The way we ask for someone's pain level?

  1. 3 I've come across patients, usually post op, that needs to be routinely assessed on their pain levels.

    Now I'm trying to look for a way to ask them on their pain level without planting into their minds the idea that they're actually feeling pain. Of course we can plan a response from their report, but we might be addressing pain that is actually not present in that moment.

    Can we ask a general question of "how are you feeling right now?", instead of "are you feeling any pain right now?" Should we be direct or indirect in these kind of situations?

    Is that possible? Thanks for your time!
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  3. Visit  cmav8 profile page

    About cmav8

    From 'Quezon City, Quezon, PH'; Joined Sep '12; Posts: 6; Likes: 4.

    65 Comments so far...

  4. Visit  jadelpn profile page
    5
    This is one of those "it depends" kind of answers! LOL!

    What do your orders say? If patient's pain is 1-3 give xyz, 4-7 qrs and 8-10 tuv?

    Some of the education that patients receive is that they need to be mindful of their pain before it becomes unmanageable. Pain is also subjective. You need to both assess for pain, then follow up to be sure that their pain is well controlled after your intervention. So there's no way "around" asking outright.

    And that is OK. Pain post-op is real, should be medicated, and needs to be.

    Bottom line--always follow your orders for pain control.
    wannabecnl, Tait, NF_eyenurse, and 2 others like this.
  5. Visit  chrisrn24 profile page
    2
    How about "are you comfortable?" or "how are you doing?"
    tewdles and GrnTea like this.
  6. Visit  K+MgSO4 profile page
    1
    How are you feeling is not the best as post GA they are not thinking the best.

    If they had been nauseous 10 min earlier you gave them anti emetics and then you return and ask how are you feeling?

    I usually ask do you have pain?
    Tait likes this.
  7. Visit  JUSTanLPN profile page
    2
    I'm this litigious day and age, I'd flat out ask if you're hurting ANYWHERE, does it radiate, quality, etc...it's not often, however, complications that can come from within(Eg. Cannot be seen with eye) Might manifest as pain that radiates to left shoulder. That would be something I'd want to catch up front.
    Tait and GrnTea like this.
  8. Visit  classicdame profile page
    2
    Instead of using the word "pain", substitute with "comfort". Since the verbal pain scale is so subjective, turn it around.

    "On a scale of 0 -10, with 10 being Very Comfortable, how comfortable are you now?" If the number is low, medicate
    Last edit by classicdame on Jun 10, '13 : Reason: spelling error
    danggirl16 and GrnTea like this.
  9. Visit  nrsang97 profile page
    5
    I flat out ask "Are you having any pain at this time anywhere?" . Where is the pain, number on 1-10 scale, radiation, etc. Give available meds and re assess pain within say 30 minutes. If they aren't better then I see what else is available and if nothing else is I call for additional meds.
    Kitty-RN, loriangel14, GrnTea, and 2 others like this.
  10. Visit  chare profile page
    12
    Why wouldn't you just ask them if they are in pain?

    Why are you concerned about "planting in their minds the the idea that they're actually feeling pain?"
    rngolfer53, Tait, CapeCodMermaid, and 9 others like this.
  11. Visit  Rhi007 profile page
    1
    It's a judgement call, one persons 5 might be another's 10...different people have different pain thresholds...mine is inhumanly high, I just about have to be dying to say 10....also use body language if they grimace when they move that's an indication of pain, some patients don't want to put you out by saying yes they have pain so always ensure you tell them it's your job to make sure they're comfortable so not to be afraid of letting you know.
    nrsang97 likes this.
  12. Visit  Pediatricjo profile page
    5
    I ask "are you having any pain?" or "what is your pain level?" I also encourage the alternative measures such as repositioning, warm pack, cold pack, ambulation, etc. Remember though, a patient's pain is their perception, not yours.
    tewdles, poppycat, loriangel14, and 2 others like this.
  13. Visit  tots24 profile page
    2
    I know that I sometimes plant pain pereptions in my patients' minds. I work with post-surgical peds patients and always just ask flat out if they are in any pain. If they say no or give me a low rating on the numeric or faces scale that I don't think is accurate, I remind them that it's okay to have pain and it doesn't mean they've done anything wrong or that the surgery didn't go well. I would so prefer to have a patient rate their pain higher than maybe it is and give meds appropriately than to have them not say anything until it's really severe.

    Most of the time I find, even in peds, that I get pretty accurate pain ratings regardless of my wording.
    rngolfer53 and Tait like this.
  14. Visit  Altra profile page
    8
    Quote from classicdame
    Instead of using the word "pain", substitute with "comfort". Since the verbal pain scale is so subjective, turn it around.

    "On a scale of 0 -10, with 10 being Very Comfortable, how comfortable are you now?" If the number is low, medicate
    I would be very cautious about this, because you are introducing a scored scale other than what is likely named in your institution's policies and order sets. In other words, if your hospital is like most others, it requires by policy that you assess pain using a numerical or other scale and other assessment data, and your physicians' order sets probably reference that data. To introduce a "comfort scale" ... you are muddying the waters considerably if you medicate based on a patient's report of a comfort of 2 instead of the prescribed pain score of 7.

    Remember too ... I hate to bring it up ... patients are surveyed whether or not their pain was controlled, so it is probably best to be in clear compliance with that requirement and assess "pain" directly, using that language.

    When patients tell me a low number for their pain or say something like "it's not that bad" ... I ask, "do you feel like you want something?" This way I have maintained their control over their own well-being.
    rngolfer53, wannabecnl, nrsang97, and 5 others like this.
  15. Visit  RNsRWe profile page
    0
    I know post ops are expected to have pain. So when I worked in that setting, I'd say "on a scale of one to ten, with 'one' being a small pinch and 'ten' being an anvil dropped on your head, what level pain are you in?

    Found out quick, handled appropriately, and usually got a smile from a patient that hadn't yet cracked one


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