"My pain is about an eight and a half"

[Emergent]

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?

[OldDude]

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.

This subject is included on the stupid patient satisfaction surveys. So, to check the box, I ask the question and put down whatever number they say, and forget about. Except when I realize the patient is really experiencing pain and then I get serious about it.

[HeySis, BSN, RN]

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?

In cases like that I ask the patient.

Have you ever had oxycodone? If so what strength did you take and how many, how often?

For your pain level I can give you one or two tabs, would like to start with one and see how it works or have both?

I find that most people know if they are opioid naive and choose to start with one, or if they are not, and are use to taking pain meds, they know they'll need the larger dose. Then I round the number appropriately (cause my computer won't except 6.5.... when it did I charted it that way.)

[klone, MSN, RN]

Do you ever get patients who give you decimals for their report of pain?

Technically, that would be a fraction

[Emergent, RN]

Technically, that would be a fraction

1/2=0.5, fyi

[klone, MSN, RN]

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

Depending on how your orders are written, one number is the difference between giving 1 or 2 Percocets (not at 8/9, but the idea is the same)

[klone, MSN, RN]

1/2=0.5, fyi

I failed dosage calculations in school, so thank you for clarifying. :)

[City-Girl]

I keep a copy of the Wong Baker Face scale which also has a corresponding 1-10 pain scale to match the face (provided by the hospital I work in, but I am pretty sure you could also find it online). While I am all in favor of medicating the patient for what they say their pain is, when they just can't commit, or give me a number plus a half, I pull out the paper with the faces and it allows them to point to the face that matches how they are feeling. I have also found this tool useful for non-verbal patients when giving pain medication is needed.

[vanessaem, BSN, RN]

How about the ones who say their pain level is a 20? I just tell them the scale is from 1-10 like I mentioned. We have no pain meds for a 20 pain level.

[psu_213, BSN, RN]

Another one of my favorites:

Me: "Rate your pain on a scale of 0 to 10."

Pt: "Oh, it's not pain. It's a pressure (ache, stabbing feeling, etc.)."

[OldDude]

1/2=0.5, fyi

Well aren't you the math smarty pants!

[Julius Seizure]

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?

The rules of rounding would suggest that a 6.5 rounds up to 7, whereas a 6.499 would round down to 6. Hope that helps.

[Davey Do]

when I realize the patient is really experiencing pain and then I get serious about it.

But, OldDude, what if the patient is the cause of the pain?

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