There will come a time in every nurse's career where they will have to care for someone who, for whatever reason, cannot communicate verbally. The reason can be broad, such as dementia or language barriers. One of the biggest challenges this creates is assessing the patient's pain level. In 2001, a group of critical care nurses developed a system that has been widely accepted in many health systems in the United States and Canada. The Nonverbal Pain Scale for Adults is an assessment tool that uses five specific categories of pain assessment. However, the accuracy of this system is a matter of debate among healthcare providers and patient representatives. In this article I will review and compare the different pain assessment methods used by healthcare personnel today. Pain affects everyone; it sends thousands of people to hospitals, clinics and private healthcare providers every day. A primitive alert system, pain is an unpleasant but important function for survival. In the physiological sense, pain is the uncomfortable sensation felt by the sensory (Taber) nerves. Pain can be described in different ways, such as burning, aching, or crushing. When assessing pain in their patient, a nurse's first action would be a question; “are you in pain”? No one will dispute that this is the most reliable method of assessment, because pain is exclusively subjective in nature. Most schools teach that “pain is there when the patient says it is.” However, although everyone feels pain, no two people feel it the same way. Other factors influence a person's perception of pain. External influence is often a consideration when a parent or family member is too afraid of eliciting a pain response. A postoperative patient i...... middle of article ......nal of Biobehavioral Medicine, 62 (4) 517-523D'Arcy, Yovonne (2008) Pain Management Survey Report, Nursing 2008, June 38 (6), 42-49 Flaherty, Ellen (2008) Using Pain Rating Scales with Older Adults, American Journal of Nursing, June 2008, 108 (6), 40-48 Harkreader, Helen (2000) Fundamentals of Nursing & Clinical Judgment, Philadelphia PA : WB Saunders Co. JACHO Joint Accreditation Commission Health Organization, 2012, Facts about Pain Management. Retrieved from www.jointcommission.org/standards_information/Paddock, Catharine PhD. (2011) Tools that objectively measure ongoing pain. Medical NewsToday. Retrieved from http://www.medicalnewstoday.com/articles/234450.phpSwearingen, Pamela (2004) All In One Care Planning Resource, St. Louis, MO: MosbyTaber's Cyclopedic Medical Dictionary. 2009 (24) 1026, Pain. FA Davis Co. Philadelphia PA