In Thailand, nurses have a key role in the assessment of symptoms and advising on pain management in patients with post-operative in a surgical ward. This study provides insight into nurses’ perceptions of patients in pain and subsequent pain management. A focus group discussion method was used with 18 registered nurses working in surgical wards. The data were analysed using qualitative content analysis.The participants’ descriptions of their perceptions of patients in pain and pain management were condensed into four themes. Two themes revolved around their perceptions of patient pain, uncomfortable patient, and restricted mobility and changed mood. The two remaining themes comprised intolerable pain would be managed, and managing pain through our own experience seems to be of importance in their professional assumption that evidence-based practice is inadequate for patients’ postoperative care. It is suggested that nurses work to a organized pain assessment guideline and pain management models according to cultural contexts. This should be developed within an understanding of the nurse-patient relationship, and specifically holistic nursing models of care can play an important role in bridging the connection between training and practice, not only between personal and professional perceptions of pain and selected strategies, but also between professional knowledge and nurses’ perceptions of patients in pain.The findings may have relevance for other similar contexts and settings.