Worst experiences of pain and conceptions of worst pain imaginable among nursing students.

Aim: This paper is a report of a study to explore nursing students' own worst experiences of pain as well as their conceptions of the worst pain imaginable.

Background: Pain is a personal experience, often assessed using a visual analogue scale. The endpoints of this scale are labelled with the extremes for pain experience (e.g. no pain to worst pain imaginable). People may understand the meaning of 'no pain', but it is unclear what meaning they assign to 'worst pain imaginable'. This indicates that a rating along the Visual Analogue Scale-line is dependent on the individual's previous experiences.

Methods: Data were collected during the autumn of 2002. In total, 549 nursing students completed a questionnaire focusing on two main questions: 'What is the worst experience of hurt, ache or pain you have had?' and 'What is the worst pain imaginable for you?' Content analysis was used for data analysis.

Results: The students' worst experience of pain was mostly related to acute or traumatic painful conditions, pain associated with female physiology, inflicted pain, psychological suffering and chronic painful conditions. The worst pain imaginable was described as condition-related pain, overwhelming pain, experiences of losses, deliberately inflicted pain, psychological suffering and as vicarious pain.

Conclusion: The findings imply that nursing students, when they are imagining pain, include dimensions such as hope of relief, grief, control over the situation, powerlessness and empathy for and suffer with other people's pain. Further research is needed to explore why professional experience as a nurse diminishes the ability to imagine patients' pain.