I was looking at one of my pt charts (paper charting) the other day and noticed one of the CNAs had charted a pain assessment on the flowsheet where they usually chart the vitals. There is a space for this allowing a numerical value. The CNA had charted 0/10. I thought about it later and started to get a bit worked up about it.
From what I remember in school CNAs can not assess pts. What do you all think? How would you approach this without making the person feel too bad?
Pain is considered a vital sign in some facilities, and CNAs usually assess vitals (just not the initial). Check your facilitys protocal and procedure manual to see if a CNA can ask pain level at your hospital.
Last edit by Mrs. SnowStormRN on May 9, '11
Quote from sweetnurse63
...Suppose the patient is alert, and tells the cna/pct that his pain is 7/10, the cna records it, then the nurse goes to patient room, lets say in 5 mins and the patient now says the pain is 10/10. I would rather write down my own pain value, because upon assessment, there may be an emergency, that is causing pain, such as, peritonitis or small bowel obstruction or anything.
Why can't you just chart that? Chart, "Pain reported as 7/10 to CNA staff. When patient was assessed by nursing staff/me, patient's pain is now 10/10. _____ Intervention done/med given. Recheck 30 minutes later pain reported as x/10."
Pain scores are just numbers, easily relayed to give quick information about the subjective pain that patient is experiencing at that moment. Pain is the fifth vital sign, and as a CNA it is
in my scope of practice to take and record vital signs, reporting anything abnormal to the nurse. It is reasonable for that number to change between reporting to the nurse and the nurse getting to assess the patient (just as pulse and BP and RR may change quickly - it doesn't mean not to record and report the abnormal value at the time it was taken!)...
To me it is no different than an abnormally high or low BP - I record it and report it to the nurse - then the nurse can reassess and treat using nursing judgment.
Last edit by juliaann on May 9, '11