How Would You Rate Your Pain????

How would you rate your pain???? As nurses, how many times have we asked that? Have you ever really thought about what you are asking and what the answer might mean? Have you ever had to give an answer to that question yourself? Just what does it mean to you? If you've even been forced to use a pain scale, you may have noticed some of its inadequacies. Nurses General Nursing Article

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Specializes in Hospital Education Coordinator.

The 1-10 scale is NOT objective. The nurse would like it to be but there is no way anyone can judge another person's pain. Think of the scale as being entirely relative to what the patient says it is. If the patient starts out at "4" and after your intervention is a "2" then the intervention was a success. The next patient may start out at a higher number but it does not matter. All that matters is that you have some way to document that the intervention was a success. The actual number is not relevant. Regardless of what the nurse has personally experienced or observed as a nurse, the scale will NEVER coincide with what the patient is presently experiencing. I believe that is where we mess up. We want the scale to be objective, but the numbers simply mean different things to different people. Example: "down the road" meant a mile or two when I lived in TN. Now I live in TX and "down the road" can be many miles. All relative.

Specializes in Hospital Education Coordinator.

but the patient is not having the same experience as you did when you had a 10. When we give the patient the scale we are asking them to relate to their OWN memories, not ours. So if the worst pain they have ever had prior to this experience was a bee sting it is hard for the patient to imagine, and report, more than that.

BostonTerrierLover, BSN, RN

1 Article; 909 Posts

Specializes in Adult/Ped Emergency and Trauma.

I don't know, I've I had that kind of pain talking to AT&T:)

I remember when I was sprout, and my dad had his back surgery, following a terrible accident where he was nearly crushed. I was soooooo worried when he would try to reposition in bed and moan or grunt,...

I would push his PCA button:)

When his doctor made rounds, he would ask,

"...So, how is the PCA doing on your pain?"

Dad would say, "Well, I'm surprised! I haven't had to press it but once to go to the bathroom yesterday. I don't think I've hit it once today."

The doctor looked really puzzled! (Thank God and Science for Lock-Outs!!!:)

brownbook

3,413 Posts

It doesn't even make any sense if we think pain number 10 is only for someone screaming, moaning, unable to talk, laugh, etc.. It makes 10 an impossible goal, for lack of a better word, and all the rest of the numbers meaningless.

I always compare my patients current pain to its source and how it feels right now. "If at its worse your back pain is a 10 what number is it now.".... "If the worst your incision could hurt is a 10 what number is it now."...."if at their worst your cramps are a 10 what number are they now," etc. It validates to the patient that yes I am in pain now, yes it hurts a lot, maybe even number 10, but no, I don't have to be moaning and writhing on the bed to validate that it hurts.

wooh, BSN, RN

1 Article; 4,383 Posts

Well it doesn't help that we all describe the pain scale differently. If the patient rates based on what the last nurse explained the rating as, but we interpret via our own explanation, how on earth is that supposed to work?

tewdles, RN

3,156 Posts

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

First...we shouldn't use the FLACC for adults, use the PAINAD instead.

The pain scale works because it allows the patient to give their perspective of the pain, which is the most important part. If the number doesn't seem to match our assessment and observations then we can correlate with chronic vs. acute distinctions, emotional/psycho/spiritual state, and current health status.

Perhaps the person is having a difficult time with their pain because they have little personal experience with pain and could use some help coping. There are nonpharmacologic interventions for discomfort that we might be able to address.

If we don't,cant' ask our patients about their level of discomfort we cannot possibly address it adequately.

DSkelton711

312 Posts

Specializes in OB/GYN/Neonatal/Office/Geriatric.

I loathe the "rate your pain" numerical scale. At least with the faces you can kinda relate. Chronic pain is harder to rate, I think, because it affects how you live your life everyday, but you try to push through it. It also is exhausting.

Specializes in pediatrics; PICU; NICU.

Thank you, DSkelton711!

As a person with chronic pain, I think my experience of pain is different than someone who is having acute pain from an accident or surgery. I frequently have days where my pain level is 6 or7 but I can't just stay home & rest because I have to earn a living & "life goes on" in spite of my pain. Therefore, I've learned ways to function in spite of my pain. Obviously, if I have to work when I'm in that much pain, I can't (actually won't) take narcotics for the pain. I usually will take an NSAID & put a heat patch on the area that's most painful. This combination works pretty well for me & will get me through a 10 hour shift. Having this type of pain every day is extremely exhausting. It's been hard for my husband to adjust to how much time I have to spend resting just to be able to do basic things to keep going. It's been hard for me, too, because I used to be pretty active & now I'm very limited in how much I can do. I tend to agree that the numerical pain scale is lacking because people experience pain differently. I'm able to find ways to function at a 6 or 7 but someone else may not have coping skills to deal with the level of pain.

agvfc

7 Posts

Thankyou so much for bringing that to our attention. Indeed, the tool is almostdegrading toward the patient. Reviewing the pain literature, we have bettertools out. Why don't we have courage and remove old fashioned tools if they don'tserve our patients well. Just because "we always "used this tool? I am so luckyto work in a progressive hospital where we encourage nurse to ask questions andcome back with better ideas. This is a project worth for the EBP council.

hodgieRN

643 Posts

Specializes in ER trauma, ICU - trauma, neuro surgical.

I like how the video said the rating of pain scale was stupid.....and then he yelled out 8 so he could get more morphine just for the hell of it. Seems like he answered his own "stupid" question...

Bubbles

158 Posts

Specializes in Hospice, Case Mgt., RN Consultant, ICU.

I never liked asking patients to rate their pain because it is so subjective and I absolutely hate being asked it. I have had neck and back pain off and on since being rearended in 1977. I agree the faces chart is of no help. The pain questions are someone's attempt to quantify a problem with a number which just is not possible!

Thanks for the laughs in the video. I really enjoyed that. It really will be hard to keep a straight face now when I have to ask that question!