Breaking down miconceptions using analogies


The misconceptions

Pain is sometimes left under-controlled just because a team is not gathering all the information they need to find the right interventions. There is a huge misunderstanding that symptom screening is the same as symptom assessment. In best practice, these are two different processes that are meant to fit together in a specific way: a patient that screens positive for a symptom then has that symptom assessed. The screening and assessment might be done by different people but information from both are needed to find ways to control the pain, sometimes with medications. Choosing the right medication including at what dose and how many times a day, depends a lot on extra information an assessment gives you. This is where the breakdown happens: when screening, which provides less information, is mistaken for assessment, the team lacks the important information that is needed to figure out how to relieve the pain. 

Analogy- it is like going to a mammogram. It can tell us if there is a mass in the breast but we wouldn't skip to getting treatment for breast cancer right away. We need more information to confirm what the mass is to decide what needs to be done about it. We'd say to the person who went for chemo right off of a mammogram "woah, you're skipping a step there": the biopsy. Going from screening for pain straight to prescribing a medication for it is the same. The only information a screening gives is that the patient is in pain and how bad it feels. We need to know much more about the pain to find out what type it is in order to determine which intervention, from the many many options we have, will help relieve it. For a mammogram, the next step would be a biopsy. For a positive screen for pain, the next step would be a symptom assessment, like the OPQRSTUV

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