how to ask patient for pain scale score correctly? - Page 4

And of course, my comment was reflecting the fact that you were identifying what a pain of 10/10 is to YOU, with a "sigh" relative to their (the patient's) interpretation.

The reality is that when it comes to the patient's pain and qualification of such there is NO relationship to your personal experience with pain. Our personal qualification of pain levels is of NO relevance to the patient's description or qualification of their pain.

So comments that suggest that the patient may exaggerating their pain level based upon our opinion of what their response should be (as compared to our own) is an unprofessional assessment of pain which puts our subjective thoughts on pain before the patient's. IMHO

PS I have clarified my thoughts. Compare their pain to their pain. I say "If when your abdominal cramps were their worst it was number 10, what number is it now." Or "when your chest pain was it's worst it was a 10 what number is it now." Or "If when your cramps (for woman) were their worst was number 10 what number is it now." Etc.

The pain scale is a joke! You are either in pain or your not! Patients look at you like you are crazy how can you put a number on it, its either a little or a lot! Get real!

I used to ask what it was 0-10, zero being none and ten being hit by a truck. One day my patient responded "Well, it's not nearly as bad as the time I was hit by a truck...."

I don't use that example anymore!

LOL. I feel your pain.

It helps to have the chart available when needed.

1-2: I know it's there, but tolerable
- I do not usually medicate, unless patient requests (some patients are medicated round the clock at home to keep pain levels low, so used to it and will request meds while in hospital, watching clock, so medicate them as long as within parameters and VS/cognition/arousability within normal limits.
- may reposition &/or apply cold or heat, etc. for comfort
3-4: mild discomfort/pain
- Medicate if patient requests it. If not, advise patient to call if he/she feels pain is getting worse.
5-6: I feel it, I am very uncomfortable. I need something to take the edge off this pain.
- Definitely want to stay on top of it. If patient refuses pain meds, educate as to pain, pain control, need for pain relief, etc, and continue to monitor.
7-8: I am in severe pain.
- Definitely needs pain meds.
9-10: I am in "excruciating, mind-numbing, I am about to go into shock from the pain" pain
- definitely medicate
- monitor closely...VS? Cognition? Arousability?

For patients who consistently smile, laugh, joke, on phone, eating, walking all over the unit while maintaining 10/10 pain level, I use both the 0-10 and the FLACC score.
If pain remains high &/or unrelieved, I discuss calling for new orders/changing meds w/doctor. I have had a few patients who, when informed that if pain med is not working it is my duty to call and get new orders/new meds/whatever, will suddenly state that their pain has finally eased a little from that narcotic that had not touched their pain all shift long o.O

This one is also relevant: xkcd: Spinal Tap Amps

Yes, for the patient with the sense of humor, I have found myself saying, "On a 0 to 10 scale, with 0 being no pain and 10 being so bad that you have gone into shock from the pain and are unable to answer...what is your pain score?"

I always say, "what would you rate your pain 0-10, with 10 being the worst pain possible?" However, probably 80% of the time, they've interrupted that very short explanation with their number, which is usually in the 8-10 range. I've gotten to the point that I just don't believe a numeric scale is very helpful. We need a flacc scale for adults, IMO.