How Would You Rate Your Pain???? - page 4
I was with a friend recently who was awaiting a craniotomy. We were in the OR holding area when the nurse came in and asked him "How would you rate your pain on a scale of zero to ten with zero... Read More
Nov 21, '12I think that the number scale being the *only* acceptable tool is a result of "point and click" flowsheet charting. With good, old fashioned paper charting, you would quote the pt or write what symptoms they were displaying. Nowadays it seems like all assessments have to conform to a narrow, predetermined set of boxes to click on the flowsheets.
Nov 21, '12Southern US Pain Scale
0..........I feel ahrite
1-5.......achin' a lil'
7-8.......hurtin' "badder" now
8-9.......really hurtin' a bunch
9-10......hurtin' like hell
10+.......Just Cut it off! -or- Pull it!
What's really funny is that many of you will assume I am joking, Lol!Last edit by BostonTerrierLoverRN on Nov 21, '12 : Reason: Formatting
Nov 21, '12I love that!!! LOL
And it is very true. But heck......us southerners call it as we see it.
Nov 21, '12I know you're not joking. I had an older gentleman last night tell me he "hurt like the devil." I called it a 6 and put that in the notes.
I find the pain scales semi useful. Mostly I try to ask how the pain changes, is what we're going making things better, that sort of thing. Everyone's experience is so subjective. I had a patient last week tell me his pain tolerance is good, do if he gets to a five, he's really hurting. Other people say they're at a ten for a hangnail.
Nov 21, '12I just have to try so hard not to suggest a number when I am assessing, it's like pulling teeth to get them to pick a number. It's worse with males(and I am a male), but it's like I said earlier, we just don't won't you to think "whuss" to yourself, so your going to get a lower number, after a few long seconds of pause and soul searching.
I know it was a good idea to do 1-10, or FLACC as you can compare it back, and gauge relief. But, if your not even getting an honest pretreatment level, on paper the intervention may not look as good as it really was.
Also, the patient may be chronic pain, and normally live with 3-5 pain levels, but seeks medical attention over an 8, and will be totally happy once returned to a 5 or less. It was sooooooo sooooooo sad when Vioxx was taken off the shelves, because that medication treated chronic pain well(arthritic Ped and Adult); It was sooooo effective!!!
Nov 21, '12I only use the 10/10 scale because of charting, but rely more on the pt's description of the pain. Usually this works well, and I can give them a suitable med from their PRN list, it doesn't work well when the dr decides to prescribe based on the numeric scale. That really annoyed me when I did stroke rehab. It was impossible to premedicate my patient with how the orders for her oxycodone was written.
Now for me, I sprained my lower back muscles a few years ago and they went into totaly spasm. I could not move without screaming in pain. My mom needed to call 911 because I could not get myself off the kitchen floor, or even turn myself without almost passing out. I still felt silly answering 10 on the pain scale because I know it's relative. So who am I to say that I have 10/10 pain when the person next me has half of their arm hanging off? Guilt makes me do funny things sometimes.
Nov 21, '12I will expect total and complete pain relief when dealing with a case of cardiac pain, especially one with additional symptoms. In those cases you (you being the patient) do not need to tell me what the number is. You do not need to talk, you just need to lay there and breathe. I will do my protocols and get you pain free, period. I may ask you questions as you begin to get some relief. Trust me, for those few cases I see, I act as if it's objective because if I let a patient having an MI tell me "no it's okay" they may die.
Women are so bad about this... they have chest pain and want to do any number of things, including go have a BM, instead of get relief.
For me, I like to try and assume I haven't felt the worst pain imaginable yet. There are about three things that rank at the top together, so far: a really bad kidney stone (the kind that blocks and causes pyelo), the dentist hitting a nerve without enough anesthetic in place, and the metatarsal/phalangeal joints of my big toes when they decide to hurt for no reason. I am sure there is a reason but never would I have thought my toes would hurt like a kidney stone. And yet it is utterly embarrassing for me to admit to a doctor that my toes hurt, especially since they haven't been cut off or anything.
I like the idea of comfort goals. I may start using that.
Nov 21, '12I had surgery this afternoon. When I arrived in the pre-op area, the nurse handed me a piece of paper with the Wong "Faces" scale -- those cute little faces -- and asked me about pain. I have chronic knee pain, and I've always had a lot of difficulty rating my pain on a 1-10 scale. Those little faces made it possible for perhaps the first time to definitely say "It's a 3 right now". I'm going to be suggesting we incorporate that into our practice on our unit!
Nov 21, '12Ruby Vee, It's great to hear from you, I hope you feel well. Sorry you had to go under the knife so close to the Holidays- but I hope it makes a world of difference for you and Godspeed in recovery!!
Nov 22, '12Quote from Ruby VeeExcellent idea!I had surgery this afternoon. When I arrived in the pre-op area, the nurse handed me a piece of paper with the Wong "Faces" scale -- those cute little faces -- and asked me about pain. I have chronic knee pain, and I've always had a lot of difficulty rating my pain on a 1-10 scale. Those little faces made it possible for perhaps the first time to definitely say "It's a 3 right now". I'm going to be suggesting we incorporate that into our practice on our unit!
As a team, our practice is elevated when we are all using the same tools with skill.
It is important to use tools to help measure pain so that we can report outcome to treatment in as few words as possible.
Hope you are back on your feet soon!
Nov 23, '12Quote from Ntheboat2I just read a few of them. Thanks for the advice. Worse comes to worse I will have to work while in pain....Yeah, yeah...."I just forgot to get my BSN."
Just kidding!! I can't help it.
Have you seen any of the threads about nurses who take prescription medication? Nurses aren't human you know. It might be worth checking out if you're gonna be relying on scripts to get you through.
Nov 23, '12Quote from PRICHARILLAisMISSEDOr pee while in painI just read a few of them. Thanks for the advice. Worse comes to worse I will have to work while in pain....
Sep 28, '13After just reading a lot of heavy stuff in the political forums, I thought we could use a little lighter reading. So bumping this back up.
Everyone needs to laugh once in a while.........