Pain Assessment and Nursing Management

Unrelieved pain is not simply an unpleasant experience to be tolerated until the next scheduled dose. It drives a measurable physiological stress response — tachycardia, hypertension, increased myocardial oxygen demand, splinting and shallow breathing, delayed mobilisation, impaired wound healing, and immunosuppression. Postoperative patients who cannot take a deep breath because it hurts develop atelectasis and pneumonia. Patients who will not mobilise because of pain develop venous thromboembolism and pressure injuries. Poorly controlled acute pain is also the strongest modifiable predictor of the transition to chronic pain, which persists long after the original injury has healed. At the same time, the drugs used to treat pain are among the highest-risk medications a nurse administers, and opioid-induced respiratory depression remains a recurring cause of preventable in-hospital death. Pain management is therefore a balance held continuously by the nurse: undertreatment causes real harm, and so does inattentive treatment. Neither erring toward reflexive medication nor erring toward withholding is safe practice.