Critical care patients often experience significant pain and anxiety. These symptoms may be rooted existentially as patients endure fear and uncertainty, but disease and treatment sources are other common offenders, as are noxious environmental stimuli. Unrelieved pain induces a generalized sympathetic response (increasing heart rate, blood pressure, respiratory rate, and peripheral resistance), disturbs sleep and appetite patterns, and heightens anxiety. Anxiety can also increase the perception of pain. Thus, these symptoms often go hand in hand, interfering with the healing process.

On any given day, nurses exert considerable time and energy employing interventions to enhance comfort and ultimately, the patient’s experience. Some of these are dependent functions—namely, administering pharmacological agents—whereas many others are nonpharmacological approaches within autonomous nursing practice such as therapeutic listening, emotional support, family presence, repositioning, distraction, or integrative therapies. The purpose of this clinical review is to explore an...

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