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"My pain is about an eight and a half"

Nurses   (7,293 Views 68 Comments)
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Do you ever get patients who give you decimals for their report of pain? Somehow they lose credibility with me when they do this. Seriously, they can't settle on either and 8 or a 9? And, they think that we really care to that degree?

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All the time. It makes documenting difficult since I have to pick one number or another, it cannot be in between. It also affects, sometimes, how much pain medication I can give a person. For example, for a pain of 6, a person might receive one dose and for a 7, that dose might be doubled. So, it's very difficult, then, when that person rates their pain at 6.5.

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My personal favourite is the one who asks for morphine for 10/10 pain and when you take the med into them they are lounging back on the bed, looking as relaxed as

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"It's a 12", while playing a game on their cell phone. Oh how pain is subjective...

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Do you ever get patients who give you decimals for their report of pain? Somehow they lose credibility with me when they do this. Seriously, they can't settle on either and 8 or a 9? And, they think that we really care to that degree?

I hear you, I hear you I hear you...

HOWEVER: When I was in ER last year for my bicycle wreck injury, I rated my pain the same way. Now, even though I had a head-on MVA when I was 19 years old and suffered multiple injuries, I base my "10" on knee surgery I had when I was 36 years old. So, initially, when the ER nurse asked me what my pain level was, I said "8 or 9". After they gave me pain medicine and patched me up, I rated my pain at a "2 or 3".

I thought about the situation afterwards and asked myself, "Why didn't you just say '3', or '8'? I didn't really think about it at the time.

I know, I know, I know... Patients and the pain scale are boogers.

But- what the hey? It's only a point of reference.

And no, Emergent, we really don't care to any great degree.

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Somehow, "an 8 or a 9" is entirely different than "8 1/2".

I get not wanting to commit to a stupid number. But giving fractions is a little overly precise...

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@4:32 "Say eight!"

One of my favorite comedy sketches

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I recently went to an Urgent care center for something because the pain was so bad. WHen they asked me to rate my pain I also said 8 or 9. I am not sure why that came out but it did. I told them it wasn't a 10 because I was certain something could hurt more than this, but it was bad enough that 600mg of advil didn't help. But I wasn't sure which one . - Sigh. I now just SMH at myself.

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I hear you, I hear you I hear you...

HOWEVER: When I was in ER last year for my bicycle wreck injury, I rated my pain the same way. Now, even though I had a head-on MVA when I was 19 years old and suffered multiple injuries, I base my "10" on knee surgery I had when I was 36 years old. So, initially, when the ER nurse asked me what my pain level was, I said "8 or 9". After they gave me pain medicine and patched me up, I rated my pain at a "2 or 3".

I thought about the situation afterwards and asked myself, "Why didn't you just say '3', or '8'? I didn't really think about it at the time.

I know, I know, I know... Patients and the pain scale are boogers.

But- what the hey? It's only a point of reference.

And no, Emergent, we really don't care to any great degree.

See....you HAVE a point of reference. Not as bad as the knee. Worse than a migraine, better than a hangnail.... I think that for a lot of us who don't have a reference, we struggle with the number. I started using the Whaley and Wong faces with my new job and I *think* it produces a better response. There's no way to quantify a face on a chart, though....

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We use the number system for kids 8 and over in Urgent Care. I tell them, "No, our computer program doesn't allow for 1/2s. You have to tell me a single number." I seldom get 10s. I explain that 0 is no pain and 10 is imminent death.

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I have diagnosed math/number phobia :).

I seldom ask what number their pain is. It's not that hard to get a good idea from what the procedure was, the patient's demeanor, report from anesthesia, etc. They are grimacing and moaning, I say I'll get you something for pain and give the highest "safe" dose. They are sitting up, alert, visiting, eating and say it hurts a lot I give them a smaller dose. I put a pain number in the box to match what I gave.

Of course it isn't so black and white as I make it sound, but it works quite well most of the time.

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I round it up for documentation purposes.

My favorite, though? "Oh, my pain isn't bad at all. I give it an 8."

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