Client in a long-term care facility complains of pain. The nurse collects data about the client’s pain. The first step in pain assessment is for the nurse to: Select one: a. Get the description of the location and intensity of the pain b. Determine the client’s status of pain c. Accept the client’s report of pain d. Have the client identify coping methods
The correct answer and explanation is:
Correct Answer: c. Accept the client’s report of pain
The first step in pain assessment is always to accept the client’s report of pain. Pain is a subjective experience, meaning it is whatever the patient says it is. Only the individual experiencing the pain can truly describe it. Therefore, the nurse’s responsibility begins with believing the client and recognizing their report as valid, regardless of any visible signs or clinical indicators.
Pain is often misunderstood or underestimated by healthcare professionals when it is not clearly evident through physical signs. However, research and best practice guidelines emphasize that patient self-report is the most reliable indicator of pain. This is especially critical in settings like long-term care facilities, where many residents may be elderly, have chronic conditions, or experience cognitive impairments that complicate pain expression. Listening actively and without judgment builds trust and encourages honest communication from the client.
Once the nurse accepts the client’s report of pain, they can then proceed to gather more detailed information, such as the location, intensity, duration, quality, and any aggravating or relieving factors. This is part of a comprehensive pain assessment that may involve using tools like a numeric pain scale or the Wong-Baker FACES scale.
Without first acknowledging the client’s report, any further assessment might be biased or incomplete. Dismissing or minimizing pain can lead to undertreatment and negatively impact the client’s physical and emotional well-being. Therefore, the most essential first step is to validate the client’s expression of pain as real and important. This forms the foundation for appropriate pain management, clinical decision-making, and improved quality of care.