Discrepancies between patient and nurse perceptions of post-operative pain: shortcomings in pain control

Abstract

In this study of 60 patients and 30 nurses the objectives were to identify the degree of concordance between patient and nurse ratings of post-operative pain, and to assess the use of pain control methods used by nursing staff In the control of post-operative pain. Discrepancies existed between nurse and patient perceptions of post-operative pain experienced by patients 7.2 hours post-operatively with nurses significantly under-rating pain levels compared to patients. Unless patients complained of pain, nurses made no formal assessment of the patient's need for analgesia. There were often significant delays between requests for pro re nata (prn) analgesia and drug administration. Nurses tended to set higher priorities for institutional tasks, relying on analgesics for pain control rather than utilizing preparatory or non-pharmacological methods of pain control. This failure to use effective preparation plus non-pharmacological means of pain control in the management of post-operative pain has significant cost implications in terms of greater drug utilization and longer in-patient stays. This is in addition to the discomfort for patients from inadequate control of post-operative pain. These results indicate strong grounds for improving post operative pain control.