title: Nurses' personal opinions about patients' pain and their effect on recorded assessments and titration of opioid doses.
abstract: In many clinical settings, nurses have a vital role in pain assessment and titration of opioid doses. Surveys of nurses have revealed knowledge deficits in these areas that are thought to contribute to under-treatment of pain. The present study surveys nurses' decisions about assessment and treatment of pain in 2 patient situations and confirms that nurses continue to undertreat severe pain. As shown in previous studies, nurses may be more influenced by the patient's behavior than the patient's self-report of pain, especially in relation to decisions about opioid titration. Nurses are less likely to increase a previously safe but ineffective dose of opioid for a smiling patient than a grimacing patient. Survey results reveal a tendency for nurses' personal opinions about the patients' pain, rather than their recorded assessments, to influence choice of opioid dose and to contribute to undertreatment of pain.
authors.affiliation: City of Hope National Medical Center, Duarte, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: McCaffery
authors.forename: B R
authors.initials: BR
authors.lastname: Ferrell
authors.forename: C
authors.initials: C
authors.lastname: Pasero
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006801:Humans; D009020:Morphine / Q000008:administration & dosage; D009730:Nursing Assessment; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing*; D010147:Pain Measurement / Q000451:nursing*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine