LovelyLyn

One can see that pain is subjective. Determine whether a PCA would be beneficial to a pediatric patient can be subjective as well. "PCA is prescribed mostly for children 5 years old and older" (Holden & Patt, 1995). "Children selected for PCA should be able to push the injection button and should understand that pushing the button will give them medication to relieve pain" (London, 2003). In another clinical experience I had an eight-year-old patient who had a NG-tube and a PCA. When I assessed his pain on a 0 to 10 scale he rated his pain as a 9. After further questioning I discovered that he correlated the discomfort of the NG-tube to the PCA. He believed that every time he pushed the PCA it went down his throat causing more discomfort. Obviously some patient teaching was needed... And I think it is inorder to say that this patient was not developmentally delayed and would be age appropriate using the Tanner's Stages of Development. Findings from the article, Patient-Controlled Analgesia for the Pediatric Patient (Orthopaedic Nursing, 2003) concluded that children must be carefully screened for their cognitive and physical ability to manage their pain using PCA. Family-controlled analgesia and nurse controlled analgesia may be considereed in select cases as alternatives to PCA in children with cognitive or physical disabilities. One can see that there are many obstacles using a PCA with pediatric patients. What is your experience with this? Is it the physician or the nurses responsibility to assess the cognitive ability of the patient? Are 5 year olds able to effectively regulate their pain with a PCA?

Thank you for the wonderful reply. The link was very helpful. Your patients are lucky to have such a wonderful, compassionate nurse.

Let me begin by explaining that I am a nursing student who just finished my pediatric rotation. What a wonderful part of the nursing community. The best thing about my experience were the patients. Children have given me a new definition of RESILIENCY! In my short clinical experience I had many wonderful experiences with the seasoned pediatric nurses. I did have an experience where a post-operative 5 year-old patient was complaining of pain. He verbalized his pain as well as had non-verbal cues such as grimacing and guarding. My reference nurse said that he was "being a baby". I wanted to know your opinion... What is the most effective way to assess pain in pediatric patients? What are your experiences with treating pediatric patients? What effect do parents have on pediatric patients? Do you think children are more reluctant to use a PCA compared to adults? Words of wisdom are appreciated!!!