In my residency days, I encountered a patient with a contagiously fun personality who rated his post-surgical pain at a 9 out of 10, using Oxycodone round the clock while laughing at comedy TV shows, enjoying meals & engaging staff with humor. I decided to mix it up a little bit & asked him how he would rate his pain on a scale of 1 to 50 instead! He thought for a little bit and rated his pain as a 35! 😁
To cut down narcotic overuse, besides using scheduled non-narcotic analgesics, I also like using a visual or a graphic pain-rating scale to add an objective but collaborative assessment to the patient’s pain score. Here’s one for you to try & use, especially with patients that you appear much more comfortable than their subjective pain rating suggests. So, if the above patient was rating his pain at a 9, a good question to ask – “If you were struck with lightning would you be laughing & joking?” Makes them think! We would then ‘bargain’ & settle on a pain score somewhere between his subjective rating and my objective rating to drive a more appropriate pain med usage 😀
