Pain Assessment: Simplifying the Complex
Teaching Guide – Pain Assessment Role Play
Discussion leader: make copies of the role descriptions on the opposite side of this card. Separate your group into teams of three. Team members should choose to be a nurse, patient, or observer. They should not read each other’s role descriptions. (Skip the observer role if needed.) Give the “nurse” a copy of your pain assessment form to fill in. (Sample pain assessment forms are also available on the web at
Give the teams 2 minutes to review their roles, and then tell them to start the role play. The assessment should take 5-10 minutes, and the critique by the observer should take about 5 minutes. About 8 minutes or so after they start, remind the group that the assessment interview should wrap up within 2 minutes. At 10 minutes, instruct them to begin the critique if they have not already done so.
After the group has finished its team role play and critique, lead a large group discussion. Some possible topics:
- Do you think that most nurses would be able perform a pain assessment?
- How time consuming was performing and documenting the assessment? Does your documentation system cue you to obtain all the information needed for a complete assessment? If not, how can you make sure that all nurses gather the necessary information?
- How should a nurse communicate an assessment to a physician? Think about: how soon should pain of this intensity receive intervention? How could a nurse summarize this information?
Observer: Did the “nurse” determine:
Pain intensity
Pain quality
Pain location(s)
Physical findings at the site of pain
How long the patient has had the pain
If the pain varies with time of day or activity
What makes pain better
What makes pain worse
Analgesic history
Barriers to reporting pain and using analgesics
Goals for pain relief
Pain’s impact on sleep and other quality of life issues
The patient’s emotional state and mood
The patient’s support system
Nurse
You are admitting a 67-year woman to monitor neutropenia following a three-week course of chemotherapy completed a week ago. As part of your intake assessment, you ask her if she is having any problem with pain.
Patient
You are 67 years old. You learned several months ago that your breast cancer has spread to your lungs and to the bone in your right thigh. You have just completed an intensive course of chemotherapy. Your doctor has told you that a nurse will come to draw your blood and to check on how you are doing.
Your right thigh aches all the time and sometimes throbs. Your feet sometimes have an annoying tingling, burning sensation. When this happens, you just take your shoes off and don’t walk, because even lightly touching the skin on your feet bothers you.
If you are asked to rate your pain on a scale; this is new to you. However, when you understand what it means, you will say that your thigh pain is 6/10 most of the time, but that it gets up to 9 at its worst – usually after you walk for more than a few minutes at a time. Your foot discomfort is not exactly what you’d call pain, but if pressed, you’d rate it at as about a 4/10 when it flares up.
A heating pad helps your hip pain a little, and at least makes you feel like you’re doing something when the pain is at its worst. You have pain pills – the bottle has a long name on it, but somebody told you its other name was Percocet. You’re supposed to take two every four hours, which you always do. However, sometimes it hurts so badly that you take 3 at a time, and sometimes you take it more often because it stops working before the 4 hours is up. After you take your medicine, the best your thigh pain gets is 5/10.
Your daughter made a comment the other day that she was worried about how much medication you’re taking. You are too – you don’t want to get hooked, and you don’t want to be “out of it.” And, besides, you’ve been really constipated… You’ve been trying to drink lots of fruit juice, but this hasn’t helped very much.
Stevenson K, Gordon D, Dahl J, UW Board of Regents, 2000