The way we ask for someone's pain level?

[cmav8]

I've come across patients, usually post op, that needs to be routinely assessed on their pain levels.

Now I'm trying to look for a way to ask them on their pain level without planting into their minds the idea that they're actually feeling pain. Of course we can plan a response from their report, but we might be addressing pain that is actually not present in that moment.

Can we ask a general question of "how are you feeling right now?", instead of "are you feeling any pain right now?" Should we be direct or indirect in these kind of situations?

Is that possible? Thanks for your time! :)

[FMF Corpsman, MSN, RN]

This will be the last time that I am going to repeat myself, any further inability to comprehend that I didn't make a sweeping generalization about any nurse’s rest fully on the shoulders of the reader, not mine. Even from my previous post "Weeping Angel and any other VA Nurse I may have unintentionally offended. I attempted to stress in my OP, that I certainly wasn't being all-inclusive." I am in for this particular post especially, writing from the perspective of the PATIENT, rather than another nurse, but having spent as many years in the trenches, both literally and figuratively, I feel I am more than qualified to voice my opinion. In order to not offend, which is something I find offensive to my own standards, as I usually call a spade a spade and damn the fallout. Truth be told at the VA I go to for services some of the nurses sit around on the butts while their patients call lights go on for over an hour, they have been left on bed pans and fracture pans for exorbitant amounts of time, left in soiled beds for even longer, after their call lights were ignored and they didn’t get the assistance they required. These are soldiers who don’t like to ask for help to begin with and were just fighting the Taliban in Afghanistan, and some have been returned here to recover and recuperate. For them to be ignored long enough for them to soil their bed is a terrible affront to them, they already feel diminished, but most people don’t understand that. It takes special nurses to work at the VA, those with a special kind of empathy and sensitivity, but then some suit hires any yahoo that walks in off the street, it ruins everything.

[MrChicagoRN, RN]

My method:

"Are you having any pain or discomfort? Where?".

After further clarification... "On a scale of 1-10, where 1 is little or no pain, 5 is moderate pain, and 10 is the worst imaginable pain; how would you rate your pain?"

[FMF Corpsman, MSN, RN]

Nice post LadyFree28, it's great to be back.

[dt70]

Instead of using the word "pain", substitute with "comfort". Since the verbal pain scale is so subjective, turn it around.

"On a scale of 0 -10, with 10 being Very Comfortable, how comfortable are you now?" If the number is low, medicate

I like that. I have a very high pain tolerance and only complain when it get's severe. Lots of times I wished I got a small dosage relief midway.

[tewdles, RN]

My pain assessment is a bit different dependent upon where I am working, what the goals and focus of the care is, and how much time I have.

In the ED I am going to get directly to the point and may poke you in the stomach to prove you have acute pain... ;-)

In the PICU I am going to ask you about owies, and am going to watch your every movement and VS.

In the L&D, I am not going to ask you anything, I am going to offer you something before you kill that young man next to your bed.

In the office I am going to sit for a few minutes and talk about your aches and pains using whatever language you use to tell your friends about them.

In hospice, I make certain that I understand exactly what YOU want (which may takes hours to unwrap using whatever tools available) and then I work tirelessly to make certain you never have to WANT for better pain relief.

[FMF Corpsman, MSN, RN]

My pain assessment is a bit different dependent upon where I am working, what the goals and focus of the care is, and how much time I have.

In the ED I am going to get directly to the point and may poke you in the stomach to prove you have acute pain... ;-)

In the PICU I am going to ask you about owies, and am going to watch your every movement and VS.

In the L&D, I am not going to ask you anything, I am going to offer you something before you kill that young man next to your bed.

In the office I am going to sit for a few minutes and talk about your aches and pains using whatever language you use to tell your friends about them.

In hospice, I make certain that I understand exactly what YOU want (which may takes hours to unwrap using whatever tools available) and then I work tirelessly to make certain you never have to WANT for better pain relief.

Tewdles, you make a very good point, so far one that hasn't been spelled out quite as well. Each nurse or at least, each specialty needs to develop their own method or nomenclature to utilize when assessing their patients pain levels. Obviously, Pediatrics might have some degree of difficulty understanding what it is exactly you are asking them, just as someone whose first language was something other than English. This is a little bit off the pain score, but I once had a woman the staff was trying to collect a urine specimen from and try as they might, they simply couldn't communicate with her. It wasn't until someone finally came up with instructing her to "pi$$ in the cup," that she finally understood. Sometimes communicating with patients can be difficult and occasionally, we have to look from where they came to get a better understanding of how to reach them. Being able to do that doesn't diminish us, it makes us all the better.