PainFree Program

Joseph Cravero, M.D., was a pediatrician for four years before he became an anesthesiologist. As a pediatrician he was regularly asked to perform medical procedures on children, but he did not have the training to make those procedures painless. Today, as director of the PainFree Program at the Children's Hospital at Dartmouth (CHaD), he and a multidisciplinary team of certified nurse anesthetists, registered nurses, medical technicians, physicians, and child-life specialists see to it that no child has to suffer pain, even during minor procedures.

Cravero tells the story of a 16-year-old developmentally disabled boy who needed a spinal tap. His mother had taken him to another hospital, where the terrified boy thrashed for over an hour until the procedure had to be abandoned. Thanks to Dartmouth's PainFree Program--where young patients are cared for by people who give this kind of treatment every day--the spinal tap was completed in ten minutes under sedation. At first, when Cravero saw the boy's mother in tears after the procedure, he was confused. "You don't understand," she told him. "This was such a big thing in our lives-- now we know it does not have to be so bad."

Cravero talks frequently at medical conferences around the country about

his unusual program, which has received a $250,000 grant from Ronald McDonald Charities of Eastern New England and a national Volunteers Hospital Association leadership award. It was recognized as the best new program in an individual hospital emphasizing safety and patient care. He explains that the PainFree Program does not just provide better care for patients, it allows physicians to do their jobs better and is more efficient and costeffective for the institution as

a whole. He describes the program not as a magical breakthrough but as a question of priorities.

"How hard do we want to work at it so kids don't have to suffer in the hospital?" Cravero asks. For this pediatric anesthesiologist and father of three, the answer is obvious. "Parents will come to accept their child's illness or condition and deal with it," he says. "But what they can never get used to is seeing their kids suffer."