Children’s pain management still suffers from the misconceptions of the past

Despite good progress to change clinicians’ perceptions, optimal care is not being offered

Despite good progress to change clinicians’ perceptions, optimal care is not being offered

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Over the past decade, our knowledge of children’s pain management has grown substantially. From debunking once held misconceptions surrounding children’s 'inability to feel pain' to the development of age-appropriate assessment tools, a great deal of time and effort has been dedicated to managing children’s pain.

We have now learned that uncontrolled pain in this vulnerable population has far-reaching consequences. Children will not simply forget at the sight of a lollipop or when they walk out the door. It will extend into their adult lives. 

Changing attitudes

We have developed new drugs and rediscovered old ones, using them in novel ways. The myriad options clinicians have at their disposal to treat and alleviate pain and suffering in the paediatric patient is unprecedented.

From the nurse to the paediatrician, education has increased. There are local, national and international campaigns designed to update and improve knowledge, change attitudes, inform policy, and create a culture where pain assessment and management is paramount.

We have guidelines on assessment and policies for pain management, all geared to reduce time to analgesia and standardise practices. 

Unrecognised pain

The truth, however, is that we are still not getting it right.

Pain in children continues to go unrecognised, undertreated, and is often ignored. Nurses, reportedly, still do not believe patients who say they are in pain and are withholding prescribed analgesics. 

Children are less likely than adults to receive opioids, even if the child’s admission is for a condition known to be painful, such as a long-bone fracture, vaso-occlusive crisis in sickle cell anaemia, or after surgery. 

Fear of over-sedation and addiction, as well as suspicion about our patients’ true pain levels, continue to pervade our daily practice, inhibiting our ability to provide optimal care.

If we truly want to address the status quo and prioritise the improvement of children’s pain management, we must first acknowledge this painful truth.

About the author

Penelope Sweeting is a lecturer of nursing at Charles Darwin University, Australia

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