Veedoubleyouu

a helpful pain scale for people who have difficulty with doing body inventory or quantifying pain

0-10 Scale of Pain Severity

10 - Unable to Move I am in bed and can’t move due to my pain. I need someone to take me to the emergency room to get help for my pain.

9 - Severe My pain is all that I can think about. I can barely talk or move because of the pain.

8 - Intense My pain is so severe that it is hard to think of anything else. Talking and listening are difficult.

7 - Unmanageable I am in pain all the time. It keeps me from doing most activities.

6 - Distressing I think about my pain all of the time. I give up many activities because of my pain.

5 - Distracting I think about my pain most of the time. I cannot do some of the activities I need to do each day because of the pain.

4 - Moderate I am constantly aware of my pain but I can continue most activities.

3 - Uncomfortable My pain bothers me but I can ignore it most of the time.

2 - Mild I have a low level of pain. I am aware of my pain only when I pay attention to it.

1 - Minimal My pain is hardly noticeable.

Dear Nurse, a week ago, I was in a car accident. A week ago, I was brought into this hospital, unresponsive, a week ago, your trauma team put a tube down my throat to help me breathe. A week ago, doctors and nurses whom I may never meet again, saved my life.

Nurse, I am not sure what your name is, I can’t seem to read your tag, and perhaps that’s because you gave me something that’s made me drowsy, but I can hear your voice. You sound agitated. I know you’re having a busy and really stressful day. I know you have three patients today in intensive care, when you should only have two, I know you’re next up for admit, and how much that sucks. I know you haven’t had a break yet. I even heard you recite report about me to the attending Doctor. “She’s lethargic, not really responding.” Nurse, I can hear you, why can’t you hear me?

I had no choice but to listen as you cleaned me with cold water, and I wondered if it was because I have a fever. I listened, as you and your work buddy complained about your coworker, how she always calls out. I felt exposed, even though I know you made an effort to place a gown over my private parts. I know in my heart you were doing the best you could but I felt an embarrassment beyond recognition and saw myself hovering in a corner above, watching this unfold. I felt soothed, as you began to rub my back with cream, and tried to reach for your hand to say thank you.But, you misinterpreted and reached for the restraints. “She’s not pulling this tube on my shift.”

I lay there once you were done, staring at the ceiling, listening to the alarms of the cardiac monitor, the swish of the ventilator - I listened to the footsteps, and stretchers whizzing by, the urgent voices, and finally silence. I began to count the shadows that passed by, and guessed it was perhaps the early hours of the morning. I reflected on the accident that I do not remember, but learned of from hearing the nurses during report. I tried to swallow past the intense pain of the invasive tube down my throat, and I felt frightened about what was happening to me, yet no one was really listening. I began to shiver as the night grew cold, the sheets doing little to cover me, my hands still captive in restraints. I drifted into sleep, a dream state of freedom.

“We’re going to take your tube out now,” I awoke to the voice of a doctor I had never seen. A kind face, his hand reassuringly touching mine, softly coaxing me to slow down my breaths as they pulled the tube. I coughed out the trapped secretions, and inhaled the blessings of breath; and I looked around hopefully for my nurse, but she had left, in place a different nurse, and I wanted to tell her - and my nurse of last night that I am also a nurse, and I understand the stresses. I understand the need for safety precautions, I understand the need to blow of steam. I understand the speed, and need for disconnect at times. I understand the urge to run at the end of the shift. I understand it was maybe one of those nights, and I can relate to surviving the idiosyncrasies of night shift more than you can imagine. I know you perhaps did the best you could and I wanted to thank you for caring for me. But most of all, I now understand what it means to be the person on the other side, and I wish it upon no person.

1. You have a great education. You worked hard for it. No one can take that away from you.

2. A crappy assignment won’t last forever, but you may appreciate the great assignments a little more. At worst, you’re stuck for 12 hours or maybe a three day stretch - at best, you may actually find you learned something vital out of the shittiest of days.

3. You might be irritated with recertifications, repeating BCLS, ACLS, PALS etc., that’s required every two years. You may be irritated at mandatory mock codes, you may roll your eyes at simulations in nursing school. But you’ll find yourself thrown in an unpredictable, emergent situation and your hands may shake, but they’re well practiced hands and they’ll know what to do.

4. Making errors doesn’t make you a crappy nurse. You learn, and you remember.

5. You may feel like you’re running a marathon, jumping through hoops all day; playing detective to figure out what’s happening with patients, mediator between arguing doctors and family members, standing up to administration - but there’s sometimes a moment when you realize how pivotal the role of nursing is in advocacy for patient care, patient rights, and nurse’s rights. And you would do it all over again, no regrets.

6. You may be a new graduate, and wondering how the heck nursing school is so completely different from reality, you may be feeling like you can’t do this on your own, but then there’s that one coworker who unfailingly supports you. The coworker who saves you (and the patient) from a mess. The coworker who remembers what it’s like to be new and unsure of clinical decisions.

7. You may find yourself wondering if you’re in the right field when nothing seems to go right, but then there’s also a little voice that speaks up, saying you’re not a quitter and you just get on with it.

8. You may feel stuck in the wrong position, the wrong unit, the wrong hospital, but nursing has a diverse amount of opportunities. . Switch it up, change your focus, change your mindset, change your situation. Just because they’re not happening now doesn’t meant they won’t at some point. Keep going.

9. There may be days you will need support, but there’s days when you’re the supporter - and there’s no greater feeling than standing by a friend/coworker when they are in need.

10. You take the good shifts with the crappy shifts. There may be aggressive patients, persistent family members, pointless meetings/inservices that disrupt your day, but there’s also patients who touch your soul and remind you why you love what you do, and perhaps just be grateful for simple things in life.

11. You may feel tired, run down, you may feel burned out, but look up; you’re not alone. You have a phenomenal teams of nurses, doctors, respiratory therapists, unit clerks, transporters, nursing assistants, and pharmacists who are right there with you. If you’ve got a good group of coworkers, ones you can laugh about it all with, you can make your way through any of the tough times, or chaotic situations.

6:48am. It’s here. You have new scrubs, squeaky new sneakers, and your hair is pulled back, (plus you have your good luck charm). You’re ready. Your first day off orientation, and you’re pacing the locker room nervously, trying to remember the plan, “charts, assessment, 10am meds, diabetics check, more meds, oops, don’t forget to make sure patients are fed…”

7:15am. You get your first assignment. Thankfully it’s the same zone you worked in with your preceptor. You had a jam packed orientation. Great nurses, but not a lot of consistency with scheduling conflicts. You feel a mix between fear and adrenaline. You’re ready, today’s the day - you are “a real nurse”. (Holy crap!)

9:00am. What the hell have you gotten yourself into. The OR is calling, Transport is here to take your patient to CT (which you didn’t even know was ordered, (really Dr. Intern?) your patients haven’t been fed, the tech is nowhere to be seen, your nurse manager wants a meeting, and you haven’t even checked your charts. Plus there’s two call bells that keep ringing. And you didn’t get to your assessments yet. Sh*t.

12:45pm. Ok….this isn’t so bad. You finally passed the 10:00am meds (45 minutes past the cutoff but who’s counting). You helped the tech clean one patient, you’ve done your assessments. And you had a few minutes to chat with the really sweet older patient with no family. You finally have a moment to breathe and check to see what’s missed in the charts. Hold on, why’s that stretcher going into one of your rooms? A new admission? (Rats). So you confirm with the charge nurse, yes it’s yours - even though you know very well there are other zones with less patients, and yours is practically full. (hazing…hmm). Patient seems quiet. Seems like a good admission (oops, maybe you shouldn’t jinx it yet…)

3:00pm. You got through your midday meds. One of your IV’s blew, but hey, you actually got one in on first try! Another admission, a “hallway patient” apparently until you can discharge the patient you had no idea was leaving, but hey, the ambulette is there. Confounding. You seem to be the last to know. Where’s the social worker? Maybe they have a clue….you have no idea what to do. You sure as heck don’t feel comfortable sending the patient yet. He seems a bit…..confused. Update, the hallway admit patient is combative, needs a one-to-one and just defecated in the hallway. (Today’s really not going as planned).

5:45pm. Your neighbor tells you she’s going on a break, and you realize, you haven’t even taken a sip of water, let alone peed in maybe 12 hours. (Oops). But you don’t want to sound whiny, so you say “sure no problem. Anything you want me to do?” And she casually mentions her patient in room X is “likely going to code, ‘they’ know about it.” Your head whips around. “See you in half an hour.” And she’s gone. WHAT! you scamper to the room, and sure enough the patient is so blue, you sort of stand there for a terrified minute before yelling, “code!” Eyes wide as saucers, hands trembling you ambubag the patient while the code team comes in and pushes you aside. You push back and get to work on the patient. In the distance, you hear someone yelling, your first new admission just fell out of bed (Dangit. You jinxed the good admission), and also there’s another patient rolling in to you from the ER. But right now, this patient is your patient. You shakily continue to hang IV fluids, somehow find supplies for blood draw, and in a rush of activity move the patient to ICU. Your neighbor comes back and wonders where her patient went. You’re sort of lost for words, so you just go to your zone, and take care of your afternoon meds, your falling person, and somehow gulp down a protein bar with vitamin water. Best meal you’ve ever had.