Nurses' strategies for managing pain in pediatric units: A qualitative study in Iran

Context: Pain management is one of the main clinical challenges that health‑care jobs encounter with it. The nurses play a pivotal role in providing pediatric pain management.
Aims: This study was conducted to determine nurses’ strategies for managing pain in pediatric units in Iran.
Settings and Design: This qualitative study was conducted with a content analysis approach at one teaching hospital in Amirkola Children’s Hospital in Babol, Iran.
Materials and Methods: Data were collected from 16 nurses, using semi‑structured interviews during the year 2015–2016. The inclusion criteria were the nurses with at least 3 years of work experience in children’s departments. Sampling was purposeful with maximum variation. Immediately after each interview and recording, the content was transcribed using Word software. Interviews were individually conducted in the hospital nurses restroom.
Statistical Analysis Used: Data analyzed by conventional content analysis method simultaneously data collection based on five steps of Granheim and Lundman. To ensure the accuracy and reliability of data were used according to Lincoln and Guba’s criteria.
Results: The data analysis showed that the main them was nurses’ undeveloped clinical judgment. The contents included sixth subthemes such as “incomplete investigation of the presence and severity of real pain,” “priority to pain pharmacological actions,” “inadequate understanding of nurse to the time and lack of analgesics,” “nurse’s inadequate attention to the conditions of the use of nonpharmacological and pharmacological interventions,” “inappropriate assignment of nonpharmacological pain to the mother,” and “incomplete evaluation and record of pain relief.”
Conclusions: Nurses use the strategy of underdeveloped clinical judgment to manage pain in pediatric units. Due to this determined fact, it is necessary to design a practical model for improving the clinical judgment of nurses in pediatric pain management.