Jason Hautala RN
Thanks for the comments:
Josh: While I agree Jeremy Bentham could have made a better pain scale, the fact of the matter is out of the 7 aspects of pain that should be addressed, the MINIMUM conditions to address pain is FOUR aspects, namely:
1. Its intensity.
2. Its duration.
3. Its certainty or uncertainty.
4. Its propinquity or remoteness.
It’s a shame that they simplified his work so much to get to the intensity only scale. You mention the scale gives us data that we can use, as it is relative to the patient. I did mention its only possible function as a tool for trending, but giving the patient the option to pick their own number is just setting us up for failure. We should say, if the pain when you got here was a 5, what is it now? Just look for “better” or “worse.” If you give them the ability to pick any number they think they deserve, administrators will use this number as if it were real data … See Lisa’s comment.
MARpan8iv: I like part of the description of what each number stands for, but suggesting which medicine they get for each number is just totally wrong, especially if you tell the patient that. May as well hand them a menu and ask them which narcotic they want, just order it by the number. Some pain, no matter how far it exceeds the patient’s ability to cope, is not going to be getting any narcotics. Other pains, while they may not be in too much distress at the moment, will be treated with narcotics, such as a lingering chest pain after the NTG has been given.
If you wanted something to describe the various numbers, I think this chart is more appropriate: http://1.bp.blogspot.com/-NFhkYlTB1sk/T67_-oryqOI/AAAAAAAAAus/mumAyqi2No0/s1600/0painscale.jpg
Lisa: thank you for the post … my thoughts exactly. It is a shame that nurses are getting into trouble because administration thinks that the number is real data and we need to change the number by a statistically significant amount, such as below 5 in your hospital. I have so many people that would be dead if we ever drugged them enough to get them to admit their pain was below a 5.
While it is true some people are stoic and will not show as many noticeable signs of being in pain, I think most nurses are better able to judge how much pain a patient is having better than the patient himself. The question is, how well is the patient tolerating the pain and which treatments can I offer to help him tolerate it better. The number is irrelevant .