Pain: Recognizing and reporting pain

Definitions & Key takeaways

Pain is a feeling of discomfort that ranges from mild to severe. Acute pain is sudden, short, and associated with tissue damage. Chronic pain lasts longer and is associated with certain medical conditions. Pain is an individual experience that depends on many factors. As a healthcare provider, a patient might tell you they are in pain, or you might notice some nonverbal signs of pain. Never ignore pain. Use the pain scale to obtain the relevant information. Get the client's vital signs, and report observations to the attending health care provider.

Chapters:

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Intro0:00–1:02

Pain is a feeling of discomfort that ranges from mild to severe, usually caused by an underlying condition and is never normal.
Acute pain is a sudden, usually severe pain that typically decreases over time once the underlying cause resolves. It can last from days to weeks and is often caused by some sort of tissue damage.
This includes trauma (like burns, sprained ankle, broken bones); surgery; or diseases and conditions (like appendicitis).
Chronic pain lasts longer than a few months and is usually associated with headaches, back pain, arthritis, nerve pain, and many others.
Pain can interfere with the client’s ability to function and their quality of life. So it’s important that nursing assistants know how to recognize and report it.
Many of your clients will feel pain, but it won’t be the same for everyone. Pain is an individualized sensation that depends on many factors.

Pain threshold and tolerance1:02–1:48

Each person has a different pain threshold, which is the point when they start noticing pain, and pain tolerance, which is the highest amount of pain they can handle.
For example, if you pinch someone with a low pain threshold, they might immediately say it hurts, while someone with a high pain threshold will probably not report any pain at all.
Now, the way someone handles pain is not just limited to pain threshold and tolerance. There are other factors to consider like anxiety, rest, energy level, hunger, culture, past experience with pain, and so on.
Now, as a nursing assistant, you might be the first to notice when a client is in pain. It is easy to notice when the client tells you they feel pain, but sometimes they won’t be able to tell you, or they might not want to.

Nonverbal signs of pain1:48–2:29

However, a client in pain will usually show some physical signs of pain that you should learn to recognize. These include irritability, restlessness, mood change, insomnia, clenching the jaw, frowning, grimacing, moaning, not wanting to move or change position, redness of the affected part, avoiding the use or rubbing the affected part, and increased or decreased vital signs like temperature, pulse, blood pressure, and breathing rate.
Each person experiences pain differently, so to help you report the severity of pain, you can use the pain scale approved by your facility.

Using pain scales2:29–3:39

There are a few types of pain scales, but they all have the same basic features where on one end of the scale there is no pain and it increases to the worst pain at the other end.
A visual scale doesn’t have any words added to it, so the client can rate their pain level between the two points. A verbal scale has adjectives, like “mild,” “moderate,” and “severe,” written on the line in the order of severity.
The numeric scale has a series of numbers from zero to ten, zero meaning no pain, and ten meaning the worst pain. Lastly, the Wong-Baker scale has faces drawn on it, each representing a level of pain.
A client should point to the face that fits their feeling the best. The Wong-Baker scale is useful for people who can not verbally express themselves clearly under these circumstances, like children or those who don’t speak English if an interpreter is unavailable.
The client’s report should always be respected and believed. In some cases, you’ll also need to get the client’s vital signs—temperature, pulse, heart rate, blood pressure, and breathing rate—and report them to the nurse.All right, as a quick recap… Pain is a feeling of discomfort that ranges from mild to severe.

Obtaining the relevant information3:39–3:50

Recap3:50–4:24

Acute pain is sudden, short, and associated with tissue damage. Chronic pain lasts longer and is associated with certain medical conditions.
Pain is an individual experience that depends on many factors. A client might tell you they are in pain, or you might notice some nonverbal signs of pain.
Never ignore pain. Use the pain scale to obtain the relevant information.
Get the client’s vital signs, and report observations to the nurse.
Pain: Recognizing and reporting pain: Video | Osmosis