L&D pain scale

We use the 1 to 10 scale or a visual 1-5 scale.I find I have the best luck when using a visual aid that we have. There are "smiley" faces that start at 1 with a smile and work up to the 5 which has the face crying.

I show them the aid and ask the patient which one is most like them. There will always be those patient that do not have a true concept of the reality of the pain involved in the labor process.

------------------

Sheryl

If you enjoy word puzzles come visit me at www.CrosswordsForNurses.com

HI! We also are supposed to use the 1-10 scale. 1 being no pain and 10 the worst pain. we have a poster in each room for the pt to see. we are also supposed to assess pp pt,& surgery pt with their vs and then chart the pain number on the graphic sheet.

Pain scale documentation is now required by JCAHO...however, most first-time early labor patients have NO concept of pain, so it is absolutely hysterical to chart their perceived "10"s and have no interventions charted...Instead, I chart what the pt tells me and chart what interventions I do (like comfort measures, etc) and ALSO chart the lack of observed signs of severe pain, like "pt is able to talk easily thru her contractions" or "pt sleeping between UCs, and effortlessly doing breathing techniques thru UCs" or "no flushing of face, no diaphoresis, no change in resp patterns w/ UCs"

------------------

Yeah, it is a JCAHO requirement. Yeah, we use the pain faces scale and record pain by the numbers on the graphic. We have education sheets and we have a plan of care for pain control goals that we have to get signed by the patient. We do all the things you have posted here. I just wonder how you really apply the "Pain Standard" to labor and delivery situations. Labor, is inherently painful to a large population. Setting an acceptable level of pain control at 4 or 5, knowing that as the labor progresses, the perception of pain usually also increases, as well as knowing that most of our pain control interventions will not meet the unrealistic goal, is really not appropriate. It is nearly deceptive. It just doesn't make sense to me. How are most of you applying the requirements and the solutions that the hospitals' pain teams have invented? In looking at the pain standards, it seems to me that it was intended to address CHRONIC pain and/or cancer pain rather than the acute pain of childbirth. It even could address post op pain of cesarean sections or postpartum pain. It applies to post op GYN's. When you go to the pain sites, the pain assessments, goal setting, interventions and documentations with VS, seem to apply to chronic or cancer pain. So correct me here. How do you really meet this standard? What are you doing to make this apply to OB pts. in labor? And how do you use it with children? or newborns? This is driving me nuts. HELP!! How do you meet the standards really??? Thank you for clarifying this for me. Policy and procedure would be helpful too......

The verbal assessment 1-10 scale is moreless standard however an assessment of pain should always be done rather than just getting a number to chart. However when in active labor with out an epidural on the pain scale you can almost cross out numbers 1-7.

Jared

I am a nursing student and I would love to hear any imput on how you rate labor patients pain. This happens to be the exact topic of lecture right now. I know that most people use the 1-10 scale or the 1-5 scale, but how do you incorporate how each individual precieves pain. There are you many aspects that have to be assessed also, like cultural and family influences, past experiences with pain and horror stories that they have heard from women who have been through labor.

Last night's primip - 2 cms., contractions 20-40 secs., mild (indentable) to palpation. Pain scale explained, asked "On scale of 1-10, where is your pain now?" Her reply "15'!!!

Any wonder we can't take this seriously?