Why pain assessment must start with believing the patient.

Nursing students may find it difficult to change how a patient's care is managed or even to initiate any changes at all. On a busy surgical ward I attempted to assess and alleviate a patient's uncontrolled post-operative pain using a pain-assessment tool. Patient compliance was good, but ward staff responsible for managing the patient's care took little notice. This was not, I believe, because the pain-assessment tool was ineffective, but because staff gave pain control low priority, and, more fundamentally, because they did not believe the patient when she said she was in pain. This paper follows the postoperative patient from assessment through to discharge. The importance of believing patients' accounts of pain is illustrated.