Describe your 10/10 pain. Piggybacking off of recent pain discussions.

[0.adamantite]

I have felt 10/10 pain. I had a medical procedure that was incredibly painful, awake and unmedicated. Being a nurse, I wanted to be tough. I closed my eyes, gripped the table, moaned, clenchedd my teeth, every muscle in my body tensed and had "tunnel vision" if I opened my eyes. Sounds also seemed distorted. All I could focus on was the horrific pain. As the nurses and doctor asked me questions I could only get out one-word answers.

When the procedure was over, they encouraged me to rest, but I wanted to be tough. So I got up and had a vasovagal response to the pain. My blood pressure dropped, my hands and feet went cold yet my core felt like I was feverish. I was so pale my lips were ghostly white. I got dizzy and felt as close to blacking out as I have ever been in my life. I was rushed back to bed and had to remain for extra time to recover.

I know everyone reacts differently to pain, but when someone says their finger pain is 10/10, while sitting upright calmly in bed, it makes me wonder. But then again, I am not someone used to pain. Do you think people misunderstand the pain scale? Do you think the 10/10 is over used?

[OCNRN63, RN]

what makes me mad is those pt's who are so snowed you have to ask them a couple times what their pain is, and its always still 10/10.

That can happen if the pt is getting the wrong type of analgesic for his type of pain. For e.g., opioids for neuropathic pain can be ineff. So yes, it's entirely

poss. for a pt to be zonked and still be in extreme pain.

I find some of the posts of "My pain was really 10/10, but that pt pain wasn't." If a pt says he has pain and he can have something, just save the judge mental attitudes and medicate him. If you think something seems wrong, do some research about his condition and what would be the best pain regimen for him.

[Ruby Vee, BSN]

I'm a nurse; I use the pain scale every day in my job. You'd think I'd be able to give my own pain a number. But no. Not until someone dragged out the pain scale with the faces on it -- you know -- the one they use for kids. Smiling face, no pain. All the way to the crying and screaming face. THEN I can rate my pain. The numbers just don't seem real to me.

[nrsang97, BSN, RN]

My 10/10 was back labor. I had terrible back labor. I couldn't feel the contractions just pressure on my back. I seriously thought that my son was trying to come out my back. I was also induced and was not able to get an epidural. I went from 35.-10 in under an hour so I was not able to get the meds.

I just medicate my pt appropriately. If they are saying 10/10 I give what I can, have them rate later. I agree with Rubyvee that the pain scale doesn't always make sense to people either.

[withasmilelpn]

The pain scale is such a subjective and difficult thing even for me as a nurse. I think the worst pain for me was with my having my first Child - was given Cytotec, and the contractions were so fierce and close together that I remember just feeling 'lost' in the pain, clutching my husband while in the shower they recommended to try and 'get my mind off of it.' Ha! - it was like my whole world had narrowed down to trying to survive that pain. Three other children after and none of them we're like that - thank God! That would be my 10 for 10 experience.

[Twinmom06, ASN, APN]

my 10/10 was intractable biliary colic with a gallstone stuck in the neck of my gallbladder. 0.5 of Dilaudid and Zofran and I was feeling nuttin for a good 6 hours. BUT with that said, I have a pretty high pain tolerance, as they kept wanting to give me Percocet post-op and I didn't need it. Didn't need it after my c-section either. But I realize that pain is subjective, and someone elses 10/10 might be my 5/10

[ixchel]

My 10/10 was the fall that made my undiagnosed spinal fracture turn into spondylolisthesis. Immediately after the fall, I think I thought I was okay, but split seconds later the pain was exploding. Tunnel vision, nausea, a sudden drop in blood pressure I think because had I not sat down immediately, I would have fainted. Then after I sat down, I realized sitting hurt even more. I thought the pain would pass, but after about 10 minutes of it steadily not getting better, I realized I probably broke something. As it turns out, I didn't, I just messed up stuff that was already messed up. The intense part of the pain lasted months, probably a 4-6/10 daily. It's tame now. It's more of an inconvenience at this point when it comes and goes in an activity-limiting way, but I've learned to prevent it from getting bad again.

[That Guy, BSN, RN, EMT-B]

Everyone who walks through my doors is a lying, drug seeking med hunting narc fiend. Nah just kidding. It does seem odd how others can relate a 10/10 to a splinter in the finger, but it still gets Dilaudid ha ha

[tokebi]

We all should also keep in mind that chronic pain sufferers do not exhibit the typical response that we expect with severe acute pain. None of the sickle cell crisis patients I've had showed moaning, grimacing, guarding or VS changes. They would be watching movies, texting on the phone, and just looking pretty calm to me. But I have no idea what it is like to have sickle cell pain. I do know these kids lived with such pain all their lives and they don't need suspicious or judgmental reaction from nurses... they get plenty already.

I watched my husband dealing with chronic pains, and I can rarely tell when the pain is bad because he never shows the typical signs. Only after getting to know him really well and able to pick up smallest signs, I realized he just gets cranky and irritable when his pain gets severe.

So, when someone with chronic pain rates 10/10 while calmly talking on the phone, I'll just go and get the med. No question from me. Will I get duped? Sure. But rather that than risking anyone under-medicated because of my unnecessary judgment.

[Nurse SMS, MSN, RN]

I don't think I have ever had 10/10 pain. Unmedicated childbirth probably hit a 9. Postoperative abdominal surgery touch a 8. I rated my kidney stone a 7 in the ER. Yet the only pain that makes me tear up is catching a freezing cold pinkie toe on a piece of furniture and nothing makes me cuss aloud faster than stepping on a Lego with a bare foot at night.

I just give the ordered pain meds and monitor. Doesn't matter if the pain is real. Of course it won't seem real to me - its not my body. My patients are more comfortable and my shift much more pleasant if I just fulfill my role and medicate and monitor.

[ixchel]

We all should also keep in mind that chronic pain sufferers do not exhibit the typical response that we expect with severe acute pain. None of the sickle cell crisis patients I've had showed moaning, grimacing, guarding or VS changes. They would be watching movies, texting on the phone, and just looking pretty calm to me. But I have no idea what it is like to have sickle cell pain. I do know these kids lived with such pain all their lives and they don't need suspicious or judgmental reaction from nurses... they get plenty already.

I watched my husband dealing with chronic pains, and I can rarely tell when the pain is bad because he never shows the typical signs. Only after getting to know him really well and able to pick up smallest signs, I realized he just gets cranky and irritable when his pain gets severe.

So, when someone with chronic pain rates 10/10 while calmly talking on the phone, I'll just go and get the med. No question from me. Will I get duped? Sure. But rather that than risking anyone under-medicated because of my unnecessary judgment.

One of the things we learned in med/surg was the difference in nervous system response in chronic vs. acute pain. You're exactly right. I will put on my strong face when I'm around others and my pain is bad. You'd never know it. But if it were acute, I wouldn't be able to hide it because the rest of my body would be spazzing about it, not just hurting where I'm used to. But it does still hurt, sometimes just as much. I guess I'm just used to it.

[Kyrshamarks, BSN, RN]

From personal experience with sever pain, a person can be snowed and still have 10/10 pain. I once got a total of 40 mg morphine over a 3 hour period. Alot I inow and I was flying twenty feet off the bed but the pain was still there just as intense. The nurse refused to call the doc and get something different ordered becasue i her words with that much morphine I could not be in pain. Thankfully her shift ended an hour later, that dayshift nurse came in, I am stikll flyiong high but she took one look at my face and said you are still in pain. She called the doc, got a dilaudid 2mg order and that stopped the poain completely for 13 hours for me. Morphine did zilch other than make me stoned. So next time they say 10/10 even though they look stoned they may still have pain.

[Here.I.Stand, BSN, RN]

We all should also keep in mind that chronic pain sufferers do not exhibit the typical response that we expect with severe acute pain. None of the sickle cell crisis patients I've had showed moaning, grimacing, guarding or VS changes

I haven't taken care of many sickle cell pt's; my first job on the neruo/ENT floor got some as overflows when the BMT floor was full. And of course when I floated to BMT. But I remember them being as you describe. One lady when I admitted her asked once for pain meds and otherwise was more concerned about getting toast w/ jelly, a spare towel for her bedside table, and a VCR for her room. The other one I remember got 20 mg IV Dilaudid q 2 hrs, and IV Benadryl q 4 hrs. He was walking, talking, going outside to smoke...didn't show any signs of pain. (I only remember his dosages b/c I took care of him a few times as a new admit, and without fail the pharmacy would call the floor and say, "You do realize this is enough Dialudid to snow a horse, right?" Plus the BMT nurses would tell me when floating that this is always what he gets so don't worry about killing him.) But they were admitted for sickle cell crises, not b/c they were jonesing. What did we all learn about this disease? The genetic aspect, the abnormal RBC shape, and that it's PAINFUL. Very, very painful.

So, when someone with chronic pain rates 10/10 while calmly talking on the phone, I'll just go and get the med. No question from me. Will I get duped? Sure. But rather that than risking anyone under-medicated because of my unnecessary judgment.

This all day!!! I'd rather give 100 drug-seekers their fix than allow one person to suffer needlessly.

On a personal note, I've mentioned my five kids many times. My postpartum pain has been worse than normal, based on what I hear other moms talk about. After the first one they were just like menstrual cramps but w/ #2-#5 they were more like labor. I was sent home w/ Percocet after vag deliveries. Those first couple of days, did I care if my mother-baby RN thought I was drug seeking? Heck no. (Maybe they didn't, to be clear they never acted judgmental) I clock watched without shame, b/c I WAS HURTING. And I did clock watch for ibuprofen just as much as the Percocet, so...

I share that b/c as unpleasant as that felt, I do think it helped drive home the point for me that pain IS very subjective. I do not know what that person in the hospital bed feels like, and they don't need my judgment.