Comfort and Pain and Symptom Management
Pain assessment
Ask about pain in the patient's own words using a simple scale or faces scale. For patients who cannot report, use behavioral cues: grimacing, guarding, restlessness, moaning, withdrawal, or changes in sleep and appetite. Pain is what the patient says it is; behavior is your evidence when words are not available.
Non-pharmacologic comfort
Positioning, warmth or cool compresses, massage, music, distraction, relaxation breathing, and a calm environment. These complement - never replace - medications. Report pain that is unrelieved or worsening.
Common symptoms
- Dyspnea: elevate the head, use a fan, keep the room calm, report to the nurse.
- Nausea: small meals, oral care, fresh air, report to the nurse.
- Constipation: fluids if tolerated, mobility, report bowel changes.
- Agitation/restlessness: could signal pain, urinary retention, or fear - report it rather than assuming it is "just dying."
Traps to watch
- Assuming a sleeping or nonverbal patient has no pain.
- Withholding comfort measures because "medication is the nurse's job."
- Ignoring new symptoms as inevitable.
Rule of thumb
Treat the patient's report and the behavior; report what does not improve.
Worked example: A nonverbal patient with dementia grimaces and pulls away during repositioning. The assistant pauses, uses gentle touch, repositions slowly, and reports the behavior to the nurse so pain can be assessed and treated before the next turn.