Two Big Questions For Pain Experts

Specialties Pain

Published

If it's assumed that the patient's pain is ALWAYS what they say it there are two major questions that arise. The questions arise because they are real-life situations.

1. A patient has had surgery that isn't expected to be painful. The patient has had 4mg of Dilaudid for pain that is reported as 10. The patient has a goofy grin and says: "I'm going to say that my pain is a 10 because I like pain medicine." (This actually happened)

Do you continue to administer Dilaudid in this situation? Do you take his report of pain at face value? I was advised by my co-workers to send the fellow home and I did so.....He left smiling......Did we do the wrong thing?

2. A patient is close to being in a Dilaudid coma after receiving 10mg of Dilaudid. The patient appears very comfortable and, when awakened, rates his pain at 10. (This actually happened)

Do we have a pain emergency here? (I've seen many situations that are clearly pain emergencies but this one doesn't seem to be a pain emergency.) Can you in good conscience send the patient to the floor with a pain of 10 under these circumstances?

O.k.....I asked more than two questions but the other questions are tied to the main ones.

Specializes in PACU.

OP, what has you so convinced that a new and better way to assess pain wouldn't be welcomed by the medical/nursing community?

I'm not convinced of that at all. The fact that the current crop of "experts" have dominated pain control policies gives me little hope of sanity in pain control any time soon.

You can call it nonsensical criteria and idiocy all you want, that doesn't change the fact that it's the best we have.

It's not the best we have. It's caused an epidemic of overprescription......It's been a disaster! Opioid habits are out of control in this country.

The best we have involves a realistic approach.

Simply complaining isn't constructive and won't better or improve a situation.

Stating important truths is very constructive.....Being blind to important truths makes the situation worse.

Specializes in Pain, critical care, administration, med.

I think this poster is not very educated regarding pain though he claims to be and likes it. Really! He has a issue with what everyone thinks. You do sound burned out maybe it's time to pack it in. While patients aren't always honest we as nurses can be way too judgmental. Every patient has a story. As nurses we need to listen, provide feedback, assess and educate. While addiction is on the rise a good number of patients remain under treated for the fear of becoming a addict or because of what the provider may think.

I have done pain management for over 10 yrs and certified in pain. I encounter the posters view everyday. As much as I educate they can't change their own biases. Let's discuss how we as health care providers do this better and avoid wasting time on ignorance.

I'm not convinced of that at all. The fact that the current crop of "experts" have dominated pain control policies gives me little hope of sanity in pain control any time soon.

Your own words: "I haven't devised a new system for pain control.......It would almost certainly be a complete waste of time as it would never be implemented."

Not much room for misinterpretation or ambiguity.

I have given you the benefit of doubt, no more. When you contradict yourself you lose all credibility as far as this discussion goes.

I finally feel like I'm done with this entire discussion. Quite a liberating feeling :D

I'm putting the horse to rest.

Specializes in PACU.
I think this poster is not very educated regarding pain though he claims to be and likes it. Really! He has a issue with what everyone thinks. You do sound burned out maybe it's time to pack it in. While patients aren't always honest we as nurses can be way too judgmental. Every patient has a story. As nurses we need to listen, provide feedback, assess and educate. While addiction is on the rise a good number of patients remain under treated for the fear of becoming a addict or because of what the provider may think.

I have done pain management for over 10 yrs and certified in pain. I encounter the posters view everyday. As much as I educate they can't change their own biases. Let's discuss how we as health care providers do this better and avoid wasting time on ignorance.

I'm plenty well educated. What makes you think that pointing out the fact that the patient's pain isn't always what they say is makes me uneducated?

What makes you think that me pointing out the obvious fact that overprescription is an epidemic in this country and has caused serious harm makes me uneducated?

Instead of making dishonest accusations against me why don't you address those two facts?

Citing extremely important facts isn't a sign that someone is uneducated.

Specializes in PACU.

I have given you the benefit of doubt, no more. When you contradict yourself you lose all credibility as far as this discussion goes.

I haven't contradicted myself.....That's patent nonsense. You lose all credibility by posting patent nonsense.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

thread closed for staff review.

+ Add a Comment