Oh agreed - it was the patient that asked me for a painkiller before we tried moving her because her inflamed foot was hurting so much. While I can't be sure that she wasn't refusing analgesia earlier it would seem unlikely. I'm very much aware of capacity - the patient didn't initially want to go to A&E, and she appeared to have capacity to refuse. I had to tell the nursing staff that there was no way I was going to wrestle an elderly lady out of her bed against her will. Agreed also about the NSAIDS, but life is sometimes too short for a jumped up truck driver to be questioning such things, and the patient was going to be admitted under the orthopods, so I'd assumed that they'd sort something more appropriate out. And yes - I've taken to not bothering asking if my patient who is in the worst pain of their life has tried taking anything for it. In fact if a patient says 'yes' to that question we feel like throwing them a party, it's that unusual.