A primary purpose of this study was to examine relationships among nurses' knowledge and attitudes about children' pain relief, nurses' abilities to overcome barriers to optimal pain management, nurses' analgesic practices, and pain levels of hospitalized children. Significant positive relationships were found between nurses' (N = 67) analgesic administration and children's pain, and between nurses' years of practice with children and nurses' abilities to overcome barriers to optimal pain management. The children's (N = 132) mean pain level was 1.63 (scale of 0 to 5), with one half of the children reporting moderate to severe pain. Of the 117 children who reported pain, 74% received analgesia. Nurses administered a mean of 37.9% of available morphine and means of 36% to 54% of recommended amounts of morphine, acetaminophen, and codeine.