How Would You Rate Your Pain???? - page 3

I was with a friend recently who was awaiting a craniotomy. We were in the OR holding area when the nurse came in and asked him "How would you rate your pain on a scale of zero to ten with zero... Read More

  1. by   BostonTerrierLoverRN
    I don't know, I've I had that kind of pain talking to AT&T

    I remember when I was sprout, and my dad had his back surgery, following a terrible accident where he was nearly crushed. I was soooooo worried when he would try to reposition in bed and moan or grunt,...

    I would push his PCA button

    When his doctor made rounds, he would ask,

    "...So, how is the PCA doing on your pain?"

    Dad would say, "Well, I'm surprised! I haven't had to press it but once to go to the bathroom yesterday. I don't think I've hit it once today."

    The doctor looked really puzzled! (Thank God and Science for Lock-Outs!!!
  2. by   brownbook
    It doesn't even make any sense if we think pain number 10 is only for someone screaming, moaning, unable to talk, laugh, etc.. It makes 10 an impossible goal, for lack of a better word, and all the rest of the numbers meaningless.

    I always compare my patients current pain to its source and how it feels right now. "If at its worse your back pain is a 10 what number is it now.".... "If the worst your incision could hurt is a 10 what number is it now."...."if at their worst your cramps are a 10 what number are they now," etc. It validates to the patient that yes I am in pain now, yes it hurts a lot, maybe even number 10, but no, I don't have to be moaning and writhing on the bed to validate that it hurts.
  3. by   wooh
    Well it doesn't help that we all describe the pain scale differently. If the patient rates based on what the last nurse explained the rating as, but we interpret via our own explanation, how on earth is that supposed to work?
  4. by   tewdles
    First...we shouldn't use the FLACC for adults, use the PAINAD instead.

    The pain scale works because it allows the patient to give their perspective of the pain, which is the most important part. If the number doesn't seem to match our assessment and observations then we can correlate with chronic vs. acute distinctions, emotional/psycho/spiritual state, and current health status.

    Perhaps the person is having a difficult time with their pain because they have little personal experience with pain and could use some help coping. There are nonpharmacologic interventions for discomfort that we might be able to address.

    If we don't,cant' ask our patients about their level of discomfort we cannot possibly address it adequately.
  5. by   DSkelton711
    I loathe the "rate your pain" numerical scale. At least with the faces you can kinda relate. Chronic pain is harder to rate, I think, because it affects how you live your life everyday, but you try to push through it. It also is exhausting.
  6. by   poppycat
    Thank you, DSkelton711!

    As a person with chronic pain, I think my experience of pain is different than someone who is having acute pain from an accident or surgery. I frequently have days where my pain level is 6 or7 but I can't just stay home & rest because I have to earn a living & "life goes on" in spite of my pain. Therefore, I've learned ways to function in spite of my pain. Obviously, if I have to work when I'm in that much pain, I can't (actually won't) take narcotics for the pain. I usually will take an NSAID & put a heat patch on the area that's most painful. This combination works pretty well for me & will get me through a 10 hour shift. Having this type of pain every day is extremely exhausting. It's been hard for my husband to adjust to how much time I have to spend resting just to be able to do basic things to keep going. It's been hard for me, too, because I used to be pretty active & now I'm very limited in how much I can do. I tend to agree that the numerical pain scale is lacking because people experience pain differently. I'm able to find ways to function at a 6 or 7 but someone else may not have coping skills to deal with the level of pain.
  7. by   agvfc
    Thankyou so much for bringing that to our attention. Indeed, the tool is almostdegrading toward the patient. Reviewing the pain literature, we have bettertools out. Why don't we have courage and remove old fashioned tools if they don'tserve our patients well. Just because "we always "used this tool? I am so luckyto work in a progressive hospital where we encourage nurse to ask questions andcome back with better ideas. This is a project worth for the EBP council.
  8. by   hodgieRN
    I like how the video said the rating of pain scale was stupid.....and then he yelled out 8 so he could get more morphine just for the hell of it. Seems like he answered his own "stupid" question...
  9. by   Bubbles
    I never liked asking patients to rate their pain because it is so subjective and I absolutely hate being asked it. I have had neck and back pain off and on since being rearended in 1977. I agree the faces chart is of no help. The pain questions are someone's attempt to quantify a problem with a number which just is not possible!
  10. by   EmJeanRN
    Thanks for the laughs in the video. I really enjoyed that. It really will be hard to keep a straight face now when I have to ask that question!
  11. by   hiddencatRN
    Quote from wooh
    The thing that annoys me most about the pain scale is that it doesn't account for how different pains are more or less tolerable. Ankle pain that's the same intensity as back pain is more tolerable to me than the back pain. The back pain is more tolerable than the head pain. Least tolerable pain for me? Sinus pressure in my teeth. Even if it's really only a "2" I'd like full anesthesia knock out when I've got it going on.

    In peds, I FLACC everyone that I can get away with FLACCing. Or OPS. FACES is ridiculous. Even for kids. All the pain scales are ridiculous, because you can't make something as subjective as pain into an objective number.

    Do you hurt? Lot or a little? Tolerable or do you need medicine?
    That's all the "scale" we really need. Too bad that's not considered "objective" but "Pick a random number/picture" is considered objective.
    I usually ask kids if they hurt a little, medium, or a lot. Everyone seems to understand that. I ask a pain scale with numbers and people of all ages appear confused. It irritates me yo no end to ask someone their number and get a response like "oh, I don't know, it's not too bad" but then I can't chart that because the chart requires s number. But wait, if pain is what the patient says it is, I should be able to chart their non number.
    Quote from Ntheboat2
    You might wanna keep all that crying to yourself when going for a pre employment physical

    (It's descent, not decent to the baseline btw) So, how was the litter-chore?
    I won't be a problem when I start working. I've decided to just let the VA script me whatever it takes to get me able to do the job.

    Oh, and I understand the difference between "Decent" and "Descent." I just forgot to include the "s."
  13. by   Ntheboat2
    I won't be a problem when I start working. I've decided to just let the VA script me whatever it takes to get me able to do the job.

    Oh, and I understand the difference between "Decent" and "Descent." I just forgot to include the "s."
    Yeah, yeah...."I just forgot to get my BSN."

    Just kidding!! I can't help it.

    Have you seen any of the threads about nurses who take prescription medication? Nurses aren't human you know. It might be worth checking out if you're gonna be relying on scripts to get you through.