Do you think the pain scale is accurate?

[flashpoint]

I've been reading some other threads and talking with some of my coworkers lately and it makes me wonder how accurate the 0-10 pain scale is. I've heard nurses describe '10' as being the worst pain you could possibly imagine or the pain you would feel when you have your arm ripped off...is that fair? I've had migraines that were the worst pain I have ever had, but not the worst pain I could imagine...so does that make them only a '6' on the standard pain scale? Was I wrong to rate the pain at an '8' or '9'? I had a kidney stone that made my worst migraine seem pretty mild...does that mean that next time I get a migraine, I can only rate it at a '3' or '4'?

I've never been comfortable with the 0-10 scale...people's pain tolerance is so different and what is a '3' to me might be what a '10' is to someone else. I think I like the Wong-Baker Faces Scale better...it seems easier to pick out a face that describes how you feel rather than trying to put a number on something.

I know both are just tools, but it seems to me there should be a better system...if anyone wants to invent a machine that could determine the actual level of pain, I would be happy to try it out.

:)

[Markthemalenurse]

The reasons we're so keen on the pain scale, JACHO, etc. is not to decide if a patients in pain and what he needs, but primarily for followup. This is where we've let people down in the past. We've always been free with the pain medicine, but we never cared if it worked or not. The pain scale is a great gage of effectiveness. "You said a 6 30 minutes ago, what is is now?" This holds us accountable for calling for more pain medicine or other interventions (rather than the 'sorry your pain meds not due for 3.5 hours"), or we know it's working just fine.

I agree with Tweety - I was just recently in the hospital for Diverticulitis and I was hurting. I asked for pain medication which I got in a timely fashion; however, the nurse never came back in to ask me if it worked. I understand the nurse was probably busy, but a simple, "Did it work?" would have been nice. (Yes the medication did work).

[ragingmomster, BSN, MSN, RN]

Speaking specifically to labor pain, I will ask:

Is this your first labor?

On the 0-10 scale, 0 being no pain, and 5 being distressing, 10 being the worst pain you've ever had, can you give the pain a number? ( I will document exact description if pt gives more than just a number.)

Does the pain go away completely between ctx?

Would you like some pain medication now?

My f/u evaluation includes:

Are you able to tolerate the pain more easily now?

Again- Does the pain go away completely between ctx?

What else can we do to decrease your pain?

I feel that a number just isn't enough, I know from my experience that a throbbing pain of a 10 is more tolerable that a stabbing pain of the same level... does that make sense?

[wubbakat]

I think your wording on obtaining is really a great way to express it (ie. being able to do ADL's versus not being able to do them due to pain.) Will try that, Pain is very subjective to the patients, and is sometimes extremely hard to assess it if they really don't have a very good pain threshold. Again thank you for the tip

[wubbakat]

I think your wording on obtaining is really a great way to express it (ie. being able to do ADL's versus not being able to do them due to pain.) Will try that, Pain is very subjective to the patients, and is sometimes extremely hard to assess it if they really don't have a very good pain threshold. Again thank you for the tip:nurse:

[LoriAlabamaRN]

I really like that assessment, asking about ADLS, I might just try to incorporate that! I always ask (pre-pain meds) what level of pain is tolerable for them. For example, if their pain is a 9 and they can tolerate a 3, then after the pain meds I see if its come down to their "tolerable" number. But I like yours better!

[fsutallyrn]

Just wanted to say, that even though this maybe the first real painful situation for these moms it can still be a ten. Before giving birth (when I was younger, but still an adult) I had a broken mandible and maxilla with my mouth wired shut for 6 weeks, I had my gall bladder removed due to lodged stones, and I had my ovary rupture as well for which I had to have surgery (all of which were bareable to me without much pain meds) and nothing, I mean nothing could even compare to the pain I felt during childbirth, other women I knew had hardley any pain at all, it just depends on the person. pain is what the patient says it is

[jill48, ASN, RN]

I'm very satisfied with both the faces and the rating of 1-10. I don't describe 10 as the worst pain you can imagine, but as the worst pain you have ever experienced. This may not work for children who have not experienced alot of pain in their young lives, but I work with adults and it works well. Plus, pain is subjective. My 10 is different from your 10. I'm not medicating the number, I'm medicating the patient. I have never had anyone say that they thought the faces were insulting. If they had, I would ask them, "Well can you suggest a better way of evaluating pain?" Plus, we don't just medicate by number; like a 1 = tylenol, a 5 = darvocet, and a 10 = percocet. We have other adjectives available to narrow down that number, such as stabbing, burning, acute, chronic, etc.:smilecoffeecup: