Pain scale (Rated R)!!!

  1. Found in another post here on allnurses...

    I have a great story about this. The pain team was rounding in the ICU and stopped to see an early-20's-something guy who had had pleurodesis and still had his chest tube in. Now, I'll grant you CT's hurt like hell. But this guy was whining like you wouldn't believe, despite the PCA epidural. So the anesthesiologist asked him to rate his pain 0 - 10, with 10 being the worst. "Ten," the pt whined. The doc paused, and said, "No, I don't think you clearly understand the pain scale. Let me give you an example. If I took 2 bricks, and SMASHED!! your balls between them, that would be a 10. Now, given that, how would you rate your pain right now?" "Oh", the startled pt replied.
    "Three."</
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  2. 27 Comments

  3. by   donmurray
    Wonderful! roflmao! Is that called fine tuning the accuracy?
    Don. (tearfully!)
  4. by   TriciaRN
    LOLOL!!!!!! That kind of puts it into perspective for them huh? I love it!
  5. by   Ted
    LOL!!!

    Ted
  6. by   kennedyj
    lol. i'll have to remember that one next time a patient says 10.

    sweeeeet!!!

    Jared
  7. by   cwood2b
    I cannot stop laughing! That was great!
  8. by   misti_z
    I'll have to remeber that one. Helps put it into prospective for them doesn't it!
    And I guess for women, 10 would be how hard the man squeezes your hand as he's getting crushed with two bricks, huh?
  9. by   babs_rn
    For women I use the pain of childbirth to compare to a 10. For older men, it's kidney stone pain. Otherwise I often go for the little "face chart" scale. If they're walking about, laughing and joking, I don't care what they say...it's NOT a 10. I remember when that "pain scale" came out in the first place, I thought it was a crock then and I still do. No way you can put a number to something subjective. Plus many times in the ER they'll continue to give you a high number to either (1) win sympathy (2) avoid going home or more commonly (3) get heavier drugs. JCAHO is actively encouraging narcotic dependence in society. We're all turning into a bunch of wusses.


    Babs
  10. by   bungies
    I agree with your assessment of the pain scale, babs, but it IS useful in a field like hospice care, where patients are very much more in touch with how they feel. I think I'd find it difficult to rate pain myself, except relative to other pain (e.g. whether analgesia has made any difference). I have seen academic writing trying to pass the pain scale off as objective data! (The original post by nurseyperson seems to question that, doesn't it?)
  11. by   lynnern
    I agree with Babs RN - Working in the ED requires you never to lose your humor factor! People walking around - going out to smoke - talking to you in a normal voice pattern (sometimes annoyed) give me a rating of 10 all the time. It is all in there perception. Children, however, using the face scale are more accurate in their subjective description of pain - I suppose they just haven't learned how to manipulate the system to get pain relief yet!!! Thanks for the insight! Our nurses tell pts that a 10 is if someone rips your leg off and beats you over the head with it!
  12. by   HazeK
    we just laugh & laugh in L&D over the new JACHO requirement for using a pain scale!

    For years we've used documentations like "breathing thru UCs" "crying" "writhing in pain"
    along w/ mental status documentation like anxious, calm, cooperative, withdrawn, etc.

    NOW we get to ask a natural childbirth mom who is 8cms dialated her level of pain from 1-10....then, walk to another room where a first-time mom is having some cramping in her lower back, at 2 cms...and listen to THIS patient call her pain "a 7"....honey, she has NO IDEA what is ahead of her!

    I always thought that assessing a patient included assessing for level of pain...and then treating it with comfort measures or medications.... Why did JACHO feel the need for this new annoying rule??
  13. by   mustangsheba
    The annoying rule is in response to public demand and even legislation that addresses the fact that real pain in the majority of the American population was not being addressed. Much of the untreated pain was in the terminally ill and the elderly and resulted in suicidal ideation. I love the bricking idea and I'm not especially fond of JCAHO, but I support the attempt to manage pain more humanely. I think we get a bit jaded working ER cuz we see a preponderance of whiners there.
  14. by   housoj
    Have we forgotten that pain is what the patient says it is? Granted, the ER deals with a totally unique clientel, but in the ICU I find the scale helpful in dealing with post CABG and Chest painers, etc. Yes ....there is the occasional BIG baby who makes me nuts with his whinning, but medication makes them sleep....lol !!!

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