The gap between saying and doing in postoperative pain management.

AIM To understand how nurses contribute to postoperative pain management in a surgical setting and to identify barriers to achieving optimal postoperative pain alleviation. BACKGROUND Postoperative pain is inadequately managed. Nurses play an important role in assessment, treatment and evaluation of postoperative pain in surgical wards, but combined observational and interview studies about how they approach these activities have rarely been undertaken. DESIGN AND METHODS The study design is descriptive. Observations and in-depth interviews were conducted with nine nurses on three surgical wards at two hospitals. Each nurse was observed during five shifts, day and night, and interviewed after the final observation. The collection and analysis of data followed principles of qualitative research. FINDINGS One main theme emerged about the nurses' approach to postoperative pain management: a discrepancy between what the nurses said they did and what they actually did. CONCLUSION The study revealed a gap between what nurses said and did in postoperative pain management, and this gap was smaller when the nurses took an active approach. An active approach towards patients about postoperative pain seemed to enhance pain alleviation. RELEVANCE TO CLINICAL PRACTICE Nursing education and practice both need to promote knowledge of pain and pain management, as well as empathy and empathic communication in relation to pain. They need to collaborate in guiding nurses to act in accord with theoretical knowledge and so enhance competence in nursing actions related to postoperative pain management.