Academic journal article Nursing and Health Care Perspectives

Letters to the Editor

Academic journal article Nursing and Health Care Perspectives

Letters to the Editor

Article excerpt

Assessing level of pain as the fifth vital sign is especially relevant in the context in which the idea originated, "The Peaceful Death Symposium" (Editorial, March/April 1999). The causes of pain among the terminally ill generally have already been diagnosed. Recognizing and treating the pain are the demands.

Far too many persons die in pain. Pain recognition and relief are strategies that may reduce requests for assisted suicide. Using a reliable measure to indicate experienced pain (such as an analog scale in which the degree of pain is rated 1-10 or pictures of happy and pain-wretched faces for children) would facilitate measurement and recording.

Impediments to measuring this fifth vital sign do exist. One is the dictum that a comprehensive assessment needs to be done each time the client complains of pain. The assessment includes such things as location, duration, and character. This assessment is time consuming if done as often as vital signs. Another impediment is the conventional wisdom that to ask clients whether they have pain is to possibly cause pain through the mechanism of suggestion. Of course, the belief that use of narcotics leads to addiction is also applicable. …

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