ABSTRACT

It is very rare for patients to imagine they have pain, and usually they are very consistent in how they describe their pain. Some patients may not be able to say they are in pain, but they looked distressed, the partner or family suspects that the patient is in pain. If the pain is obviously very severe and the patient is very distressed we need to report this immediately to the nurse or doctor responsible for the patient's care. The pain we are witnessing might be breakthrough pain. This can happen when the patient's pain is being closely monitored and regular analgesia has been prescribed. Some change may have happened to alter the dose requirement of the analgesic that the patient is regularly taking, so if we have the authority and have had instructions about giving analgesia for breakthrough pain then go ahead and give what has been prescribed.