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, getting Oxycodone round the clock but looking very comfortable, enjoying meals, naps, TV shows & joking with staff often. To mix it up a little bit & I asked him how he would rate his pain on a scale of 1 to 50 instead! He gave it some thought & rated his pain at a 35! 😁
To cut down narcotic overuse in patients who seem to use them inappropriately – 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. 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 😀
