In honor of Emergency Nurses Week I would like to talk about pain. Seems appropriate considering 99.9% of patients arrive in the ED with some sort of pain whether it is an ear infection, a flea bite (yes, she even brought the flea in a little ziploc bag) or a severed limb. I've been having issues lately with the "pain scale". You know the one. "Can you rate your pain on a scale of 0 to 10 with zero being no pain and ten being the worst pain you have experienced?"
It's the last part that gets to me. The worst pain YOU have experienced... see the problem here? I automatically believe anyone who has delivered a child or passed a kidney stone. You have probably experienced pain at or close to a ten. But what about the 17 yr old chatting on her cell phone to her BFF about the totally hot paramedic, who rates her abdominal pain at a 10 out of 10. If I'm feeling particularily feisty I respond:
"So if you were lying in the middle of the street with a semi truck parked on your legs what would your pain be?"
" A 10"
"And what is your pain now?"
"A 10. Can I finish eating my Cheetos?"
Perhaps the worst pain she experienced before now was a splinter in her pinkie toe.
And then this patient I had the other night. She comes to my room hunched over in a wheelchair pushed by a hospital volunteer (I knew it was a volunteer because they always run, if it was one of our staff they would have leisurely joked with me as the patient struggled to keep breathing.) So Ms. Stoic somehow gets onto the gurney without passing out and proceeds to tell me that she "thinks....something....is ....wrong.....with.....my....lung". I tell her to stop talking and just focus on breathing while the doctor gets ready to insert a chest tube and I look at her arm. She has an obvious fracture (and by obvious I mean the bone is sticking out) and I am starting an IV to give her some pain medication.
"Oh no, it's not that bad" she says as the doctor inserts a giant metal rod into her chest. "Maybe a 2 or 3." I look at the puddle of blood on the floor as she asks,
"Maybe I could have some tylenol?"
I'm guessing she was in labor and had kidney stones at the same time, perhaps with a semi truck parked on her legs....
6 comments:
Good story Jamie...and on that note I don't know how you don't throw up or pass out. Blood is gross!
You should write a book!! There is no place like the ER. And then there is the story of Dad with the PE, having trouble breathing and told them the pain was a 10. Still had to wait 45 minutes. I thought he was going to pass out and finally had to go get a little angry. He ended up in the hospital for 3 days!
Wow...I always hate answering that question. Great stories! I always think of you when I watch Scrubs...thats how I would want an ER to be like if I were a nurse or Dr.
It's funny you should mention the semi-truck parked on somebody. Not too long ago I received an email with the attached story (and pictures) of how a semi-truck came to be parked on someone...but they were dead. I'm guessing their pain was a 10.
Yeah, after birthing a few kids and some really bad migranes, pain takes on a whole new dimension.
Jamie, I can't believe you deal with that stuff every day! Much as the thought of the second lady makes me want to "spit up", it would probably be the teenagers that would make me quit that job. Kudos to our ER nurses everywhere...
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