News From the End-of-Life: Article examines palliative care, pain management

Use of sedation, other ethical issues addressed

In its July 2002 issue, the American Journal of Nursing examines the difficulty in managing pain in terminally ill patients and the role nurses can play in alleviating their patients’ pain as their patients face the end of life.

The article is the second in a bimonthly continuing education series on palliative nursing care, funded in part by a grant from The Robert Wood Johnson Foundation. The article addresses several areas of pain management, including: pain assessment, the principles governing the use of analgesics, nonverbal cues that may indicate pain, differentiating pain from other symptoms, the use of sedation, and related ethical issues.

The article, "Difficulties in Managing Pain at the End of Life," can be accessed on line at

For most terminally ill patients, pain relief is possible. Yet pain remains a primary concern for many patients and their families. Despite decades of efforts to improve pain management, researchers continue to document inadequate assessment of pain and unrelieved pain in patients with a number of life-limiting diseases.

The American Journal of Nursing article presents methods nurses can employ to help manage patients’ pain, including careful assessment of nonverbal cues when the patient is not verbal, the administration of pharmacologic and nonpharmacologic treatments, and sedation when necessary to provide comfort.

The author of the article, Joan T. Panke, MA, RN, APRN, is a palliative care nurse practitioner and is the executive director of the DC Partnership to Improve End-of-Life Care in Washington, DC. She also is a curriculum consultant and faculty and advisory board member on the End-of-Life Nursing Education Consortium project.