Valorisation des activités infirmières au sein d'une structure de prise en charge de la douleur chronique

The nurse working in a structure of support for pain (SDC) has clinical, organizational, institutional missions as well as teaching and research. Its activity is essential for the support of SDC. However, most of the missions undertaken do not appear in the list of acts and are therefore not paid. In this case, how to enhance the nursing activity in SDC? First, optimization contains clinical skills. Many nurses working in SDC forming the mind-body techniques, patient education, cognitive behavioral therapy, hypnosis and many more. These courses require an investment of nursing, the SDC team and institution. If the relevance of these support starting to be taken into account, as they are based on training recognized and validated, the remuneration of these acts remains absent. Second, optimization of quality is necessary with institutional missions by participating in meetings of referents pain or CLUD, organizing appointments and patient groups and training services. The nurse participates in the improvement of traceability knowing that management of pain is a quality indicator, allowing the certification of a health facility. Third, optimization must be also in teaching and research. Indeed, its teaching assignments include participation in university education (university diploma on pain) and research missions with the implementation of the Hospital Program for Nurse and Paramedic Research (PHRIP). For optimization on the financial side, it is necessary: 1) to rate all nursing procedures performed during hospitalization day by SDC; 2) draw all nurses' consultations even if there is no compensation; 3) to make education and research. Indeed, given the lack of visibility on the sustainability of general interest (MIG), it will enhance the teaching assignments, research, action and innovation (MERRI). Will be valued financially, lessons for students in medicine, scientific publications indexed on PubMed, participation in clinical trials and PHRIP. In conclusion, if the public health actors and the Department emphasize the important role of nurses in the SDC and in the hospital, financial valuation is far from optimal, not based so far on the MIG. It is therefore important to focus on the organizational aspect, teaching and research.