An ethnography study of nurses' cancer pain management in Sri Lanka

Cancer pain is a serious problem that requires specialised nursing knowledge to manage. This ethnography study explored the experiences and practices of cancer pain management among nurses at the Cancer Hospital, Sri Lanka. Data were collected at the Cancer Hospital in Sri Lanka during October 2007 to January 2008. Data consisted of participant observation of nursing practice in a cancer ward, semistructured interviews with 10 participants and researcher diary. Analysis of data was undertaken with Richard's (2005) method of handling qualitative data and consisted of coding data initially and an integrative process to develop categories. Findings identified Sri Lankan nurses have minimum cancer pain management practice because of a lack of resources, large number of patients to care for, shortage of nurses and unbearable workload in this hospital setting. Additionally the nurses are powerless as they have no autonomy in practice as well as no prospects of career promotion. They are stuck in a task oriented system that rarely acknowledges cancer patients' pain management needs. It is anticipated that this study may lead to improve nursing pain management for cancer patients as well as curriculum change in nursing courses in Sri Lanka. Nursing curriculum change is required to include cancer pain management education as well as care of acute and palliative cancer patients. Additionally, the Ministry of Health in Sri Lanka needs to acknowledge the importance of palliative care service as well as pain management service and a recommendation is made to implement policies at the Cancer Hospital addressing these areas.