges that they face in a constructive way, to achieve a quality life.
Pain in the older person causes disability, deconditioning, depression, cognitive and behavioural changes, a reality which is very evident within aged care facilities. In partnership with the patient, their GP, family members and staff, Melanie improves the function and quality of life of clients residing in aged care facilities.
Could you tell us about the community you are working in and the nursing you are providing to patients?
I work in the clinical area of Subacute Pain. I assist patients in the management of their pain, enabling them to get home; particularly for those who have had major surgery or trauma. I help them through rehabilitation, and education so that they will manage their pain well for the next 6 – 12 months, or for the rest of their lives.
What is unique about your role in the community?
The subacute clinical area in which I practice is aimed at addressing an issue that has not been very well managed in the past. It’s a new area of focus which recognises that prevention is a key strategy. NPs are very good at providing education aimed at illness prevention and holistic management of patients, which ultimately helps them to achieve their goals.
What’s the typical day in your NP role?
It’s very varied day to day. Caring for in-patients, the role is not planned, so specific clinical practice depends on the patients who come through the hospital door, as well as the injuries that they have sustained. It could be completely different each day. I do provide a lot of patient education and family support. I could also be dealing with someone who has just had surgery for an ongoing, chronic issue over 20 years, and needs help through their rehabilitation phase.
On the weekends, I visit aged care facilities because this is an under resourced area. In aged care homes, 80% of residents have pain. They are a vulnerable group, as any decease in mobility and function could result in a decline of their quality of life. They are often unable to describe their pain, and thus need to be observed across the day, followed with a judicious prescribing approach which will be adjusted to meet their and the families’ goals. I find this role rewarding, with a very positive improvements for the residents’ quality of life.
Why did you decide to become a NP?
I have been a nurse for 30 years and have spent 20 years working in pain management. I have a lot of clinical knowledge and skill which I can use to change a patient’s future. I was looking for a challenge - something new - but I didn’t want to lose all the knowledge, history and great connections and support I had within my organisation. So, I decided to make the most out of all that to benefit the patients. Being a NP allows me to do that.
What are you hoping to achieve as a NP?
I’m hoping to change people’s lives. If I do my job well, then hopefully each person will leave the hospital with knowledge that will prevent them from having a difficult, painful life and improve their choices due to better understanding of the health system and health literacy. People need education and support for their journey through the health system, which is a tough place to navigate without this knowledge.
It is important that we (clinicians) provide support for patients to enable them to adequately look after themselves. Function, movement and conditioning are key to maintaining strength and health. Good pain management both facilitates and improves these outcomes. Making a positive impact on the patient’s ability to cope on a daily basis, is very rewarding.
If you weren’t a NP what would you be doing?
I think If I wasn’t a NP I would be in the university doing research in the pain field, because that’s my passion.
What is your favourite memory when you are working with patients?
What I do is very individual, and I am blessed to have time to talk with patients and allocate my workload. There is no other profession in my hospital where you can spend the time required to talk to the patient if needed. So, my relationship becomes quite individual, as I’m dealing with every aspect of their lives when they leave the hospital. My patients still come back to see me to tell me how they are going and what’s happening. I get kisses on the cheek every week from my patients and their families as they try to express their appreciation!
What message would you like to give to NPs and or aspiring NPs?
I want to tell them that nursing is a great job. It allows you to continually study for your whole career, and to bring the best evidence and knowledge to help empower your patients and change their trajectory and course, making the health care system a better place. As a NP, you have a better skillset and opportunity to make that difference.