News From the End of Life: Nursing journal examines pain management

The July 2002 issue of the American Journal of Nursing examined the difficulty of managing pain in terminally ill patients and the role nurses can play in alleviating pain as their patients face the end of life.

The article, the second in a series on palliative nursing care, addresses several areas of pain management, including: pain assessment, the principles regarding the use of analgesics, nonverbal cues that may indicate pain, differentiating pain from other symptoms, the use of sedation, and related ethical issues.

For most terminally ill patients, pain relief is possible, the article says. 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 article presents methods nurses can use to help manage patients’ pain, including careful assessment of nonverbal cues, the administration of pharmacologic and nonpharmacologic treatments, and when sedation should be considered to provide comfort.

The author of the article, Joan T. Panke, MA, 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 is also a curriculum consultant and faculty and advisory board member on the End-of-Life Nursing Education Consortium project. Betty R. Ferrell, PhD, RN, FAAN, and Nessa Coyle, MS, NP, FAAN, are the series editors.

The article, titled "Difficulties in Managing Pain at the End of Life," can be viewed at