Barriers to the provision of effective pain management.

Despite major advances in the management of pain since the Royal College of Surgeons and the Royal College of Anaesthetists announced in 1990 that postoperative pain management in British hospitals was inadequate, pain continues to be an unacceptable but common sequel to surgery (Wood, 2002). Pain assessment is simple, but unfortunately it is infrequently performed. When clinicians do not obtain pain ratings from patients they are unlikely to underestimate the patients' pain. Improving pain management requires that pain is recognised as a priority and that nurses are encouraged to play an active and pivotal role within the multidisciplinary team to recognise, prevent and treat it.