How can you teach your peers about pain assessment and management?

Pain Management



N.C., a 21-yr-old African American man, presents to the ED in sickle

cell crisis reporting excruciating pain. He is known to several of the

nurses and HCPs in the ED. A nurse remarks to you that it must be

time for his “fix” of pain drugs.

Ethical/Legal Points for Consideration

• The standard of care for pain management requires that (1) a pain

assessment is done based on the patient’s self-report, (2) the best

possible relief of pain is provided under the circumstances, and

(3) competent and compassionate care is provided to all patients.

• The pain assessment also includes reviewing the patient’s

medical record to determine if there are health care issues or

conditions (e.g., frequent ED visits to request pain medication)

that may affect the patient’s response to pain and pain


• You have a duty to notify the HCP of those issues or conditions.

Document patient behaviors related to pain management. Be

objective (factual observations) rather than subjective, such as

labeling (“the patient is in withdrawal”).

• When pain relief is inadequate, you must notify the HCP. Make

sure the HCP has assessed the patient and based the plan of care

on that assessment.

• Somnolence assessment is essential as part of your pain


Discussion Questions

1. How can you teach your peers about pain assessment and


2. What factors do you need to include in your assessment and

management of N.C.?


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