how to ask patient for pain scale score correctly?

Specialties Emergency

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​well,actually in our center pain scale score just been practiced and i'm still a young baby in getting pain scale score..and i even do not know / not confident in asking patient that in pain for their pain score.sometimes i get scolded because of asking for 'how much pain does he/she suffered'...

can you'll guys give me some 'nice' way of getting pain scale score?because i know you'll expert in this..

thanx!:nurse:

My personal script is "Sir/ma'am, could you please rate your pain for me on a scale from 0-10, where 0 is no pain and 10 is the worst pain in the history of the world."

Also, this XKCD comic is relevant.

This one is also relevant: xkcd: Spinal Tap Amps

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Specializes in PCU.

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?"

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Specializes in Emergency, Med/Surg, Vascular Access.

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.

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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!

thats what i'm tryin' to say...

about why patient felt uneasy about it..

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Specializes in Emergency, Telemetry, Transplant.
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!

In some cases it may be...in other cases not. I know a neurosurgeon who does mostly spinal surgeries. He make a really big deal about the pain scale. Not just because he wants to relieve his patient's pain, but because pain relief is a measure of the effectiveness of the surgery. If one of his patients always reports 8-9-10 pain before surgery and afterward the always report 1-2-3 pain then the surgery was pretty effective.

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I've got to say that pain scale is ********. Imagine one third the pain one would feel while being crucified, OK so that's a 3, your doctor would just give you a Tylenol and tell you to suck it up if you said your pain was a 3. Although a third the pain of being crucified would still be absolutely debilitating.

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Specializes in Urgent Care NP, Emergency Nursing, Camp Nursing.
I've got to say that pain scale is ********. Imagine one third the pain one would feel while being crucified, OK so that's a 3, your doctor would just give you a Tylenol and tell you to suck it up if you said your pain was a 3. Although a third the pain of being crucified would still be absolutely debilitating.

But humans intuitively interpret the world on a logarithmic, not linear, scale. 3 is nowhere near 10 on a log scale.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

As one who has been conducting comprehensive pain assessments for some time now...coupled with personal experience of pain and need to report in a measurable way...would lead me to disagree that a numeric pain scale is a joke or silly in any way.

First, as health professionals our treatment of pain in our patients is a matter of SERIOUS importance. If your place of business is JCAHO, CHAP, or otherwise nationally certified you are mandated to report on pain and your treatment plan and follow up for the pain. Using a pain measurement tool helps us to "measure" the pain and the response to treatment.

In my 3 decades of experience I have noted that nurses struggling with a tool are often not adequately trained in the use of the tool. I believe this would be true of pain assessment tools as well. As well, there is inadequate education of nursing professionals, in general, as to the assessment, treatment, and management of acute and chronic pain. When we multiply that by the level of personal or professional "anxiety" regarding use of opioids in general we end up with too many people with chronic pain issues who are inadequately treated for either their chronic pain or their exacerbations of pain, particularly when the pain takes them into urgent care settings after hours. The level of opiophobia amongst health professionals is at times alarming.

I am always dismayed at the number of nurses who cannot believe that a person can report a pain of 8/10 and still have a relatively normal appearance. It seems that many of us either never learned about or have forgotten about our human ability to compensate for chronic conditions...like pain.

Finally, there is a tool for adults much like the FLACC. It is called the PAINAD and is designed specifically for adults (particularly dementia patients) who are unable to verbalize their comfort levels.

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well,you know sometimes there's kind of patient felt uneasy being questioned for the pain score.

sometimes i get scolded because asking for score. :(

I've never had that experience. I've had patients who seem to not understand how to give numbers ("I dunno, it just hurts") but with a little more explanation they're usually able to give me something. I work in pediatrics and honestly, it's usually the older teenagers who are the least able to give a pain score because they think being sullen and non-cooperative is grown up behavior :rollseyes: but I've never been scolded for trying to gauge a patient's pain.....

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Simply ask the patient, educate them on the pain scale. One is no pain, ten is the worst pain. Ten is the highest. It can't go over. It's a question just like a vital sign, sometimes as a nurse you have to be creative, educate the pt on different levels, and then document it. Through the years you will get all sorts of answers and responses, it's up to you to steer the interview and overcome communication obstacles. Have a little fun with it, geez. Personally, I'd be ticked if i came in and you didn't ask if i had pain, 99% of people show up because they DO have pain...the scale is a tool to document their pain...not yours, in a completely objective manner...there's no wrong answer.

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Specializes in Med/Surg,Cardiac.

As many other posters have stated, I educate them on the pain scale... 0 being no pain, 10 being the worst pain you have ever experienced. I always document vitals with it. Nonverbal cues and behaviors are charted if they rate it 10 but appear at a 2.

Patients reports CP 10/10, sharp midsternal. No shortness of breath noted on 2 liters O2 BNC. Resp even and unlabored. Skin warm and dry. Denies radiation of pain. Watching television and requests a sandwich. Refuses nitroglycerin. ..... (see this more then I can tolerate)

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