Emergency Nurses' Knowledge, Attitudes, and Behaviors Related to Patients Presenting to Triage With Pain: A Mixed...

The effective assessment and management of pain in patients presenting to the emergency department are challenged by individual and institutional factors. The literature suggests that triage nurses do not accept patients' descriptions of their pain and often use a number of tactics to legitimize the pain or bring the patients' statements about pain into alignment with their judgment of the severity or nature of the pain. This study explored the knowledge and decision-making processes of emergency triage nurses related to pain assessment and management and the contribution of pain to the perception of triage acuity.

A mixed methods approach, using survey data from the Nurses' Knowledge and Attitudes Survey Regarding Pain and triangulated with focus group and interview data, was used. The Good Reporting of a Mixed Methods Study tool was used in the reporting of this study.

Although emergency nurses responding to the survey state that patient reports of pain are valid and should be managed, qualitative data suggest that emergency nurses use a process of confirmation and challenge to determine the credibility of patients' pain reports and thus both acuity and management.

There is a significant tension between what emergency nurses state related to knowledge, attitudes, and behaviors about pain assessment and management and how they describe the process of assigning acuity when pain is the primary concern. Further research on the impact of both education related to pain assessment and management and bias training on the decision-making processes of emergency nurses related to acuity is warranted.