A common pitfall of using behavioral pain assessment tools is the tendency of clinicians to draw conclusions about the intensity of a patient’s pain based on the behavioral score the tool yields (Pasero, 2009a). There is no research that shows that a certain behavior or number of behaviors indicate a certain pain intensity. For example, one patient may lie completely still and quiet, and another may grimace and be restless, but both may be experiencing severe pain. It is essential that nurses use behavioral tools to help determine the presence of pain and to guide treatment with the understanding that behavioral tools are not pain intensity rating scales. If a patient cannot report pain intensity, the exact intensity of the pain cannot be known (Pasero & McCaffery, 2005a).