How do you all like the pain scale???

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I confess, I hate the pain scale. It's alright for some folks who like to quantify everything, but with many people I find that it is an annoying way to communicate. I hate this mandated, cookie cutter type of interaction. It reminds me of going to Safeway and having them all say the same lines to you everytime. I think the pain scale is overrated and utterly annoying.

Specializes in oncology, surgical stepdown, ACLS & OCN.
I confess, I hate the pain scale. It's alright for some folks who like to quantify everything, but with many people I find that it is an annoying way to communicate. I hate this mandated, cookie cutter type of interaction. It reminds me of going to Safeway and having them all say the same lines to you everytime. I think the pain scale is overrated and utterly annoying.

I work w/ post-op cancer patients and most of them have PCA's or PCEA's

it does get monotonus checking pain level every 2 hrs. but it really works.

I had times where the med had to be increased and times when I had to stop the narcotic and give narcan, that has only happened a few times.

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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.

That's too funny...:)

I just splash some in and call it good, what's that mean ??? :)

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Specializes in surgical, emergency.
I use the numbered pain scale and the OPQRST...and looking at body language. Since I work with mainly elderly, there are many stigmas about their pain...so I have to use all the tricks to try to establish a good pain quantification from them.

Onset/Origin What were you doing when the pain began? Did your stomach begin to hurt immediately after you fell (somatic) or several hours later after you vomited (visceral)? Somatic pain usually comes on abruptly while visceral pain more gradually.

Provokes What makes the pain worse or better? Does your chest hurt each time you take a breath and move your intercostals muscles (somatic) or is it made worse with exertion and anxiety (visceral)?

Quality What does the pain feel like? Is it sharp like a stabbing pain (somatic) or dull like a throbbing ache or pressure (visceral)?

Referred/Region Where does it hurt? Is you pain only in your shoulder you injured, (somatic) or does the pain radiate from your abdomen into your back (visceral)?

Severity Compaired to the worse pain you have ever felt...how would you rate this? What was your worse pain? (Numeric scale works in here too!).

Time How long have you had this pain? Has it been there only since the injury (somatic) or for many months (neuropathic)?

I really like the OPQRST! In addition to the rating numeric scale recognized most in charting, and quotes or assessments on movement, body language, and general conversation about the pain..one can make a pretty good solid assessment!

Just using the numeric pain scale is like using a Tylenol to solve all issues..it simply isn't enough, and doesn't work for all people :).

Tri: I love this. Actually, I guess I do a lot of this when I float to ED. I work over in OR 95% of the time. I use the basic scale with them, before surgery in case they don't know it. Many that go thru recovery c/o pain 10 of 10, but when you're not working with them, they're asleep and literally apnic! 10/10 my Aunt Fannie! :angryfire

I actually like the 10 scale, or the flacc scale, or some of the others as a tool to quantify a very subjective complaint. You may notice I called it a tool. To me the pain scale is just one tool in your toolbox of tricks to evaluate your pt. One or two by themselves are no good, you must use several to get an idea what your pt is going thru. Acute pain, chronic pain, sedated pt's, kids, drug seekers, what-ever. Use different tools for different pts. Cause we all know.....they're all different!!! :chuckle

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the smiley face is a waste...alot of people can smile with pain, and many do not smile without pain....i would like a scale that goes vertical, like a thermometer...ederly can understand it much much better...as pain goes up , it is as a temp has gone up...easy to understand...

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Specializes in Women's health & post-partum.

My HMO recently sent an explanation of their pain scale in a newsletter to the members. It goes like this:

0 NO PAIN

1 MINIMAL--slight, barely noticeable

2 MILD--low level, not very bothersome

3 TROUBLING--uncomfortable more of the time

4 DISCOMFORTING--more uncomfortable and harder to ignore

5 DISTRACTING--more uncomfortable and frequently bothersome

6 DISTRESSING--strong, very disruptive

7 INTENSE--stronger and constant

8 HORRIBLE--severe and constant

9 IMMOBILIZING--severe, constant, totally disabling

10 EXCRUCIATING--extreme, constant, worst pain imaginable

I had never seen it spelled out in just this way before--we were always left with some rather vague middle ground between "no pain" and "the worst pain imaginable". I do like the OPQRST as well.

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Specializes in cardiac ICU.
HUH? You are saying constipation is the only side effect of chronic high dosage opioid use??? :p

...that the pt's body will not adjust to. Actually, I didn't mention chronic high dosages, but it holds true in that case as well. Yes, I stand by what I posted. Why?

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...that the pt's body will not adjust to. Actually, I didn't mention chronic high dosages, but it holds true in that case as well. Yes, I stand by what I posted. Why?

Maybe because there are other side effects to long term opioid usage besides constipation?

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Specializes in Med/Surg.

If my patient gets irritated with the 0-10 pain scale, I will switch gears and make it a little easier for them, by asking them to rate pain by "it hurts a little", "it hurts some", "it hurts a lot", and "excruciating"...then to reevaluate after interventions and/or pain medication, I give them the same choices...but yeah, in most cases I still use the 0-10 pain scale. I know patients get sick of answering the same question all the time, but it is still the best gauge of their pain level and how the pain medications and interventions are working for them.

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Specializes in Education, Acute, Med/Surg, Tele, etc.

This is actually kinda cute...but when I was working in a neurovasc floor, I had this patient that had three of her sites infected because of shotty technique by MD's checking her wounds...a total sterile dressing change simply lifted and put BACK ON! UHGGGGG I wanted to kill em! But she was in for an extended stay for harvesting more and more bloodvessels because of this..and was very painful.

Now, she would always rate her pain on a "Da** it it hurts like Hel*"...and I could tell it really did, but for some reason because she used 'language' to describe pain other nurses seemed to think she was a drug seeker...oh lordie that didn't help at all. I listened more, and she and I were a real team about her dressing changes (heck she can do a sterile tech now!!! LOL! I taught her and her husband so others couldn't make the mistake and keep her in the hospital again!!!!), and how to really use the pain scales most nurses do.

Then someone used the faces one..she just about died laughing. She was like "what am I...3???". She shared the story with me and she and I giggled..and she saw that "TraigeRN devious spark" to my eyes..and said..oh oh..this is going to be good!

So I brought in one of those funny face posters..the one with all the emotions on it (I found a magnetic one that you can place a magnetic frame arround the one you feel). You know, looks kinda like the cartoon character Calvin (sort of), and has like mad, depressed, excited, confused, goofy, devious...it is cute! Well that one got so many laughs and was diagnositic to the emotions of our patients nurses started using them! Knowing how your patient was feeling emotionally really helped with assessing pain scale or other questions! And a cute funny way to do it too boot!

I say make those protocol...LOL!!! Heck, I even put one on my own clipboard for assessing, and a little tiny sticky star by my choice of the day..LOL!

Which reminds me...if anyone knows were to get that again..I lost mine and that clip board..it would work wonders at my current job...I will just need the large print type for my geriatric patients..LOL!

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Triage RN you have a great sense of humor and would be a hoot to work with.

How do I feel about the pain scale? I don't like it. I'd just rather ask if someone is having pain and do they need pain meds.

steph

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Triage RN you have a great sense of humor and would be a hoot to work with.

How do I feel about the pain scale? I don't like it. I'd just rather ask if someone is having pain and do they need pain meds.

steph

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Specializes in cardiac ICU.
Maybe because there are other side effects to long term opioid usage besides constipation?

When I asked why, I meant "What other side effects did you have in mind?" :p

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