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.

I think the 1-10 scale is too complicated. If a patient is not feeling well and in excruciating pain, to try and concentrate on an explanation of this scale is ridiculous and just pure torture to patients who are actually in pain. I go ahead and rate them at a 10 myself when they are this bad off (our 1-10 scale is linked up with the faces scale anyways which makes this easy to do) and medicate them as appropriate and then chart when the Pt.'s pain level is "tolerable" or "mild" or "moderate" or chart the patient's actual words such as "I feel much better" or "the pain is increasing" etc.

Michelle

That seems like a good way to do it. Maybe some nurses take the pain scale too far because I recently heard a nurse tell a patient who was just out of it he was in so much pain " I can't help you until you give me a number"

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I guess I am just angry because it always falls back on the nurse's shoulders. Housekeeping can't clean up puke off the floor- nursing has to wipe up the chunks so they can mop. Pharmacy isn't in the hospital 24 hrs per day so nursing is expected to run from pyxis to pyxis looking for all of our 0900 meds. The nurses aide is busy picking up dinner trays and can't stop to take someone to the bathroom so the nurse has to stop what she/he is doing to assist. I have been nursing a long time and realize the patient's needs are my primary responsibility, it just seems more and more "other stuff" is being dumped onto already tired shoulders.

This is a terrible thing because it keeps a nurse from doing what she's been trained to do. In the ED especially, I think a lot of changes need to be made. No more serving meals to a patient who's only been there a short time and will probably be on his way soon just because it's HIS dinner time.

A good nurse is a terrible thing to waste.

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

Can you name them please?

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Specializes in Utilization Management.
I told the doc I wanted Percocet. He insisted on ordering Vicodin. Vicodin did not kill the threshold of pain I had with this procedure. I saw him the day after the root canal, again he insisted on ordering Vidodin.

Maybe the doc assumed, like I did, that because Vicodin is stronger than Percocet, it would work better.

In any case, I always have to say, "Yes, I KNOW Percocet is stronger than Ibuprofen, but Ibuprofen just works better for me."

Go figure. :rolleyes:

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Maybe the doc assumed, like I did, that because Vicodin is stronger than Percocet, it would work better.

In any case, I always have to say, "Yes, I KNOW Percocet is stronger than Ibuprofen, but Ibuprofen just works better for me."

Go figure. :rolleyes:

If I had a doc who thought that Vicodin is stronger than Percocet I'd ask him where he went to med school.

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Specializes in Utilization Management.
If I had a doc who thought that Vicodin is stronger than Percocet I'd ask him where he went to med school.

Maybe I just got that impression because Percocet is so useless for me. Just goes to show how individual pain management is, I guess. Vicodin knocks me out completely. Percocet? Might as well take 2 aspirin.

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Specializes in OB, Telephone Triage, Chart Review/Code.

I work Mother/Baby on nights. The hospital where I work requires that we use the pain scale and gives a handout to all patients.

When a patient says they are in pain, we medicate them. There are no parameters on the scale that says "no medication for 0-2, implement comfort techniques" or "3-5 may medicate with minimal dose" or "6-8 may medicate with full dose", etc.

After I medicate my patient, I am challenged on nights to follow-up on how the medication worked. Opening the door and moving the curtain makes too much noise (the curtains are in front of the doors to assure privacy for moms and babies).

Certainly, I need to know if the medication was effective...so, I tell my patients on nights if the medication isn't helping after one hour, to call me. But that doesn't help me when required to document the pain scale result of pain relief.

I understand the concept of using the pain scale and it may work wonders for some, but I think the patient should have a choice if they would like to rate their pain this way.

Postpartum women most often experience uterine cramping, perineal pain from repairs of episiotomies and lacerations, hemorrhoids, and/or postop incisional pain. Using cold packs to the perineum is a "given" to relieve pain and swelling. Even with nursing interventions to relieve pain, many patients will ask for pain medication. Whatever "number" they tell me, they still will be medicated, so I really feel the scale is not useful.

Pain is what the patient says it is, and I believe we should be documenting this instead of a number.

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Dear WebbieDebbie,

What I do for documentation is just pick a number that I think might accurately reflect what the pt is telling me. To me, demanding the pt to give a number is unkind. If someone isn't into the pain scale, but my facility demands a number, in the interest of efficiency and consideration I'll give them what they want for their charting, but I won't make a demand of the pt.

I like your idea of telling the pt to call if their pain in not tolerable after one hour. I think I'll start doing that.

~Jan

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