Unit 2 - Pain

2.1 Introduction and guidelines for good practice

At the end of this session you will be able to:

1. Critically reflected on the causes of children’s pain and guidance for good practice

In addition you will be able to:

2. Identify and make an initial evaluation on the materials you have available for parents and children in your own setting

3. Critically considered the impact of unrelieved pain on children and their families

Introduction

Most children experience pain as a regular, albeit unwelcome, aspect of everyday life.

For most children these pain episodes (often associated with the bumps, bruises and falls of growing up) will be of a short duration and often forgotten fairly quickly. Most children will also experience the common pains associated with childhood illness such as earache, toothache and sore throat.

Immunisations at various points during childhood also create small, but nevertheless memorable and not routine, pain episodes that result from a medical intervention.

Parents are vital to providing good, supportive nursing care of children’s pain.

For some parent information sheets see, ‘Pain and Your Infant’ and Parent Fact Sheets on fever, febrile convulsion, pain and painful procedures (some translated into Arabic, Vietnamese, Chinese)

Children who have ongoing illnesses or who are admitted to hospital for acute care will often experience pain either associated with their illness /diagnosis (such as burn pain, fractures, sickle cell pain) or with the health care interventions (having an IV sited, bloods taken, post-operatively). A few children are unable to experience pain: at first consideration this might be seen to be a blessing, but pain does have a protective function and without it these children are more liable to injury and morbidity.

For further information about obtaining blood samples in children.

Nurses have a responsibility to manage children’s pain: preferably by preventing pain but when this is not possible, by ensuring that it is alleviated effectively. This is important, not simply because children have the right to be pain-free but also because untreated pain impacts on morbidity and mortality (Van Hulle, 2004).

Guidelines for Good Practice

Managing children’s pain is vital as recent studies are now providing evidence that pain problems in children and adolescents can persist into early adulthood. Therefore if we do not manage children’s pain effectively we are contributing to a potential lifetime of pain for as they grow up and become adults. Brattberg (2004, p195) concludes that “more attention should be given to problems of pain and ill-health in childhood, especially among young girls.”

There are a number of useful websites (for example, The Institute of Child Health) and guidelines are readily available to assist nurses in the recognition, assessment and management of pain in children (e.g. Action for Sick Children pamphlets for parents; Alder Hey’s Guidelines on the Management of Pain in Children).

(See American Pain Society. The Assessment and Management of Acute Pain in Infants, Children, and Adolescents. A Position Statement from the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health and American Pain Society Task Force on Pain in Infants, Children, and Adolescents)