Parents did not always let the nurse know the child was in pain unless they were specifically asked a question by the nurse. This is illustrated by the fol- lowing extract from the field notes:
Went to see child and met parents at the door—child had just gone to sleep—parents reported that she had had a bad hour and really been in pain—although the parents hadn’t called anyone. Apparently the child had thrown up immediately after her last medicine (IV)—so possibly the pain meds didn’t work. Again the parents had not reported this to the nurses. (Case 2, Nurse 4) Communication between the nurses and chil- dren followed a similar pattern and again usually related to pain medications. There were some exceptions to this. Nurse 5 asked the child to let mum know if she had any pain so she could let the nurses know (Case 2). Occasionally a nurse would ask a child if he or she wanted an extra dose of morphine or explain that additional doses were available: