Emergency Department Nurses’ Experiences and Perceptions in Managing Breakthrough Cancer Pain: A Qualitative Study

Background Breakthrough cancer pain is a frequent and distressing condition that significantly impairs quality of life. Emergency department nurses play a critical role in breakthrough cancer pain recognition and management, yet their experiences remain underexplored. Methods A qualitative study using phenomenological methodology was conducted. Fourteen ED nurses from three tertiary hospitals in Hangzhou, China, participated in semi-structured interviews between January and June 2025. Data were analyzed thematically using Braun and Clarke’s six-step approach. Results Four major themes emerged: (1) recognition and assessment challenges, including difficulty distinguishing breakthrough cancer pain from background pain and lack of standardized tools; (2) emotional and professional burden, characterized by distress, helplessness, and burnout; (3) practical coping strategies, such as rapid collaboration with physicians, reliance on clinical experience, and involving families; and (4) educational and systemic needs, highlighting the demand for standardized guidelines, targeted training, and interdisciplinary collaboration. Conclusion Emergency department nurses face substantial challenges in managing breakthrough cancer pain, balancing clinical urgency with resource constraints while enduring significant emotional strain. Tailored education, standardized assessment tools, and systemic improvements are essential to enhance nursing competence and improve patient outcomes.