Anyone else frustrated by the pain scale??

Mell101 · Aug 7, 2013

Sometimes the pts who shout and scream and "roll on the ground" are those likely to not be a 10/10. You dont have to overreact for your pain to be classified as a 10/10 everyone reacts to pain differently. And yes the pt can be badly in pain and scream and shout and roll on the ground. You have to trust that what they are telling you is honest. It's your job as a nurse. Not to judge them.

Pepper The Cat, BSN, RN · Aug 7, 2013

Some times pts will say their pain is 10/10 because its the only way to get the pain meds they need. I know that post op if I take a stronger pain med when my pain is only at a 3 or 4 it will prevent my pain from reaching a 7 or 8. But I also know that if I tell the nurse my pain is only a 3, I will just get Tylenol. And that won't be enough. So I tell them it's higher than it is.

SC APRN, DNP, APRN, NP · Aug 7, 2013

everyone deals with pain differently. I don't show my pain, I do expect my nurse to believe me when I say I need meds. its not about your body and how you express pain, but how your patient does.

melizerd, ASN, RN · Aug 7, 2013

While pain is what the patient say it is, this is the real pain scale chart. We have a copy hanging in the doc's dictation room.
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Tinker88 · Aug 7, 2013

Shouldn't you be concerned with how you are going to treat that pain and make that patient more comfortable? I would not appreciate it if a nurse was thinking that in her head about me or a loved one.

DisneyNurseGal, BSN, RN · Aug 7, 2013

Patients wouldn't feel the need to misrepresent their pain score (and get more medications) if doctors and nurses took their pain seriously without question. Unfortunately, with all of the drug seekers out there, we have gotten jaded. Nowhere in our scope of practice does it say that we are to judge. If they say they are 10/10, they you need to trust them.

allnurses Guide · Aug 7, 2013

I describe it as pain of 10 can't possibly get worse, 5 hurts pretty darn bad and 0 is none. Don't get a lot of 10's anymore, when someone says 10 I ask, so this can't get worse? Sometimes they say yes, and that's what I chart. I also explain it is just a scale to compare pain with, did the meds help or are you getting worse. If you start at the top of the scale, there isn't much room for getting worse. People tend to cooperate better with the scale if they understand what we are really asking. It isn't the number as much as the comparison.

BrandonLPN, LPN · Aug 8, 2013

I can't stand when I get the 10 out of 10 pain patient and they are just looking at me. Ahh, yeah if you were really 10 out of 10 pain you should be rolling on the ground!!

You're in for trouble if you're already thinking this way as a student. You'd do well to nip this train of thought in the bud now.

First of all, pain really is subjective. It's probably one of the most subjective things there is.

Second, the 1-10 pain scale is used purely as an assessment tool for nurses to evaluate the effectiveness of an intervention. It often has little to no meaning to the patient. If someone is in severe pain, using the pain scale "the right way" is the last thing on their mind. For us to expect them to give a flying fig about the "proper" use of the scale is absurd.

And, finally, (and pay attention here) even if the patient is a drug seeker, it's not our place to judge them or to alter our delivery of care based on those judgements. If there is a valid order and the vital signs are WNL, then you are obliged as a licensed nurse to document what the patient reports his pain as and to medicate accordingly. It's just that simple.

Racer15, BSN, RN · Aug 8, 2013

Doesn't really bother me. I chart what they state and add my own notes about their behavior. They may really be in pain or they may be full of it, I just document the facts and move on.