Pain is NOT subjective

RN1982 · Jan 9, 2009

I don't really have much to add except that you are right, pain IS subjective and that your boss is a moron.

Quidam · Jan 9, 2009

I am finding that pain is not always treated subjectively. Case in point. Gunshot wound to the left shoulder. Rotator cuff blown out. Client had 3 surgeries to clean wound, sent home w/o antibiotic. Infection set in. Back in hospital, client reports pain at 9/10 Response....Yeah, right. You can only have Tylenol. WHAT? Well...what did you do at home if you have been in this much pain the whole while? Curled up in a fetal position, bit on a leather belt to stifle the screams and continued to call the Dr. until they finally consented to check the wound. Oh well...tylenol is all you get. Please ask the Dr. for something stronger. Tylenol or nothing.

Niiiiice.

Client has since had a repeat infections, wound care clinic visits and home health. Finally referred to pain management and started on methadone.

This person suffered and was forced to continue to suffer for months. Wore a portable wound vac for 4 months. and was still told, "You can't possibly be in that much pain."

I am saddened beyond belief by this experience. Family member is the client.

Iam46yearsold · Jan 9, 2009

For my point of view, pain is subjective. But the powers that be and the doctors want it objectified and quantified in something they can understand. Nothing gets them rolling their their eyes more than the term "Fibromyalgia"

sissiesmama, ASN, RN · Jan 9, 2009

Sounds to me like you're right on, the patient's pain is subjective. And Trauma was also right, your boss is a freaking moron!

Anne, RNC

I love my cat! · Jan 9, 2009

For my point of view, pain is subjective. But the powers that be and the doctors want it objectified and quantified in something they can understand. Nothing gets them rolling their their eyes more than the term "Fibromyalgia"

Sad, seeing it is Doctors that are providing an individual with the diagnosis of Fibromyalgia! Docs tell a chronic pain patient that this is what their specific complaints of pain/fatigue/IBS/etc..... are known as within the Medical Community, then the patient tells others and then people turn around and laugh, roll their eyes and discredit them!

Nice.

No wonder these people feel like they are going crazy. Look how they are treated.

eriksoln, BSN, RN · Jan 9, 2009

I hate to harp on this, but.......well, situations like yours bring it to the fore front over and over again.

Took as class to be full time once........sociology of health and illness. Next semester I went into the nursing program. I walked away from the soc. class with one thing standing out in my mind, and nothing (in school or in practice) has given me reason to dismiss it.

That thing is: This class's material focused alot on how, more than any other field in the U.S. industy, the medical field lacks competent leadership. Its management is flooded/infected with people put in positions of power for all the wrong reasons.

I started to read your post and right away saw "who is not a nurse" and bam, it all came back to me. Anyone who had any knowledge of supporting a pt. who has pain issues would understand what was going on from a clinical standpoint and why you reacted the way you did. But, well, your manager is not the right person for his/her position and.....well, you see the results.

Not that this will make you feel any better or offers any solutions on what to do about it. Its just that, jeez, no matter what I do to forget that soc. class's focus, something brings it back time and time again. Its a difficult situation to deal with, trust me I know. Dont really have any answers to dealing with this sort of management either. Its a shame the leadership of such a vital field are all the mental equivalent of house pets and are only there because they have an uncle who knows someone.

Over-the-hill-Nurse · Jan 9, 2009

Pain is subjective. I have seen patient's who are smiling, laughing, and appearing to have no pain at all but when I ask, they will tell me that their pain is a "8" using a scale of 0-10. Who am I to say that they are not having pain? I can't feel what they feel. I would have also charted it the same way you did.

And Trauma and Anne are right, your employer is a moron!

rngolfer53 · Jan 9, 2009

I hate to harp on this, but.......well, situations like yours bring it to the fore front over and over again.
Took as class to be full time once........sociology of health and illness. Next semester I went into the nursing program. I walked away from the soc. class with one thing standing out in my mind, and nothing (in school or in practice) has given me reason to dismiss it.
That thing is: This class's material focused alot on how, more than any other field in the U.S. industy, the medical field lacks competent leadership. Its management is flooded/infected with people put in positions of power for all the wrong reasons.
I started to read your post and right away saw "who is not a nurse" and bam, it all came back to me. Anyone who had any knowledge of supporting a pt. who has pain issues would understand what was going on from a clinical standpoint and why you reacted the way you did. But, well, your manager is not the right person for his/her position and.....well, you see the results.
Not that this will make you feel any better or offers any solutions on what to do about it. Its just that, jeez, no matter what I do to forget that soc. class's focus, something brings it back time and time again. Its a difficult situation to deal with, trust me I know. Dont really have any answers to dealing with this sort of management either. Its a shame the leadership of such a vital field are all the mental equivalent of house pets and are only there because they have an uncle who knows someone.

(emphasis added.)

Unfortunately, it's not only non-nurses who have trouble believing Pt reports of pain. Nurses and doctors are just about as bad. :banghead:

An excellent resource is Pain: Clinical Manual. McCaffrey and Pasero.

They have a chapter or two on the undertreatment of pain, and also some excellent strategies and questions to ask those who denigrate the Pt's pain reports.

BabyLady, BSN, RN · Jan 9, 2009

They are teaching us in school now that the subjectiveness of pain is something the Joint Commission is going to keep harping on in the coming years...so get used to it.

The drug seekers are ruining it for everyone that do come in with legitimate pain.

llg, PhD, RN · Jan 9, 2009

When I am a patient, I have the opposite problem. Apparently, I have a fairly high pain threshold. So, I don't report pain as being very severe and I don't request "enough" pain relief for people to take me seriously as a patient.

I frequently find myself saying things like, "It doesn't hurt all that much, but I do thinK there is something wrong here. Could you please take a closer look at this?" The doctor and/or nurses brushes me off because I don't seem to be suffering much ... and then we all have to deal with a more serious problem later because my little problem was not sufficiently treated and it grows to become a big problem.

Even when I was a child, my father (who was also my doctor) would say things like, "She's not a complainer. If she says something's wrong, there probably is." whenever he had to refer me to someone else for treatment.

I drives me crazy. I am often tempted to "over-dramatize" my report of pain just to get taken seriously.

Iam46yearsold · Jan 9, 2009

Sad, seeing it is Doctors that are providing an individual with the diagnosis of Fibromyalgia! Docs tell a chronic pain patient that this is what their specific complaints of pain/fatigue/IBS/etc..... are known as within the Medical Community, then the patient tells others and then people turn around and laugh, roll their eyes and discredit them!
Nice.
No wonder these people feel like they are going crazy. Look how they are treated.

Dont forget the drug companies. How many companies are offering their drugs to those with Fibromyalgia on TV. I do take exception to a lot of these medicine commercials on TV. They affect everyone who sees them also