On signs, symptoms, and pain control.

img_4998“Pain is what the patient says it is.” These words are first spoken to us very early in nursing school, and they quickly become a mantra repeated over and over and over again as we slowly progress our way through the complexities of our studies.

“Pain is what the patient says it is.”

As nurses, we have to learn all about human anatomy, as well as the physiology of countless disease processes. Before we can be responsible for someone else’s life, it’s pretty important that we’re equipped to recognize potential complications that could lead to problems for our patients.

But, even though we’re educated on the disease processes, once we’re actually in practice, however, our day-to-day focus is not channeled so much on handling the diseases themselves.

That’s what the doctors do.

Instead, nurses are trained to assess and treat the patient’s response to both the diseases, as well as their subsequent treatments. What their body actually does in reaction to this unwelcomed invasion on their wellness. And their lives.

“Pain is what the patient says it is.”

So we do this by following daily lab values – making corrections as warranted. We measure blood pressures. Monitor oxygenation levels. Body temperatures. Intake. Output. We read EKG’s. Assess for edema. We listen for both heart arrhythmias, and those fine little crackles and wheezes that can mean trouble on so many different levels.

This is the science of nursing at work – monitoring obvious signs that we can both clearly watch and accurately measure. And then we can fit all this information into the appropriate little check boxes in our electronic charting system. All done. Nice and tidy.

“Pain is what the patient says it is.”

Well … this is where things get messy, folks.

Now we’re taking the science of objective, measurable signs, and complicating everything by adding the subjectiveness of symptoms to the mix, as well. Symptoms can only be felt. They cannot be seen, they cannot be accurately measured.

So basically, what’s happened here is the beautiful crispness of nursing science has just become all mucked up by people and their pesky sensitivities.

“Pain is what the patient says it is.”

Pain is a symptom of something else – it’s not what we would call a “sign” in medical terms because, again, we can’t see or measure it. What’s causing the pain may be something we’re able to visualize, but the degree to which you honestly feel your pain is absolutely hidden from us.

“Pain is what the patient says it is.”

It’s just like fatigue, nausea, or itchiness (all three also symptoms of something else). You can tell me all about it – describing it to the finest detail – but only you can feel just how severe it really, truly is.

There is just no way for me to accurately quantify what you’re actually feeling. And there is sure no “normal range” to compare your levels to because everybody feels pain differently.

“Pain is what the patient says it is.”

Honestly … if you think about it … we all just feel EVERYTHING differently, don’t we?

Whether it’s physical pain, or the agonies of the heart. No two of us are alike. We’re built different. Look different. Process and react in our own uniquely individual ways.

“Pain is what the patient says it is.”

My point here is that as both nurses and humans we need to be careful in how we view the pain and weaknesses of others. This has been weighing on my heart more and more lately – partly because of what I see at the hospital, but also because of struggling through my own personal tangles in life.

As one who is forced to walk this difficult path of invisible illness I can attest to the discomfort of feeling what no one can see. I’ve even written about this recently. It’s not easy to walk around looking normal, yet feeling horrible. People expect normal out of you, but you don’t have much normal to give.

“Pain is what the patient says it is.”

But then … sometimes you do. You and everybody around you gets a little taste of normal … and it feels so good … but then somehow the amount of normal you can handle suddenly shrinks dramatically with no warning … and a random sucker punch ensues … and you have to disappoint and be disappointed … all over again. And this hurts. All over again.

“Pain is what the patient says it is.”

So really … pain HAS to be what the patient says it is, right? Because there’s truly no way to see or feel another’s pain. I know this as a personal fact.

We truly have no idea what other people are going through … what their journey is costing them emotionally … how this affects their ability to function through what the rest of us may consider to be “just normal life”.

“Pain is what the patient says it is.”

Just because someone else struggles (either physically or emotionally) through something we ourselves may find effortless, that doesn’t make them wrong. Or weak. Or more trouble than they’re worth.

“Pain is what the patient says it is.”

We shouldn’t just think of them with our eyes rolling in judgmental frustration, we shouldn’t turn our backs, shouldn’t walk away. Instead we should offer up a prayer and reach out to help. Just reach out.

I’m personally working on all this in myself lately.

I want to just be kind. Generous. Understanding. Gentle. Forgiving. I want to expect good. To actually look for it – in both others and in myself. I want to take the time to connect … make a difference somehow … or at least to never stop trying.

“Pain is what the patient says it is.”

Because the heart of every, single one of God’s children is unspeakably precious and absolutely worth whatever effort it takes to treat them as such. I believe that if we could all do a little better job at this, not only would it ease the burden of their pain, but it would really lighten the load of our own, as well.

Thanks for growing with me. ❤


“If someone says, “I love God,” and hates his brother, he is a liar; for the one who does not love his brother whom he has seen, cannot love God whom he has not seen.  And this commandment we have from Him, that the one who loves God should love his brother also.” (1 John 4:20-21)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s