Pain Scales

CECE,RN · Sep 3, 2009

"On a scale of 1-10 with 10 being the worst pain ever, what would you say your pain rate is?" Can you describe your pain, for example, is it stabbing, aching, throbbing, sharp, constant, etc... Administer nontherapeutic/therapeutic medication(s) and 30 minutes later, depending on what was administered....check the pain rating again to see if medication(s) was effective. This is what I am used to.

emtb2rn, BSN, RN, EMT-B · Sep 3, 2009

What cece said.

We're computerized, so there's a pain assessment window which is detailed on the initial entry. Subsequent entries just have a 1-10 numeric, FLACC or WONG option. I check pain every time I talk to a pt or hourly, which ever comes first. I also document pain observations and/or pt comments in the notes section along with the pain scale entry.

AnnieNHRN · Sep 3, 2009

We also have computerized documentation and note pain levels, description, intervention, and follow-up level. One thing I liked at my old hospital was it automatically asked you the pain level when documenting on pain meds in the computerized MARS.

I document at least twice on pain levels during an 8 hr shift.

dekatn · Sep 3, 2009

Darn, I wish we had computerized charting, I think it would make things a lot easier. We are just trying to come up with a simple yet efficient way to keep up with the med, the rating and the follow up. It would be easier if we could have everything on one page in the mar, maybe have the med listed at the top, then underneath have a place for date, time and to rate initial pain, check med given, and 3min later have follow up rating all in one place and only have to chart it one time. Something that we could use for the duration of hosp. stay.

dekatn · Sep 3, 2009

I hope I'm not sounding too stupid, I just wish the people that come up with this crap had to follow their own rules for just one week and see how they would do it in the real world and not in some stupid office behind a desk w/o a million interuptions and trying to take care of multiple pt and tasks at the same time. Sorry for the vent, but this is very frustrating to me. But, we do team nursing, one nurse does po meds, one nurse does iv meds for all the pt, that's books with all the mars and meds listed that a pt gets. space is very limited on the pages and documenting this stuff has just become overwhelming. It is up to the med nurse to document the pain and meds given and then the results. Am I making any sense or do I sound like a blubbering idiot, lol. I just got off a 12 hr shift and we had to attend a meeting on this before we left this am. Can you tell I'm stretched to the limit. Feel like a rubber band, lol. Thanks to you all for your input, I think I just needed to vent and think this thing through some more!!! Nursing, gotta love it!!

chicookie, BSN, RN · Sep 3, 2009

"On a scale of 1-10 with 10 being the worst pain ever, what would you say your pain rate is?" Can you describe your pain, for example, is it stabbing, aching, throbbing, sharp, constant, etc... Administer nontherapeutic/therapeutic medication(s) and 30 minutes later, depending on what was administered....check the pain rating again to see if medication(s) was effective. This is what I am used to.

actually during NS I got in trouble for this. We are supposed to say 0- 10 pain.

I thought it was stupid but I got a 5 minute lecture that I can't remember. But I always say it like that now.

AnnieNHRN · Sep 3, 2009

I understand your frustration. Since all your documentation is on paper, is there space on your vital signs/flow sheet to document pain meds and levels? That makes it easier for the next shift to see when meds were given and to assess pain levels over time. Just a thought. I'm sure you'll work something out. Good luck!

GOMER42 · Sep 3, 2009

OPQRST

Onset, what Provokes it, Quality of the pain, does it Radiate anywhere, Site and 0-10 Severity, Time (how long have you had this pain)

CECE,RN · Sep 3, 2009

actually during NS I got in trouble for this. We are supposed to say 0- 10 pain.
I thought it was stupid but I got a 5 minute lecture that I can't remember. But I always say it like that now.

Too funny...you should have told your instructor that you are only gonna say this to people already complaining of pain...could understand if you were doin' an assessment though... :chuckle but you couldn't get kicked out of NS.

exmil77 · Sep 3, 2009

OPQRST
Onset, what Provokes it, Quality of the pain, does it Radiate anywhere, Site and 0-10 Severity, Time (how long have you had this pain)

We just went over this, this week! The OPQRST that is...

SunnyAndrsn · Sep 4, 2009

Darn, I wish we had computerized charting, I think it would make things a lot easier. We are just trying to come up with a simple yet efficient way to keep up with the med, the rating and the follow up. It would be easier if we could have everything on one page in the mar, maybe have the med listed at the top, then underneath have a place for date, time and to rate initial pain, check med given, and 3min later have follow up rating all in one place and only have to chart it one time. Something that we could use for the duration of hosp. stay.

We have a flow sheet in the MAR. So if we give a PRN pain med, then we go to the flow sheet, fill out the time, initials, pain level from 0-10, what was given and then follow up an hour later. We also then document in a narrative note. In the narrative, I will add what pain scale was used, ie dementia, numeric, etc. We have a legend that has non-pharmacologic pain interventions, we are supposed to try those as well. EX. food/fluids, repositioning, exercise, back rub, dim lighting, quiet environment, heat/cold pack...you get the idea.

The point is to keep track on the flow sheet how often PRNs are used and how effective they are, as well as the non-med options that the pt. finds helpful for coping with pain.