So. How do I keep from grabbing a 10 blade out of the chest tube kit and slashing my wrists? Well, one, I don't have time for suicidal gestures because 15 people just checked in during the last hour and I'm the only nurse in triage, but I also have a game I like to play. It's actually more fun with dramatic patients. What I like to do is think of the most ridiculously painful scenario and present it to them to see if they'll actually say their pain is a ten.
For example, "Okay ma'am, can you rate that pain in your tooth for me on a scale of zero to ten, when zero is no pain at all, and ten is being mauled and disemboweled by a grizzly bear?"
"Sir, you can rate the pain in your throat right now, if zero is no pain and ten is someone cutting of your arms and legs and then dousing you with gasoline and setting you on fire?"
It's awesome. I have yet to meet anyone ballsy enough to rate their pain at a ten, either. If ever do, I look forward to being able to be like, "Really? Your hemorrhoids hurt worse than burning in the pits of hell while having your eyes pecked out by birds of prey? Those must be some hemorrhoids! Okay, here's a pillow to sit on in the waiting room!"
A word of wisdom to those playing at home, it's only fun with people who don't actually need to be in the ER.
This is AWESOME! I am a Chiropractor and and can't stand it when people walk in though my doors and then tell me they are at a 10 pain level in their back. Um, don't think so. I may have to borrow this tactic!
ReplyDeleteHaving been in the ER almost 3 years now, and recently being entrusted to train the sweet little recently graduated new ER staff...it's been decided that I shall become the new triage bitch. I just started orienting out there. I swear, it's like the 8th level of hell.
ReplyDeleteThat is hilarious.
ReplyDeletehahaha, I do this all the time. My go to phrase after they say their pain is a 10 when it's clearly not is, "No I 10 is like if I cut off your arm right here and seared it with gas."
ReplyDeleteI worked with a PACU RN once who after hearing several times a patients pain was a 10 after meds said ok so if a 10 is getting kicked in the nuts so hard you can't breathe what would you rate your pain? Turns out is was more like a five.
ReplyDeleteIt always amazing to me that pain from a tooth ache is worse than getting run over by a train! Unbelievable!
ReplyDeleteFirst of all, wow! you guys have a triage nurse? we catch as catch can. yet i digress.
ReplyDeletewhen the customer states a "10" toothache, i like to ask them, "so you mean, if i stomp on your foot as hard as i can right now, you couldn't hurt worse?"
Love it.
ReplyDeleteMy phrase was always "Okay, so if a zero is no pain and a ten is burning alive in a car, where is your pain?"
If they continued to insist they were at a ten, I immediately added twenty points to their bullshit score.
i tried that before but it didnt work. i said "a 10? you mean if i press on your back/leg/stomach/face the pain is not going to get worse?" and the answer i got: "of course!" to which i replied "so it's not a 10?" and the genius said "it's still a 10, and i'll be mad because you made it worse." i cant win when they deposit their brain cells by the door.
ReplyDeleteNow it's a 12!!!!
ReplyDeleteHilarious! I do the same, but it usually gets me a "9." Got to love the general public!
ReplyDeleteIf I do that, they downgrade it to a "9.5". Every. Single. Time.
ReplyDeleteI did something similarly early on in the ER and at some point my phrase of choice (when I was just too exhausted to get creative) had to do with being run over by a train and cut in half.
ReplyDeleteFast forward a few more months and I was orienting to trauma, got all checked off and was flying solo. Trauma One came in within the first few minutes of my first trauma shift and it was a dude, hit by train, with his legs cut off.
No one understood why I was giggling when the scribe asked me to ask him to rate his pain and I said not to bother and to just go ahead and write down "10". Figured I'd look way too douchey if I actually asked him my phrase of choice.
There's an XKCD strip that basically went like:
ReplyDeleteOn a scale of 1 - 10 what's your pain with a 10 being the worst imaginable pain?
---"2" *starts shivering on the table*
"Damn how dark is this guy's imagination?"
OMG You have to see this pain chart. Your post reminded me of it and I think you could have a lot of fun with it in Triage. http://hyperboleandahalf.blogspot.com/2010/02/boyfriend-doesnt-have-ebola-probably.html
ReplyDeleteHA! I do the same thing!! They end up asking what 5 would be.. I say it is a loved one across the street burning to death, screaming their name, and they still hurt back enough that they can't get up to help them, though they might try.
ReplyDeleteGotta love the "Pain Scale". I love when they answer "It's a TWENTY!" I just roll my eyes. I had this little gem of an experience a few months ago: http://tracycompletesathought.blogspot.com/2011/07/out-of-mouths-of-babe-er-patients.html
ReplyDeleteWhen I went to the ER with abdominal pain I rated it as a 4 (heck, I had a baby without meds) and ended up waiting to be seen for 6 hours while juggling a newborn. If I could do that over I would upgrade it and get to the appendectomy part a bit sooner.
ReplyDeleteIn defense of toothaches: mine was a 10/10. Sorry, it just was. I guess something could hurt worse - but I haven't felt that yet. Never been run over by a train. But have been immobilized with tooth pain.
ReplyDelete