Management of pain during weaning from mechanical ventilation: the nature of nurse decision-making.

Despite extensive knowledge of pain and pain management, critical-care nurses commonly withhold analgesia from patients for extended periods prior to and during weaning from mechanical ventilation. Nurses working in critical care were interviewed (n = 10) to gain insight into the importance of pain management during weaning and the nature of decision-making in pain management. Using the research method of grounded theory, the author found decision-making to be a dynamic and continuous process of knowledge gathering, knowledge interpretation, and action, influenced by nurses' beliefs concerning (1) the existence of and importance of managing pain, and (2) the role of the nurse. The emergent theory has the potential to guide the development of interventions in which nurses make effective, holistic, competent decisions about pain management during weaning from mechanical ventilation.