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.

First birth, no pain relief, pushing for ages.

A doctor came along with forceps. Inserted one half, then the other half around my baby's head and up my fully dilated but not really wanting to stretch any more vagina. That is the single most painful thing I have ever experienced.
I screamed in utter agony and was met with 'Oh did that hurt?'

For someone with presumably years of training and experience what the fuck sort of dickhead comment was that?

I had a section next time and it was blissful.

Three years ago I had to attend the breast clinic after finding a lump. Fortunately the lump turned out to be a large cyst. During the ultrasound the doctor said he would drain it there and then. He told me he didn't use local anaesthetic as it's not necessary and it doesn't hurt. It did hurt but was over reasonably quickly. I did gasp when he stuck the needle in and the female health care assistant did acknowledge my pain and ask if I was okay. It was fine but I did feel he was a little dismissive.

OwlBeThere
I think it's wrong that patients are offered different levels of anaesthesia / analgesics for the same procedure depending on where they live.

DH has IBD and colonscopies every 2 years; he has been offered sedation every time, although last time he declined it so he could go back to work that afternoon

Or they get jaded, numb and burnt out and need to move to a different role or leave. Yes everyone makes mistakes (and hopefully learns from them) but I think it's obvious from her posts that's not likely the case here

First of you, not one of my posts has been negligent, or in any way makes it 'obvious' that I make mistakes that I don't learn from? Seriously? Ridiculous.

Second of all, hahahahahahaha. Every medic and nurse who is jaded needs to leave? Good luck trying to visit an NHS hospital any time soon. Wow.

I agree - it's not a case of you making mistakes which if you read my post properly is what I meant. Mistakes are forgivable, a lack of empathy isn't.

Instead your attitude makes you clearly unsuited to the role you're in as you're unsympathetic to patients.

Emergency care is the very area where people are most likely to be frightened, disoriented and vulnerable. So the hcps working in it should be able to cope with that without being dismissive of patients needs at such a crucial time.

@ThefirstOHN I know! I feel robbed!. Next time intend to query it and ask for some as it’s really not any fun!

And after 2 sachets of picolax it's just adding insult to injury...

@Janethevirgin it’s not nice when people take your words, twist them and make assumptions about you is it?

Exactly @thefirstOHN my raw arsehole doesn’t need it

I'm an HCP and very rarely do my patients use the word "Pain"

They will say "It hurts" / "It stings"

If I ask "Is something painful" I want to know the Type of pain , when it happens , what relieves it , what worsens it , when it started and did anything start it off .

If someone asks me "Will this hurt" , I will be honest (but a bit vague)

The only bit that is painful is local analgesia and I will ask if they've had injections before (dental or steroid) it compares to that .

People have different pain thresholds . I won't look at an lesion and say "There's nothing there" because its not my body .

Though there are patients who do make a lot of excess noise , I don't tell them to be quiet but I might filter it out .

Try to see it from the Doctor's POV, rather than just the patient's. Imagine you did give a strong opiod, on a nightshift where you are covering 3 wards and you can't keep an eye on your patient because your hospital is chronically understaffed. Then something happens.........who's fault is it ?

Yes 70. I totally get that painis very subjective and not particularly helpful a word to you as a HCP.
I guess all I’m asking for is for a bit more honest when something is going to hurt really. But replies here have made me realise why it’s not always the best course for everyone. I still think it would be for me personally but obviously they aren’t to know that. Perhaps the onus is on me to say I’d rather you tell me truthfully if it’s likely to hurt.
I also wish some (and I mean some, lots are great) would acknowledge the pain I’m in. I was a SALT before ill-health stopped me working and I can’t imagine seeing a client who was clearly suffering and just ignoring.

*Instead your attitude makes you clearly unsuited to the role you're in as you're unsympathetic to patients.

Emergency care is the very area where people are most likely to be frightened, disoriented and vulnerable. So the hcps working in it should be able to cope with that without being dismissive of patients needs at such a crucial time*

This I find hilarious because you have no idea about my clinical practice. In fact, the only time I was ever spoken to by my consultant was for spending too long with patients, sympathising, consoling and caring for them. In fact, the only complaints I have received are because I wouldn't prescribe antibiotics for a virus.

In fact, I have never once, even when a patient with a cold gives me a 10 pain score, berated them, been rude to, or in any other way patronised them.

I simply use my clinical judgement and years of training to work out how best to proceed. Because if it was as simple as a pain of 10 meaning morphine, anyone could pick it up at a pharmacy without a prescription.

it’s not nice when people take your words, twist them and make assumptions about you is it

You do remember your post where you admitted kicking NHS staff right? Whatever reason you made up in your head to ok it (which actually, reading your posts you've admitted was wrong several times, so I dont understand why you're arguing), the truth is you committed an assault which if it had happened to someone not wearing scrubs would have had you arrested 🤷🏻‍♀️

@clairemcnam
Thank-you, your symptoms sound the same for that type of pain. I'm sorry you've not found a cause, if I do, I'll report back.

Jane my responses to you have been based on what YOU posted. Frankly the last few posts where you CLAIM to be a kind hcp rather smack of backtracking.

You didn't like having your attitude criticised and so have deflected, backtracked and misdirected in a vain attempt to detract from your earlier posts.

Which I happen to believe personally are closer to the real you.

We are all different, I have a recurring condition which requires procedures which typically are done with a sedative and local anaesthetic but choose neither because then I can drive to work (they always give me 8am). The procedure does cause pain but it's manageable, I can deal with it whereas the next person on the list is sedated to cope, I can just deal with it.

@Graphista

I never said I wasn't kind. I said a) patients lie and b) I also use physiological signs to monitor pain.

Both of which are facts. I'm sorry you don't have the critical thinking skills to understand that life and certainly medicine is not black and white.

@graphista

Curious to know what medical training you had or in what role you were “treating patients” if you think that an acute change in the colour of someone’s iris is even physiologically possible...

JaneTheVirgin

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

Fixed it for you!

Yes, this.
Also 'sharp scratch' when they insert a needle, really

Wow Jane I hope I am never treated by you

We are taught not to use the word "pain" because it has been shown to sensitise people, resulting in them experiencing worse pain than they otherwise would.

There is also a difference between pain caused by HCP (injections, local anaesthetic infiltration, post operative pain) vs pain caused by whatever condition the patient is suffering from.

Our recovery nurses are taught not to ask if the patient is in pain, but if they are comfortable. If they use the word "pain", most patients say yes. However, if you ask if they are comfortable, also most patients say yes. So which ones do you give pain relief to? For that you have to be guided by the physiological signs (heart rate, blood pressure, resp rate) and the patient themselves. We tend to ask if the patient is comfortable first and if not (or if they are obviously not), only then ask them to rate their pain out of 10. If someone is fast asleep, opens their eyes and says '10' and then falls asleep again, they are unlikely to be given much in the way of pain relief. If someone is wide awake and says 'it's about a 5-6' then they'll be given something to bring it down to below a 4.

If I tell someone that something is going to cause pain, they tense up and the pain caused is of greater magnitude than if I tell them they are going to feel a stinging sensation or a sharp pinch.

As far as non-procedural pain goes - yes by all means use the word pain, but we need it clarified and quantified. Burning, stinging, aching, hot/cold, radiating, dull/sharp, constant or coming and going - not all pain responds to traditional painkillers and some types of pain need a different approach.

And yes, some patients lie. I find it easier to assume that they are all telling the truth to begin with and only modify my management if it's obviously needed.

Jane what I don’t understand is why you have been quite so cruel and unpleasant toward me on this thread when I have admitted from the outset that it shouldnt have happened but also that there are quite extreme extenuating circumstances which the doctor himself admitted and apologised for with no bidding from me. If he had felt assaulted presumably he wouldn’t have sought me out to say sorry and would have sued me instead. There were plenty of witnesses had he felt so inclined. You seem personally affronted, angry and combative which baffles me frankly. You weren’t there. It doesn’t affect you.

Jane you're the one that's been too black & white in approach/attitude

Queenofpain - pupil size changing affects the appearance of the colour of the iris - I put it in a simpler form. Pupil dilation is a recognised pain response. Most people aren't "purely" a certain eye colour there's usually a mix of colours and pupillary changes can make certain colours appear more prominent. I trained as a nurse.

Hic - that makes a lot of sense.

I think experience can also really affect patient perception. When I had DD I literally lost all knowledge of where or who I was - I just had to hold on or I would drown. That was my only thought. I honestly didn't even remember that I was in a hospital and having a baby - I had totally lost touch with reality. That's my '10'.

So when I had appendicitis and they asked me to give a score out of 10, I only rated it as 8, because I was still lucid (but unable to walk). When they did an MRI and saw the state of my appendix, I was in theatre within an hour.

Our ability to withstand pain can also be really affected by emotions/tiredness etc, so relying on patients reporting their pain doesn't help a whole load.