In a message dated 99-09-07 21:04:20 EDT, you write:

<< Using an abstract scale, like rate your pain from 1 to 10 , doesn't work
either.  Without a point of reference there is no way to rate their current
pain. >>

Marie, I confess I don't understand the point you are making. The entire
reason for using a scale is to get the client's perception of the degree of
pain--it's the "head honcho" of a nonjudgmental, subjective assessment. It is
the complete counter to the provider who decides someone is "wimping out" on
pain the provider is not experiencing!

As long as the one asking is very clear about what 1 is vs. what 10 is, a
scale provides a very nice point of reference for a provider in terms of how
the client considers the pain. It can easily be followed by a second, such
as, "On a scale of 1-10, 1 meaning 'no interference' and 10 meaning you're
about to say 'forget it' to breastfeeding, how much is the pain interfering
with your goals for breastfeeding?" which may give a provider a clue about
readiness to hang in and work through the problem. Or one can create a scale
that is more pointed to that p.r.n. A provider can create a scale and get a
client's non-arguable perception on just about any issue that comes up! (They
are superb for collecting data re: psychosocial aspects of breastfeeding,
postpartum, etc.)

Scales are great tools for accessing subjective client data. If a provider
had asked you to scale your pain re: the bone infection, you might not have
had to wait so long for a more perceptive clinician to prescribe the
medication that helped.

<< I also warn them that the 3rd day after surgery is the worst and the pain
gets better from there. The mother's all tell me afterward that I was right.
Maybe it's true or maybe its psychological, I don't know for sure. >>

Sure you're not creating a self-fulfilling prophecy by "warning" them of a
specific day? I don't find mothers saying the third day is the worst.
However, the third is the day many go home or just got home so they may be
doing too much... If you found your surgical births to be a 1, then you
probably didn't need to take as much pain med or take it for as long as the
mom who found the pain to be a 6, which is great for both of you. She needed
the med and you didn't. So I'm back to feeling confused about the point re:
problem with using scales.

Karen

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