In this podcast, the patient complains about chest pain. The health professional will ask questions about the pain: location, level, and triggers. Let’s listen to the conversation that is in progress.
Health professional: I’m just going to start by asking you a few simple questions. When did you start noticing the pain?
Patient: A couple of days ago.
Health professional: Can you tell me exactly where you have been experiencing your pain?
Patient: In my chest area.
Health professional: When does this pain occur?
Patient: Well mostly when I take deep breaths.
Health professional: Do you feel any pain when you exhale?
Patient: No, not really.
Health professional: Ok. How would you describe your pain?
Patient: When I breathe, I feel a sharp pain in my lungs and I have to catch my breath.
Health professional: So, when you inhale, you experience a sharp pain in your chest. Is breathing in, inhaling, the only thing that triggers the pain?
Patient: Yes.
Health professional: On a scale of 1-10, one being no pain and ten being the worst pain, what is the worst pain you have had in the last 24 hours?
Patient: About an 8 or so.
Health professional: Okay, when you inhale, do you also feel pain anywhere else besides your chest? Your abdomen, arms, shoulders or neck?
Patient: Sometimes I have an aching pain in my neck and I cannot move it.
Health professional: I’m going to order an x-ray of your chest and blood work to help find out what may be the problem.
Health professional to nursing assistant: Can you please accompany this patient to the x-ray department. Here is the requisition.
Teacher: Pain is subjective. When a patient comes to a hospital complaining of pain, you suddenly become a detective, asking questions and analyzing the patient responses to help determine the cause of the pain and the best way to alleviate it. The patient will want you to stop the pain. In this dialogue, the health professional asked many questions. What was she trying to determine? What did she want to know about the pain?
Student: First, she needed to identify where it hurt.
Teacher: That’s right. The health professional located the general area of pain. Do you remember the pain location?
Student: Yes, it was in the chest area.
Teacher: Now, that the general pain location has been identified, what does the health professional try to find out next?
Student: She asks the patient to describe the pain.
Teacher: Yes, and then?
Student: She tries to determine how much it hurts.
Teacher: Yes, the intensity and degree of pain, or how much it hurts, is often determined on a scale of one to ten.
Let’s practice: A young woman comes to the clinic. The woman is crying and limping. She was picnicking in the park when the symptoms presented. Now, you become the nursing detective. Ask about the pain.
Student: Where does it hurt?
Teacher: My leg.
Student: Which leg?
Teacher: My left leg, below the knee.
Student: When did it start?
Teacher: When I was at a picnic.
Student: Can you describe the pain?
Teacher: It is stinging and it’s burning.
Student: Does the pain go anywhere else?
Teacher: Yes, pain is shooting down my foot also.
Student: Have you had this pain before?
Teacher: No.
Student: Okay now I will look at your leg.