"My pain is about an eight and a half"

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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?

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

This is why I love PAINAD patients!

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Yeah, the decimal doesn't really bother me, per se. But as I mentioned before, it can make it hard to determine the right amount of pain medication to give.

That's some precise pain management if you treat a rating of "8" vastly different than a "9"!!

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Is it going to be that different if you treat for 8 rather than 9, or 9 rather than 8?

Maybe not with the numbers 8 and 9. But say someone is going back and forth between a 6 and a 7. For a pain level up to a 6, you can give 2.5 mg of oxycodone, for example. However, for pain 7-10, that dose increases to 5mg. So, if someone rates their pain as 6.5...do I round down and give them the 2.5mg or do I round up and give 5mg?

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I recently asked a patient in the holding area to rate her pain. Her eyes were closed, and as soon as I asked, she opened them, gave me this look like I was disturbing her and rated it a 10 before closing her eyes again. Yeah, okay then...

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Specializes in Medsurg/ICU, Mental Health, Home Health.
Maybe not with the numbers 8 and 9. But say someone is going back and forth between a 6 and a 7. For a pain level up to a 6, you can give 2.5 mg of oxycodone, for example. However, for pain 7-10, that dose increases to 5mg. So, if someone rates their pain as 6.5...do I round down and give them the 2.5mg or do I round up and give 5mg?

For a pain level up to a 6, the patient would receive 2.5.

6.5 is higher than 6.

Honestly, nursing judgement would play into this for such a finely split hair. I would err on the side of making the patient more comfortable.

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Specializes in Medsurg/ICU, Mental Health, Home Health.

Also, I must complain about our pain documentation requirements.

I'm in home health and we are required to document the following at each visit:

- the lowest the pain has been in the past 24 hours

- the highest the pain as been in past 24 hours

- the level of pain at that moment

- the quality of the pain

- the pain treatment utilized

- the effectiveness of said treatment

- our action if the treatment isn't adequate (we don't administer medications, fyi, the patients give their own)

Annnd, if a patient has a wound? we must document all of these for each individual wound in a separate area, as well as document how often the pain occurs to the wound.

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For a pain level up to a 6, the patient would receive 2.5.

6.5 is higher than 6.

Honestly, nursing judgement would play into this for such a finely split hair. I would err on the side of making the patient more comfortable.

That's typically what I do as well. I just wonder if it's actually the right thing to do since the patient's pain is technically not at a 7. I'm curious, for example, if state surveyors would see it the same way.

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Specializes in Mental Health, Gerontology, Palliative.
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.

I once had 15/10 pain.

Didn't want opiates, just wanted the flipping pain to stop.

the surgeon asked if he could try and aspirate something out of an axially abscess and it was the worst pain I have ever experienced.

I live with chronic pain, the result of a life time of obesity and chronic wear and tear on my joints. Most of the time I manage it with exercise. i take glucosamine to help with the joint wear and tear

I refuse to take opiates though, I'm far to young

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I'm shocked that so many people actually ask that question on a regular basis, especially when they're prone to being annoyed by the answer. I know it's required by someone somewhere, but I just pick a number that matches what I'm giving and go on with my life.

I'm only thorough if something is very new or very different.

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Specializes in Cardiac Telemetry, ICU.

It's never bothered me because it's really not a big deal. They're most likely just trying to help because lay people don't know any better.

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Maybe not with the numbers 8 and 9. But say someone is going back and forth between a 6 and a 7. For a pain level up to a 6, you can give 2.5 mg of oxycodone, for example. However, for pain 7-10, that dose increases to 5mg. So, if someone rates their pain as 6.5...do I round down and give them the 2.5mg or do I round up and give 5mg?

That's called nursing judgment, and you apply it for what will best benefit the patient.

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Specializes in Psych (25 years), Medical (15 years).
I recently asked a patient in the holding area to rate her pain. Her eyes were closed, and as soon as I asked, she opened them, gave me this look like I was disturbing her and rated it a 10 before closing her eyes again. Yeah, okay then...

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