The Fifth Vital Sign

[bgxyrnf]

It seems that I can rarely peruse the news in any fashion without reading about the 'epidemic' of opioid-related deaths. I know that we regularly see OD'd patients in ED.

Let's go ahead and say it: pain is *NOT* the fifth vital sign and this push to insist otherwise is a classic example of unintended consequences.

Rather than trying to confront the unfortunate truth that pain is something that we often need to learn to live with, we instead look to push the idea that every police officer should carry naloxone and a nasal atomizer. We're seeing Superbowl ads marketing medication to help treat another common narc side-effect that we see in the ED: severe constipation.

I'm sorry. Pain does suck (I speak as a chronc pain sufferer myself) and *limited* use of narcs can be helpful but let's put it in its place...

PAIN IS NOT A VITAL SIGN AND I REFUSE TO CONSIDER IT SUCH.

[whisperingsage]

Until the medical industry recognizes real optimal nutritional therapy, narcs are all we have. When I had to go to the acute hospital (lost 5 pints of blood from a duodenal stress ulcer) my gut was writing for a couple of months, and I appreciated norco, and as I got better, I voluntarily reduced until I was pain free. Having been in control of my own health most of my life I was very frustrated at my body not responding fast enough. I use magnesium, vitamin C, folate, B vitamins, E, krill and fish oil, (all in pretty high doses and also anti inflammatories) , TMG and MSM (the last two have given me te fastest healing).

Having worked in SNF's and rehabs, I know those folks NEED those meds- they are being worked pretty hard in thereapy and it will be awhile of healing before they can get control over their pain. Some will not because of diet and lack of nutrients that cause real healing of tissues. Plus, most medical people don't even know what nutrients do what and what doses are optimal or what forms are best. The reality is those cells and tissues need nutrients to heal. And most people don't get them.

[ArtClassRN, ADN, RN]

Who cares if you call it a "Vital sign"?

Go ahead and stop assessing it and when you call an MD and they ask you about the patient's pain, say "Pain is not a vital sign."

You are going to asses pain through many methods, and you are going to do it continuously. So, regardless of the interventions, making a big hairy deal about whether pain is labeled a "vital sign" is silly.

[siegolindoRN]

Pain can directly influencing BP, HR, and RR, amongst other things, so it should be monitored closely. When asking for pain ratings, I always add a comment to either validate or invalidate what my patients are reporting, its how I meet the need for documentation while keeping close to the actual clinical presentation.

Opioid addiction is a public health crisis with its roots in all forms of healthcare and unless the States or Feds come up with viable solution to curtail over prescription, it will continue.

I have my biases like any other ED RN when dealing with "seekers" however one must not lose sight of the fact that although its a growing problem, most of the population doesn't fall under this category.