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Figure 16.1 Pain is considered the fifth vital sign and an important aspect of a comprehensive assessment. When patients suffer from impaired comfort and pain, nurses can provide compassionate patient-centered care. (credit: “RE:Union – A story of cancer in the family” by “mescon”/Flickr, CC BY 2.0)

According to the International Association for the Study of Pain (2021b), pain is defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” Pain can be acute or chronic, mild or severe, and expressed in many different ways. Pain is triggered by a perceived danger or stress and tells the body to withdraw from threatening stimuli. Most pain resolves after the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body.

Pain is a subjective experience and can be influenced by biological, psychological, and social factors. Pain affects people in every aspect of health care, requiring nurses to be able to assess, manage, and treat it. Pain is subjective, meaning the patient defines the pain (ANA Center for Ethics and Human Rights, 2018). Patients can express pain through verbal and nonverbal behaviors. Some patients may rate their pain on a pain scale while other patients can only exhibit nonverbal cues such as grimacing, crying, and vital sign changes.

Because the experience of pain has so many variables, pain assessment and management must be comprehensive to be effective. Nurses must perform frequent comprehensive pain assessments to determine what pain interventions would be most effective for each patient. Pain management plans must be individualized and involve the patient and healthcare team. Pain is one of the most common reasons for patients seeking care, and treating pain must be a top priority for healthcare providers in all settings.


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