Aron Ralston, an avid outdoorsman, was hiking in a narrow canyon in Southern Utah when he upset a large boulder that rolled down the canyon after him. As it fell, the boulder relodged itself between the narrow canyon walls and in the process pinned Aron’s right wrist between the boulder and the canyon wall. Aron was alone and was unable to free himself from the situation. After being trapped for five days, with no help arriving, Aron eventually made the decision to free himself by breaking the bones in his forearm with the weight of his body and amputating his hand with a dull pocketknife. After freeing himself, he hiked an additional seven miles before the search and rescue crews found him. His arm required further surgery to repair it. After the surgery, the nurses would ask Aron, “On a scale of 0-10, what is your pain level with 0 being no pain and 10 being the most pain you have ever experienced?”. Aron would reply, “0.25”. When asked about giving such an odd answer, he stated that even though he was in pain after the surgery, it was minimal compared to the pain he experienced when he cut through his ulnar nerve to free himself from being trapped by the boulder.
1. As you reflect on this story, how does it help you understand that pain is a subjective experience for your client? What types of questions will you ask your client to adequately assess their pain level?
2. Why is it important to understand that not all clients experience pain the same?
3. What objective data may be noted when a client is in pain?
4. How might pain be manifested in vital sign measurements?
5. What effects might chronic pain have on the general health of a client?
