AIBU to think that HCPs are allergic to the word pain??

[OwlBeThere]

This is only semi-serious, but actually sometimes it’s really unhelpful and makes a situation worse.
Every time I see any kind of health care professional they will use words like ‘sore’ and ‘discomfort’ when what they mean is ‘painful’ and ‘it fucking hurts’.
I heard it when I had a hysterectomy, when I’ve had biopsies, when I had my wisdom teeth out, when I broke my femur(?!?). None of those things were uncomfortable they hurt like fuck and not acknowledging that either makes you think it’s not going to be so bad (ie lumbar puncture) or makes you feel like you’re causing a fuss about nothing (definitely bloody not with a snapped thigh bone or a raging infection in my hysterectomy scar).
So why does it happen? Do they imagine it helps people? Because it doesn’t.

[herculepoirot2]

It might help some people. Not everybody feels pain in the same way, so using the word pain might actually make some people think it will be a lot worse than it actually turns out to be.

[Camomila]

I find they try to be quite accurate with the 'type' of pain so you can tell them if it's different.

Like the dentist always says you'll feel pressure but if you feel pain tell me and i'll top up the local anaesthic.

[GPatz]

My dentist said 'just a little scratch'.

Bollocks was it.

[RosaWaiting]

OP "not acknowledging that either makes you think it’s not going to be so bad (ie lumbar puncture"

OMD yes! My late father had 2 of these. I questioned the necessity because he was weak and ill etc and I got told the first time, he might experience discomfort. He was in so much pain he was in tears.

luckily we have a bit of background knowledge, but I feel for the people who get told to expect "discomfort" instead of pain.

Also when I had a spinal injury one doctor kept saying "yes I see the discomfort there" but in fairness the fuckton of painkillers prescribed acknowledged the pain.

I too wish they would use correct words.

[GnomeDePlume]

YANBU

A few years ago I read an article about some research into how children are treated in hospital especially when they are undergoing long term treatment. One of the things which came up was the well meaning dishonesty in saying 'this wont hurt' when it did. It resulted in children losing trust in HCPs.

The problem is that a lot of HCPs are specialists in their specific field. Pain is seen as peripheral, a symptom of the particular ailment rather than a part of the ailment.

I agree that using words like uncomfortable, sore etc may have a meaning to HCPs but to the patient they come across as trying to minimise the pain they are suffering.

[SinkGirl]

Totally agree with you. I used to pass out from pain during ovulation and periods (I now taken morphine) and a doctor once wrote in my notes that I was experiencing “some pelvic discomfort”.

They also told me that I wouldn’t feel anything when I had my arm reconstructed while conscious. Or that my spinal block would just be a “little scratch” (14 excruciating injections later it was finally working). Dicks.

[OneStepSideways]

The thing is, HPCs 'measure' pain by physical signs like pulse rate, and the person's behaviour, not just how the person rates their own pain.

I've had patients inform me they are in agony and a 10 on the pain scale, but their clinical signs were normal and they were reading a book!

We also get patients who are exaggerating pain in order to get morphine or other opiate based pain relief (surprisingly common and understandable, morphine has a relaxing, calming effect and a lot of people get anxious in hospital).

[MereDintofPandiculation]

A related one: my phlebotomist says "Are you OK with blood tests?" I say "no" because I get tense and have to bite hard on a finger to compose myself. Turns out that to her "OK" means "still breathing and not unconscious". We live in different worlds.

[M3lon]

Why oh why can't they just be honest? I'd really appreciate them telling it how it is. like "Most people find this really quite painful, though some waltz off with a paracetamol and others find it the worst experience they've had"

Give me the average and the range...I can then work out what it will me for me!

[Sux2buthen]

When I was having back to back labour the midwife said 'as this progresses you're going to have some horrendous pain'
How right she was
So some tell it like it is lol

[BumbleBeeWineGlass]

I'm an HCP and o always say to my residents "are you feeling any pain or discomfort right now?" I always acknowledge if anyone comes to me during the day to say their in pain or discomfort - not that it helps your point, I just wanted to say that some of us are different!

[Cornettoninja]

You do quickly learn that discomfort is code for this hurts. I agree that it would be helpful for hcp’s to recognise that it’s actual pain, for one thing it would help to feel that you’re being taken seriously.

I struggle with the pain scale too. I had an induction and during active labour I was putting my pain at 8 but confusingly i.e ‘it’s an 8’, ‘no this is an 8’, ‘fuck me this is a proper 8’, ‘just fucking shoot me in the head!’

Embarrassingly this meme put it in context for me!

[greenelephantscarf]

yanbu
it's both patronising and minimising, especially towards women who seem to never be completely believed about pain levels.

whatever happened to 'pain is what the patient tells you'?

[indianbackground]

They also don’t listen when I say that due to cerebral palsy I don’t feel much pain on one side. The fact that I was not screaming in pain was not an indication that I had only bruised my hip.
I don’t feel much pain and had broken my hip.

[JaneTheVirgin]

Pain isn't what the patient tells you, because patients lie. It's as simple as that. When you've been told someone's pain is a 10, for their cold, while they eat a sandwich and laugh on a phone call, you learn to also use physiological signs of pain. Unless you think I should immediately prescribe morphine for the cold, because they say 10?

[Taytotots]

Jane i do appreciate the need to be careful when prescribing drugs but i think i am often misdiagnosed because i don't react to pain like hcp are expecting. E.g. i have had renal colic (meant to be one of the most painful things) misdiagnosed as period pain and been left for five hours in a +e with no pain relief when i had an internal hernia (an 8 in my book!). I did in both cases say how much pain i was in. I need to work on my acting skills!

[Taytotots]

cornetto i think hcp should hand that one out.

[LolaSmiles]

I think they should listen but also be aware that some people are quite stoic and get on with things whilst others are bloody hypochondriacs.

One of my former colleagues used to always have really bad pain for this or that, but all their actions suggested it's mild discomfort. If someone was in pain with a sore foot and knee, for example, they wouldn t have gone on an all day shopping trip with their partner and wouldn't be in work in flimsy strappy sandals. But they made multiple doctors appointments over this painful foot / knee and went to minor injuries becayse they thought it needed x raying.

[AnnaMagnani]

I v much like the improved pain scale.

I too have had patients that tell me it is 15/10 while chatting and watching TV or others who are screaming in agony saying it's 8/10 - to which I think 'how can you picture something worse?!'

I've also met patients who insist on using the word discomfort so get treated as if it is a minor annoyance until you see them move and realise they are actually dying of pain.

So the whole thing is a minefield as often no-one, patients or HCPs is using the same language or scales to talk about the same thing.

[Tolleshunt]

Jane that attitude is very problematic for the 99% of patients who are not drug abusers.

Pain IS what the patient rates it at.

Yes, a tiny minority of patients abuse drugs, and seek them from HCPs. But why should that mean that the vast majority should eb left in pain to ensure that the tiny minority don't abuse them?

Many, many people do not react typically to pain.

You should listen to your patients.

[daisychain01]

Pain isn't what the patient tells you, because patients lie.

I would have thought as an HCP you'd recognise the risk associated with generalising and turning "all patients" into a homogenous blob.

How patronising is that. Just because one patient is eating a sandwich does not mean you should make sweeping statements about how patients describe their pain, across the board.

Really worrying.

[daisychain01]

Unless you think I should immediately prescribe morphine for the cold, because they say 10?

What a bloody ridiculous thing to say. Are you in any way qualified, or just bored on a Sunday morning?

[Walnutwhipster]

It drives me mad. I now unfortunately have enough experience to tell them what I need for pain relief. I was triaged in A&E once and sat with the paramedics for four and a half hours before I was seen by a doctor. I had a perforated bowel and that wait very nearly cost me my life. Another time post surgery I told them I felt like I was dying. They treated me like I was a drug seeker and ignored me for two days. Turns out I had another perforation, requiring a seven hour operation, life support and a long stay in ICU with sepsis, kidney failure, peritonitis and pneumonia. I have permanent stitches for a stoma which regularly need replacing. The area is hyper sensitive so I tell them I want entonox before they touch me. It's never refused.

[crosser62]

LOL
I once had an a&e Dr tilt his head to one side, place his hand on mine and genuinely said these words “is it physical pain that you are feeling or phychological pain do you think?”
I was writhing round, couldn’t speak, couldn’t breath properly and sweat dripping down my face while labour pains came every minute or so in waves.
Gushing blood and large clots and human tissue with my 5th or 6th miscarriage.
Until the miscarriage passed physically out of my body, I needed gas and air and morphine.
It was like someone flicking a switch, the pain just stopped.
Took anything from 8-24 hours.

I was not and am not a drug seeker. I am rational and very tough. I have a high pain threshold.
These floored me totally.

I am a HCP and not on my shift will anyone suffer pain unnecessarily. Absolutely not.