While this is not exclusively LPN related, I feel that as an LPN I should still discuss my nursing dilemmas here with nurses such as myself.
I go to triage a pt and he says in a lively and over the top voice, "I'm not doing so well."
I look at the pt. I smile at him and say, "I'd imagine you're not doing so well if you needed to come to the ER." His wife laughs and he glares at me and I slightly shrink back- oops. I begin the triage and ask him questions pertinent to the triage. He cuts me off at every question and begins to rant. He goes on and on...... and on... and on.... he belittles the physicians and nursing staff who made him this way. He's yelping and yowling about his problems. The pt is so over the top with his complaints... I get to the question, "On a scale of 0-10, how would you rank your discomfort right now?"
"Uh. A 20!" he states like it is the most blatant thing in the world.
My manager once told me, "I knew I had to leave the bedside in the ER when I sat and listened to a father yelp and howl about how he ran over his daughter and all I could think about was how he couldn't cut tot he chase and tell me the pertinent triage information. I knew it was time for me to go after that."
I look at the patient and say, "Well, anything after 10 on the 0-10 scale is reset back to 0, so if you really think your pain is a 20, then I thin I have send you back. Do you still want to call it a 20?"
The patient hesitantly looked at me, then glanced to his wife behind me, then back at me with confirmation of his indignation, "Yes! Its a 20!"
"Okay. Just so we're clear on that..." I respond.
From that point on, it was smooth sailing. The triage was easily completed. About 15 minutes later, the Primary RN comes to me and says, "No offense, the patient requests you not come back to their room"
When someone simply says it is >10, I make a note of observations on the pt such as what they are doing, how they are acting or what they are eating/drinking. I dont care if it is actually a 10 or a 2, you are gonna get pain meds either way so there is no point in fighting it.
When someone simply says it is >10, I make a note of observations on the pt such as what they are doing, how they are acting or what they are eating/drinking. I dont care if it is actually a 10 or a 2, you are gonna get pain meds either way so there is no point in fighting it.
I agree. It's just that sometimes the pain scale feels like a dance the nurse and pt have to have when neither one wants to.
I know the pts who just want the drugs, and GUY is right, they're going to get them whatever they say. That's why I find it insulting to have to pretend it's anything other than what it is. I know tha't how the system works.
That's how it must work. I get the OP's anger and it has nothing to do with a lack of compassion. Nobody likes to be made to feel stupid.
# Pain scale is useless. It just teaches people (seekers) how to get the pain medicine they want, and the new people just look at you confused.
I honestly could care less...if they are in pain, they are in pain. The fact that pain is subjective throws any logical debate about this, out the window.
thenursemandy...ikr! and usually the lil one is 0% the persons child. At anyrate, I think its interesting that the pt fired the OP just for trying to determine his scale of pain, and then clearly trying to add some charm and humor to the situation. Sigh...its like you cant win these days. Pts are amazing creatures sometimes. ..Sorry that happened to you.
I've fired myself before. I've come out of a room & told my partner nurse that it's just not working & we're gonna have to swap a patient.
I've had another nurse fire herself.
I've had patients fire me. I've picked up patients who've fired the other nurse.
I just chalk it up to differing personalities & move right along.
Regarding pain scales, I don't give a flying flip what number you give me. All I want to know is "Is your pain enough that you want/need pain medication now or not?" I've had patients howling they want pain medication & tell me "It's a 2." I've had patients texting, laughing and eating tell me "It's a 10."
Seeing as my 15/10 comment has drawn so much humour, I'd just like to ask how many of you have suffered severe pain?
Ever been diaphoretic, chilled, unable to sit/stand/lie in any position, unable to eat/drink or void all as a result of medical condition that came out of nowhere? Ever had your BP drop suddenly while having your pulse hit 180? Faced the sudden and unexpected prospect of dying?
Too many of you seem to find humour in it that I wonder about the compassion of my fellow nurses.
Oh, and if it's any consolation, I do know who fathered my children.
Specializes in Oncology; medical specialty website.
Sigh... I once saw a pt who could do nothing but scream and cry. Scream and cry. Scream and Cry....
That was a 10/10.
Scream and cry....
The same day, a gentleman refused to throw his Hardee's burger & fries away and his chest pain was a... Sigh... 10/10
If u can verbalize anything, it is at most a 9. If it is a 10 then it cannot be verbalized and nothing more can ever be expressed in words.
Nothing can be more than a 10, for to be expressed in a greater than 10 numerical rating is to diminish the value of a 0-10 pain rating scale.
I disagree. I had cancer pain that was +10/10. While I was able to verbalize it, all I could do was give the rating and rock back and forth while being asked where, what kind, how long, etc. I couldn't open my eyes, and all I could think about it was "Make it stop, make it stop, make it stop..." I did, however, answer questions.
I think it's completely reasonable to tell the patient that's telling me their pain is >10 that 10 is the highest it can be, so I will document 10. No need to get into an argument about it at all or have an attitude about it. The fact of the matter is that the pain scale is 0-10 with the highest possible number being 10. Most people can understand that logic.
You can say just about anything to just about anyone if you say it right.
That Guy, BSN, RN, EMT-B
3,421 Posts
When someone simply says it is >10, I make a note of observations on the pt such as what they are doing, how they are acting or what they are eating/drinking. I dont care if it is actually a 10 or a 2, you are gonna get pain meds either way so there is no point in fighting it.