Wednesday, March 11, 2009

On a scale of 0-10...

In medicine if a patient is experiencing pain, the clinician is expected to use the OPQRST mneumonic to describe different aspects of the pain. OPQRST stands for Onset, Provocation/Palliation, Quality, Radiation, Severity, and Timeline. The responses I get from the severity question have been the most mystifying to me. It seems as though about 5-10% of the patient population just cannot wrap their heads around the concept of the 0-10 pain scale:


Clinician, "On a scale of 0-10, 0 being no pain, and 10 representing pain so severe it causes you
go into shock and pass out, how would you rate your pain right now?"


Patient, "15!"


Clinician, "???...let me try putting this another way, on a scale of 0-10, where a 10 is like giving
birth to octuplets without anesthesia, how bad is your pain?"


Patient, "15...maybe even 20!"

Two points:
1. No one who has the patience to endure the waiting room in a county medical clinic, fill out the 12 random questionaires required to enter the exam room, and sit calmly while a clinician meticulously goes through the OPQRSTs of pain could possibly be in 10/10 pain. That person would have died or killed someone by that time.
2. Who said 15, much less 20 was even an option? I'm no mathematician, but even I know that if given the option of choosing a number between 1-10 that 15, 16, 17, 18, 19, and 20 are clearly not options!?!
Don't get me wrong, I love my job. On a scale of 0-10, I'd give it a 20!

1 comment:

Sue said...

HAHAHA I've had so many patients that just didn't understand the scale either. It's hard not to laugh at some of their answers.