From this post, I received a lot of comments about the pain scale that we use in healthcare. In the last couple of years, JCAHO (our accreditation bureaucracy for health care) has mandated that we must ask if our patients are having pain at least every 2 hours. Of course, for this to be of any use at all, we must first ask the patient what a tolerable level of pain would be; a level of pain that would require no intervention from us in terms of getting pain medication. For most people, that number is 4. Don’t ask me why; that’s just what most people say.
Most of the commenters said that the pain scale was stupid: “I also hate that pain scale. JCAHCO imposed it on us. If someone walks into my office there is no way that I am going to believe that their pain is a 10.” And: “I was always told that 1 is barely any pain at all, and 10 is the worst pain that YOU have ever felt in your life. That means that everyone has experienced one or more 10′s in his life, doesn’t it? I mean, my 10 might be a new mother’s 3, but like, how am I gonna know that?”
I believe the second commenter got it right. The pain scale is supposed to rate YOUR level of pain in regards to your tolerance of it. When I had a kidney stone, I walked into the ER and confidently rated that pain a 10. It was the worst pain I had ever felt in my life. Of course, this process breaks down if the worst pain someone’s ever had in their life is, like, a splinter.
“I think the pain scale is pretty much useless.. I had cancer in 95 went through 3 surgeries and the recovery from one of them was the worst pain I could ever have imagined. so, now when someone asks me what my pain is I can’t imagine it ever being a 10, so of course that is what I compare my pain to, and even though it may be very bad pain I will say something like a 3-4.” But you CAN imagine it being a 10! You lived through the worst pain you could have imagined. Regardless, it all depends on your tolerance. If you said that you could tolerate a 5 or 6, then I doubt the nurse would give you pain meds for a 3 or 4.
“I totally understand the frustration with the pain scale and not wanting to be poked. I had my gallbladder out last March and would get extremely frustrated during my trips to the ER. Luckily I had a friend there to point out that I am extremely stoic so I was probably in more pain than I would admit. I think I was poked by 3-4 nurses and doctors one day and was ready to say yes, I hurt because you’ve been poking me all day.” This comment just made me roll my eyes. As if I don’t have enough to do, now I need to learn how to read your mind? Listen, do yourself a favor: screw being stoic. If we ask you if you’re having pain, and you say no because you’re being macho, what do you expect us to do? Furthermore, I’m sorry that you had to be poked so much, but until we invent and regularly start using medical instruments from Star Trek, there isn’t much else we can do. We don’t really relish causing pain.
One more thing about pain… Pain medications aren’t really intended to completely take away pain. Sometimes they do, but mostly they just dull the pain to a tolerable level. If you feel like the pain scale is stupid and that you simply cannot come up with a number that reflects your pain level, just ask for some pain medicine if you need it. Maybe that’s what we should be asking instead, anyway.