I hate the pain scale. What I hate more, is JCAHO for deciding that pain is the "5th vital sign."
Vital signs are vital for life. You must have a blood pressure to be alive. You must have respirations to be alive. You must have a pulse to be alive. You must have a body temperature to be alive. You DO NOT have to have pain to be alive.
BP, pulse, respirations and temperature can be measured quantitatively. Pain level is a quality of life measurement. For those of you who haven't been to the hospital or doctor's office in a while, the pain assessment goes like this:
On a scale of zero to ten, zero being no pain and ten being the worst pain you can have, where would you rate your pain?
So, what is an example of the worst pain you can have? It differs with everyone. And motivation often determines the answer.
In the health center I run, I find that there are 2 pain scales.
If motivation is to file a false worker's comp claim, the "worker's comp" pain scale doesn't go below an 8 and is often a 10.
If motivation is to be able to work and not get sent home or to the doctor for the day, the "working" pain scale rarely goes above a 5. The fact that Tylenol is the strongest thing I can give you for pain doesn't hurt (sorry for the pun.)
I wonder what JCAHO will decide is the 6th vital sign? I know, patient satisfaction!