Using a gentler hand: reflections on patients with pressure ulcers who experience pain.

Nurses who care for patients with pressure ulcers who experience pain were asked to reflect and write a story about this phenomenon. The objective of this study was to determine the meanings derived from nurse caregivers' reflections about patients' pressure ulcer pain. A Heideggerian hermeneutical approach was the methodology used for this inquiry. Stories from 42 participants, including nurse generalists and advanced practice nurses, were analyzed. Input was solicited from two qualitative research teams. Findings consist of three constitutive patterns and eight related themes: Nursing expertly (reading the pain, attending to the pain, and acknowledging and empathizing); Denying the pain (assuming it doesn't exist, not hearing the cries, and avoiding failure); Confronting the challenge of pain (coping with the frustrations and being with the patient). Lessons learned from this analysis are to stay connected with your patients; listen, attend ("be with") and comfort; and use a gentler hand.