Barriers to nursing pain management in the emergency department: A qualitative study.

Background: Although pain is a common complaint among patients presenting to emergency departments (EDs), there is a dearth of nursing literature about barriers to pain management.

Purpose: The study aimed to uncover and understand barriers to pain management in the ED from the registered nurse (RN) perspective.

Methods: Semistructured interviews were conducted with 12 ED nurses in a Jordanian hospital. Data were collected throughout August 2016.

Results: Two broad categories with subcategories emerged. The first category describes the idea of types of patient, which included three particular groups. These were patients who are violent, patients with relatives who are, and patients with expectations of care that nurses view as unrealistic. The second category describes the taxing ED environment, with two subcategories of staff shortages and physician dominance of pain management. Nurses reported feeling as if they are the victims of external factors and perceived that barriers affected teamwork and led to distress which impairs pain management.

Conclusions: The role of ED nurses in pain management is multifaceted. Therefore, implementing policies to overcome barriers such as violence among ED attenders and the perceived hostility of the ED environment through mandatory security systems, and continuing nursing education including for violence prevention may be beneficial.