Critical care - Pain assessment: Nursing

Pain assessment helps to identify and manage a patient’s pain. Pain is commonly experienced by patients in the critical care unit, and it can act as a stressor that can worsen their condition. It can also have long-lasting effects on daily functioning, quality of life, and overall well-being. As the nurse caring for critically ill patients, you’ll provide patient-centered care by performing pain assessments to effectively address your patient’s pain.

Now, pain is an unpleasant sensory and emotional experience that occurs in response to actual or potential tissue damage.

So, you’ll start your assessment by obtaining your patient’s report of how they perceive and interpret their pain. If your patient is able to verbalize their response, you can begin by asking whether or not they have pain. If they answer yes, then you should gather more information to better understand their pain. To do this, you can use the PQRSTUV mnemonic.

P stands for provocation, or what provokes or causes the pain, like moving or taking a deep breath. It also stands for palliation, or what relieves the pain, like resting or changing a position.

Q refers to quality, or how your patient describes the pain, such as sharp, achy, burning, stabbing, or dull.

R stands for region, or the location of the pain, like the arm, head, or abdomen. You can also ask if the pain radiates, or moves from one area to another, like chest pain that wraps around to the back.

S refers to severity, or how your patient would quantify their pain. To determine severity, you can use a pain scale such as the numeric pain scale where your patient assigns their pain a number from 0 to 10, with 0 being no pain and 10 being the worst pain.

Other pain scales include a visual analog scale where the patient places an “X” on a horizontal line, with one end representing no pain, and the other end representing the worst pain; and a face scale where the patient assigns a facial expression to their pain intensity.

T stands for timing, and refers to the onset, duration, and frequency of pain. For example, your patient could report that their pain started 2 weeks ago, lasts for less than 10 minutes, and is intermittent; while another patient could report their pain began a few hours ago and occurs continuously.

U refers to understanding and is your patient’s perception of their pain. For example, they may say their pain feels like the pain they’ve previously had from heartburn.

And lastly, V indicates values, which are your patient’s preferred pain treatments, such as medication, heat or cold application, or guided imagery.