How do you all like the pain scale???

Chaya, ASN, RN · Dec 14, 2004

ITA, but as long as TPTB want reams and reams of documentation I'll have to sling this BS at them. A fair number of my pts cannot think in those terms so I have to put it into words for them, them write it down in numbers. More work.

kim93079 · Dec 14, 2004

personally I like it because it gives a way to try to rate something that is highly subjective. It gives a more tangible symptom to deal with and shows that relief measures have worked.

Tweety, BSN, RN · Dec 14, 2004

I don't like the cookie cutter scripts we sometimes have to spout out. I'd rather be more spontaneous in my "customer service".

However, I work on a trauma unit and spend most of my time controlling pain and dealing with pain. I like to know what my patients pain level is and if the treatment is effective or not. The pain scale is a good way to assess that.

actioncat · Dec 14, 2004

Oh God! I love this question. I totally agree, Mystery.

SmilingBluEyes · Dec 14, 2004

I think the pain scale is useful sometimes for children, mentally-challenged or other people who are not always able to express their pain in other ways. Yes, sometimes, we can "See" people are in pain, other times, not. Some laugh when in pain (Believe it or not, I do----to dispel worry on the parts of others and relieve stress). Not all people in pain behave the same way.

Besides using vital signs (which also may fail to tell me if a patient is in pain)--- It gives some people a way to express how much in pain they are, in terms I can understand (as I can never say I know exactly how their pain affects them at the time).

Do I "like it" (the pain scale)? Not really. I find it cumbersome and insufficient most times. But for some people, it's the only way I have to assess and document their pain and what interventions work, (numbers changing)--- and what others don't. Lacking a better way that complies with JCAHO (*sigh*), I will have to continue to use it, I guess.......

Brotherbob, BSN, RN · Dec 14, 2004

I like the pain scale when evaluating pain relief. It is something to relate to. Does not work for every patient, but is better than nothing.

prmenrs, RN · Dec 14, 2004

If you hate the adult scale, try using the Premature Infant Pain Profile, or whatever it's called. The baby gets a 3 for sleeping. The Newborn one is better. And a post-op that's just laying there very still, not moving, w/his eyes closed, doesn't score any higher till his heart rate goes up and sat goes down. :angryfire Dumb, can we say dumb?

chad75 · Dec 14, 2004

I don't like the adult pain scale. If you get many people with chronic problems, they near curse at you when you ask them to rate their pain. I also don't think its neccesarily accurate, it seemed I got many "10" answers when I worked on a med surg unit by people who were chatting calmy with family, laughing/smiling 5 days post op. I know pain is whatever the patient says it is (nursing 101), but honestly, during the worst GI pain imaginable "10" you aren't going to be scarfing down taco bell while having an amiable conversation on the phone(actualy have had that situation). Or the 10 pain level who falls asleep in the five minutes it took you to get their meds.

The patient who stands up in his room leaning on the bedside table because he can't lay down due to back pain could easily be a 8. Pancreatic cancer I hear can be excruciating. Overall I think the pain scale is a joke and not really understood by patients even after you explain it, or if they do understand it they choose to over rate their pain maybe in hopes of getting more medication or getting it faster, we live in a "more is better" society. I'm not suggesting said people are drug addicts, just a bit over zealous, they are the type of people that use one and a half scoops of laundry detergent instead of the recomended one, or take four ES Tylenol.

:uhoh3:

JVanRN · Dec 14, 2004

I'm not suggesting said people are drug addicts, just a bit over zealous, they are the type of people that use one and a half scoops of laundry detergent instead of the recomended one, or take four ES Tylenol.

Wow...I use one and 1/2 scoops of laundry detergent...my boyfriend called me on that the other day :uhoh21: :imbar sorry I know that is totally off base...it's was just funny cuz we got into the dumbest arguement over it (he wins...I will not admit this to him)....

Back to question at hand...i think in theory the pain scale is a good idea but most of the time I just get a blank stare when trying to explain it....Some times with adults I use the faces that your supposed to use with kids and it works better....in neonatal we use the N-PASS (neonatal pain and sedation scale) I like it okay i guess.

chad75 · Dec 14, 2004

*Derail ahead*

Wow...I use one and 1/2 scoops of laundry detergent...my boyfriend called me on that the other day sorry I know that is totally off base...it's was just funny cuz we got into the dumbest arguement over it (he wins...I will not admit this to him)....

We truely live in a supersize society, we are near brainwashed to want bigger portions of everything not just food. The only thing to couteract that is education. The extra half scoop of laundry detergent does do a thing except cost you more money for washing your clothes. The 2 extra tylenol isn't helping more, do it often enough and its actually harmful. Just say no to the supersize !! :chuckle :chuckle

Mystery5 · Dec 15, 2004

I I know pain is whatever the patient says it is (nursing 101), but honestly, during the worst GI pain imaginable "10" you aren't going to be scarfing down taco bell while having an amiable conversation on the phone(actualy have had that situation). Or the 10 pain level who falls asleep in the five minutes it took you to get their meds.

Tell me about it, :rolleyes:

I have experienced this many times. Frankly, I see some chronic pain types (usually with a long history of GI complaints) who come in, highly dependent on huge doses of narcotics, totally savvy to the pain scale and able to fully exploit the current climate of acquiesing to every demand made by these patients. Many of these folks appear to have more emotional pain than anything, IMO, and are experts at manipulating the medical establishment to fullfill their unhealthy needs.

I really have no problem giving folks any narcotic that is ordered, and don't feel it's my place to rehab people. But, I dislike the feeling of being manipulated and sometimes end up resenting this type of pt because I feel like the system is forcing me to play along with their charade, even though I realize that they are deeply troubled, suffering people deserving of the same compassion that anyone deserves.

As far as 10/10 pain, I've personally experienced that in the natural childbirth of my 6 children, and it is excruciating in transistion, right before commencing pushing. It's practically unbearable and there is no way that a person can sit calmly while enduring this. Very few people would be able to stoically cope with this type of pain and not present definate signs of it's intensity to others.