Nursing students' clinical experiences of pediatric pain management: A descriptive qualitative study

Aim To explore nursing students' clinical experiences in pediatric pain management and identify their educational needs. Background Hospitalized children worldwide continue to experience unrelieved pain despite treatment advances. Undergraduate nursing education is essential for pain management competence; however, research has focused primarily on theoretical knowledge, offering limited insight into real clinical experiences. Design Descriptive qualitative study. Methods Twenty-four third- and fourth-year nursing students participated in individual semi-structured interviews. Data were analyzed using thematic analysis. Results Five themes emerged: (1) Interpreting Pediatric Pain: Gaps in Clinical Recognition and Assessment; (2) Clinical Decision-Making: Difficulties Integrating Assessment and Intervention; (3) Communication as a Relational Strategy; (4) Parental Influence: Balancing Support and Clinical Decision-Making; and (5) Clinical Performance Under Emotional Strain. Students demonstrated gaps in pediatric pain assessment, frequently neglecting its subjective nature and underusing standardized tools. Pharmacological decision-making was largely unrecognized; non-pharmacological strategies were emphasized instead. Although students applied appropriate communication techniques, integrating these into clinical decisions proved difficult. Emotional challenges were prevalent, underscoring the need for self-regulation and reflective practice. Conclusions Nursing students faced considerable challenges meeting the complex demands of pediatric pain management. Deficits in pain assessment and pharmacological competence, combined with overreliance on non-pharmacological approaches, may compromise effective pain care during transition to professional practice. Implications for practice Curriculum developers should design pediatric pain education bridging theory and clinical practice through concept-based, student-centered strategies — including simulation, case-based discussions, and reflective practice — alongside structured, supervised clinical experiences targeting pain assessment, pharmacological decision-making, and family communication. © 2026 Elsevier Inc.