how to ask patient for pain scale score correctly?

psu_213, BSN, RN · Sep 10, 2012

One more thought that a colleague came up with...

Suppose your pt tells you they have a pain of "100" out of ten. You give them pain meds. Go to reassess. They say "It's a little better...now it's like a 7." You have decreased their pain by over 90%! I'd say that's pretty good.

Esme12, ASN, BSN, RN · Sep 10, 2012

As one who has been conducting comprehensive pain assessments for some time now...coupled with personal experience of pain and need to report in a measurable way...would lead me to disagree that a numeric pain scale is a joke or silly in any way.
First, as health professionals our treatment of pain in our patients is a matter of SERIOUS importance. If your place of business is JCAHO, CHAP, or otherwise nationally certified you are mandated to report on pain and your treatment plan and follow up for the pain. Using a pain measurement tool helps us to "measure" the pain and the response to treatment.
In my 3 decades of experience I have noted that nurses struggling with a tool are often not adequately trained in the use of the tool. I believe this would be true of pain assessment tools as well. As well, there is inadequate education of nursing professionals, in general, as to the assessment, treatment, and management of acute and chronic pain. When we multiply that by the level of personal or professional "anxiety" regarding use of opioids in general we end up with too many people with chronic pain issues who are inadequately treated for either their chronic pain or their exacerbations of pain, particularly when the pain takes them into urgent care settings after hours. The level of opiophobia amongst health professionals is at times alarming.
I am always dismayed at the number of nurses who cannot believe that a person can report a pain of 8/10 and still have a relatively normal appearance. It seems that many of us either never learned about or have forgotten about our human ability to compensate for chronic conditions...like pain.
Finally, there is a tool for adults much like the FLACC. It is called the PAINAD and is designed specifically for adults (particularly dementia patients) who are unable to verbalize their comfort levels.

I can't LIKE this enough!!!!!!!!

I also think nurses forget that pain is subjective it's about how the patient feels not how you perceive they feel.

TheSquire, DNP, APRN, NP · Sep 10, 2012

I also think nurses forget that pain is subjective it's about how the patient feels not how you perceive they feel.

There's a difference between someone who stoicly with a straight face tells me their pain is a 10, and the person who's laughing, talking on their cell phone, and eating red-hot frito lays products that their pain is a 10. I'm not inclined to believe the latter, and I include all that subjective information when I write my note.

whichone'spink, BSN, RN · Sep 10, 2012

This is a joke, but an ED tech I used to know came up with an interesting way to get patients to rate their pain accurately. Slap them on the arm as hard as you can, that is a 5. Is their pain worse than that or not? I don't think the Joint Commission will go for that though.

7feetunder · Sep 11, 2012

This is a joke but an ED tech I used to know came up with an interesting way to get patients to rate their pain accurately. Slap them on the arm as hard as you can, that is a 5. Is their pain worse than that or not? I don't think the Joint Commission will go for that though.[/quote']
LOL.i'm quite sure I'm recieving my customer complaint and writing incident report in next minute..
haha!big no.no

nrsjnet · Sep 11, 2012

I usually tell them that the pain scale helps us know how well we are doing in managing their pain because we can't feel what they are feeling and will know if we are making progress. They usually understand

maelstrom143 · Sep 12, 2012

For fun: http://rlv.zcache.com/a_better_pain_chart_poster-p228976370094879342t5wm_400.jpg

OH, LOL! I have this one saved on my pc. I look at it each time it has been a rough, dilaudid q2h for everyone day!

7feetunder · Sep 14, 2012

Haha!thats scale so funny! XD

VICEDRN, BSN, RN · Sep 16, 2012

"on a scale of zero to ten, where ten is the worst possible pain imaginable and zero is no pain at all, what would rate your pain right now at this very instant?"If they request further guidelines, I say five is a typical headache or body aches from the flu, zero is you have nothing you would call pain right now. I further educate them that it is okay to say zero if the pain is coming and going and isn't there right now as we are used to that experience and it will not change our evaluation. I also supply a list of pain words as needed. "for instance, dull, sharp, stabbing, throbbing, constant or intermittent, aching, pins and needles, etc" are all "pain".