When you're the patient...

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Just curious if other nurses do this, or if it's just me. When I'm the patient, I tend to not report pain or under report it, for the sake of not appearing weak and/or not wanting to be bothersome to my nurse/techs. Especially if I think I'm being kind of a weakling in my head.

I had an ultrasound yesterday, part of monitoring a chronic condition. It was kind of painful as the condition is apparently worsening. It had never been painful before, but this was. Not hideously awful pain, only like a 3 or 4 at best, but enough that throughout, I was really uncomfortable and still kind of sore hours afterward and still kind of tender today. The tech was not poor with her technique at all, and not heavy handed or rough, so I know it wasn't her. It only hurt when she was visualizing the problem area.

I was thinking about it today, wondering if maybe I should have spoken up, or if it was really a moot point because what can you even do for a painful u/s anyway, right? However this is par for the course for me as a patient, all the time, regardless. It doesn't matter what they're doing to me, I'm always going to try to man up and be as stoic and silent as possible and not report pain. In hind sight and reflection, I guess it's not such a good thing, is it?

OrganizedChaos, LVN

1 Article; 6,883 Posts

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

No. I report as much pain as I am in. They don't know I'm a nurse & I went to get help. If I'm in a lot of pain, I say so. I don't want to remain in pain. I don't feel bad for the techs & nurses when I say I'm in pain, I just make sure to be polite.

quazar

603 Posts

I suppose it's conditioning as well. It is verboten in my family of origin to express physical pain or show physical weakness, especially if you are female.

OrganizedChaos, LVN

1 Article; 6,883 Posts

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I suppose it's conditioning as well. It is verboten in my family of origin to express physical pain or show physical weakness, especially if you are female.

That's probably it. If you're in the hospital, you're there for a reason. Don't be afraid to speak up. You're the only one who knows how much pain you're in.

crazin01

282 Posts

Specializes in tele, ICU, CVICU.

I find I also minimize pain. Maybe not so much a nursing thing, but a background thing. My 80 year-old grandmother has OA so bad in her right knee, that she can barely walk with a cane (which is not her norm at all & incredibly hard for her to be still). She was told about 2 years ago she needs a replacement that she doesn't want. (she is slowly filling me in on the 'missing pieces' of her medical history) and had I known this, it would have been addressed 2 years ago. My grandpa (82) recently had a minor accident, involving a few out-PT visits and I was there for them all, drove etc. Yet she cancelled her ortho appointment looking into viscous supplementation injections for said knee. And only made it again when I made her.

Maybe not so much as pain, but I think as nurses we definitely don't take care of ourselves like most. How many times have we not called in for a cold or something minor that significantly affects your work? And of course a huge part is the employer giving employees a difficult time for call-offs & penalizing those for actually utilizing their sick time.

Sorry to go off-track, but I think it's sort of related. Us nurses are tough. ;)

macawake, MSN

2,141 Posts

Just curious if other nurses do this, or if it's just me. When I'm the patient, I tend to not report pain or under report it, for the sake of not appearing weak and/or not wanting to be bothersome to my nurse/techs. Especially if I think I'm being kind of a weakling in my head.

I've had about half a dozen surgeries and I have underreported pain on more than one occasion only to have observant nurses lecture me about the importance of adequate pain management. More on that later on in this post.

I don't under report my pain for the same reasons as you do though. I just figured out after my first surgery that I really, really hate the way opioids make me feel. I hate losing control/being mentally sharp, I hate the nausea, not to mention constipation that follows. I decided I'd rather tough it out the next time around.

Quazar, I don't think that admitting that you're in pain is a sign of weakness. I view pain as the body's warning system. It's simply the body's way of signalling that something's up , designed to give us a chance to try to attempt preventing further injury. I think of it much the same way as I do thirst or hunger.

As far as bothering the staff, pain is a legitimate complaint and we as nurses are there to help with that. I really don't think that you should feel like you're being a burden or a nuisance if you ask for help with pain management.

I was thinking about it today, wondering if maybe I should have spoken up, or if it was really a moot point because what can you even do for a painful u/s anyway, right?

It doesn't matter what they're doing to me, I'm always going to try to man up and be as stoic and silent as possible and not report pain. In hind sight and reflection, I guess it's not such a good thing, is it?

As a nurse it really bothers me when patients do this. (Yes, I know. Slightly hypocritical of me. What's good for the goose ought to be good for the gander).

It's harder to control pain once it's gotten really bad. I'd rather get in there early with meds as it usually takes a smaller dose that way and the patient doesn't have to experience distress unnecessarily. I know that this isn't relevant to the ultrasound procedure you've described here, but adequately controlled pain allows for properly executed breathing/exercises and early ambulation, both beneficial for recovery and the prevention of complications after surgery. (And yes, that's what the nurses told me too, after my surgeries as I was lying through my teeth, all pale in the face, respiratory rate of 25 (ridiculously shallow breaths at that), tachy with a BP of 175 over something.. Yeah, I'm not in pain :facepalm:). Also, pain is a symptom of something and I think it's good for the nurse or physician to be aware.

I know that we can't give medical advice here but I can tell you what I do if I'm scheduled for a check-up or similar that I know in advance will be painful. I'll take p.o. paracetamol (acetaminophen) and ibuprofen an hour or two in advance. Might be placebo but it helps me a lot.

I'm sorry that you're dealing with the condition and that the u/s was painful. My advice is speak up in the future. Admitting to pain in a healthcare setting is not a sign of weakness.

Take care!

I tend to not speak up, as well. I don't think it has to do with nursing, though ...I just try to tolerate things when I perceive them as temporary. But if I knew it would be happening again, I would speak up before the next time in the hope of being better prepared.

quazar

603 Posts

I don't under report my pain for the same reasons as you do though. I just figured out after my first surgery that I really, really hate the way opioids make me feel.

As a nurse it really bothers me when patients do this. (Yes, I know. Slightly hypocritical of me. What's good for the goose ought to be good for the gander).

It's harder to control pain once it's gotten really bad. I'd rather get in there early with meds as it usually takes a smaller dose that way and the patient doesn't have to experience distress unnecessarily.

I hate opioids as well. The side effects make me absolutely nuts, and I'm really really sensitive to them, so a tiny dose affects me like mad. I just don't like them. Give me toradol or tylenol, skip the rest thanks.

It's funny you mention that whole "hate it when patients do that" and how it's harder to get it under control because you're so right. I spend many shifts explaining that to patients myself. Funny how we never take the advice we dish out. ;) I'll let my doctor know at the follow up appointment to discuss the u/s results that it was painful, just so she knows.

quazar

603 Posts

I tend to not speak up, as well. I don't think it has to do with nursing, though ...I just try to tolerate things when I perceive them as temporary. But if I knew it would be happening again, I would speak up before the next time in the hope of being better prepared.

This is true as well. I kept thinking, "dang that hurts!", but then I'd think to myself, "well what the heck is she going to be able to do about it? NOTHING." So I just kept quiet. Hindsight now, I'm thinking at least she could have added it to her report as to the specific locations that I was indicating were painful, to help with the diagnostic report if anything.

So many nurses that I take care of, I notice, are really hesitant to report pain or get pain control. It's frustrating when it happens to me as a nurse, but then here I am contributing to the problem as a patient. Derp.

Cricket183, BSN, RN

1 Article; 250 Posts

Specializes in Oncology (OCN).

I have a chronic pain condition called Reflex Sympathetic Dystrophy aka Complex Regional Pain Syndrome. When my husband accompanies to my appointments or on the rare occasions when I have been to the ER over the past 10 years he tells me that I tend to minimize my pain when reporting it. He says I'm so matter-of-fact about it that I don't give a clear picture of how much it is really affecting me. It's not something I do intentionally, it's just how I communicate. I also tend to be very quiet and stoic, especially when my pain is severe. I do not see admitting pain as a sign of weakness or anything like that but I also don't think I should have to embellish or be dramatic for someone to believe I'm in pain. (I hope that makes sense without being insulting because I most definitely do not mean it that way.) I'm so use to being in a pain that it's just a normal part of life. As a rule I do try to stay ahead of my pain because I have learned the hard way that if it gets out of control it is incredibly hard to get back under control.

I have had to have half a dozen surgeries or so and have been doing monthly ketamine infusions over the past 2 1/2 years. I do hate feeling "bothersome" to the nurses and other healthcare staff during these admissions.

quazar

603 Posts

He says I'm so matter-of-fact about it that I don't give a clear picture of how much it is really affecting me. It's not something I do intentionally, it's just how I communicate. I also tend to be very quiet and stoic, especially when my pain is severe. I do not see admitting pain as a sign of weakness or anything like that but I also don't think I should have to embellish or be dramatic for someone to believe I'm in pain. (I hope that makes sense without being insulting because I most definitely do not mean it that way.) I'm so use to being in a pain that it's just a normal part of life.
I totally get that. I have chronic pain issues from other stuff, and am very matter of fact about that when asked. I've had nurses gawk at me when I answer the pain question with "daily." Then I calmly explain to them that pain is a constant in my life, and that I don't expect to be pain free, ever. It's something I deal with, and this is my baseline. That's just how I explain it to them. When you have chronic pain, yes, it's not something you tend to get overly excited about any more.

Kitiger, RN

1,834 Posts

Specializes in Private Duty Pediatrics.
No. I report as much pain as I am in. They don't know I'm a nurse & I went to get help. If I'm in a lot of pain, I say so. I don't want to remain in pain. I don't feel bad for the techs & nurses when I say I'm in pain, I just make sure to be polite.

Somehow, they always seem to know that I'm a nurse.

It's hard to remember to not speak in "medical-ese".

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