It’s no secret that I work with the long-term facility geriatric patients. Therefore, of course, I don’t do anything impressive like insert (or, in our cases as nurses, assist with) chest tubes, remove teeth, wipe off gsw’s or anything crazy like that or possible in an acute care (I’m thinking mainly trauma, here) arena.
But I still do plenty of things that could be considered painful. I flush my patient’s PICC (yes, LPN’s are allowed to do such in Minnesota) lines, insert catheters both of the indwelling and straight kind, blood glucose checks (nearly everyone flinches and whines when I dig out the little finger puncher), jab a syringe full of 80 units of Lantus into thighs and arms and abdomens, change dressings of various sizes and strange wounds, remove stitches and staples, and other things that I can’t think of right now. Due to facility protocol, we have to dig out the EZ hoyer lift when someone’s on the floor – no matter the situation. I’m in there with other staff, grabbing vitals and stuffing the sheet under them and popping them out like a shoe horn from under the bed.
Of course, there are other things that I’d like to think matter. I’m there when the family needs someone to talk to. I warm up that blanket in the fancy microwave so I can keep my patient warm. I nod and bend over so I can listen to the patient convinced that someone’s poisoning her. I laugh and sing along with the patient singing every song in her book while she waits for her pills. I’m there when others aren’t – whether they can or cannot, whether they’re afraid of everything involved in caring for someone or they just don’t have the space to.
All the same, this image?
While I never actually say it, I’m afraid to admit that it makes me chuckle a bit.
When I dig out that catheter, when I wipe a patient’s finger vigorously with an alcohol swab in preparation for a stick, I won’t tell them it doesn’t hurt. Pain perception is in the mind. My mind is different from my patient’s. It may not hurt me so much as it irritates me, but it may seem excruciating to them. I don’t say, “little poke!”. I say, “Quick poke here.” right as I click. I ask the patient to take a deep breath and explain that the pressure will be gone soon as I put the tubing in for a catheter.
I’m not perfect. But I’ve been a patient that’s heard, “Oh, it doesn’t hurt, you’ll be fine.” Maybe my pain perception is horrible. Maybe I’m a wimp, and I can’t take too much. These are entirely possible, but I won’t tell my patient something that I don’t know.
Keep it real! You don’t know if it’ll hurt.