A qualitative study was undertaken to describe how parents and nurses respond to hospitalized young children experiencing pain from surgical interventions. Participant observation was used to identify care behaviours and the care context within which the children experienced, and caregivers witnessed, post-operative pain. Interviews with parents, nurses, and children were also conducted during the observation periods and prior to discharge to augment the observational data. Care provided by parents included comfort measures and vigilant monitoring of the children's pain. Nurses primarily provided technical care, used limited pain assessment approaches, and were not able to adequately alleviate the children's pain. Factors, strategies, and feelings associated with these care behaviours are described. The most salient recommendations arising from these findings are that nurses: (a) be provided with education about pain assessment and management, and (b) be empowered by policies that allow them to sensitively and effectively respond to children in pain.