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Pain management begins with empathy

Your willingness to provide pain management is a reflection of your ability to empathize with the patient

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Greg Friese

Updated February 3, 2015

In-between heaving sobs, my 5-year-old daughter explained how she lost control of her bike and slammed into the blacktop. I saw a bit of dirt and maybe a tiny drop of blood on her knee. She pointed to her elbow, but it just looked red. Analytically, it didn’t look too bad, but before I could offer sage dad advice of “get back on your bike and ride,” my wife turned on what I call the ‘Mom Empathy Machine.’

She gently swept little Margaret into her arms. Next she said, “I bet that really hurts. Let’s make it better.”

Then fully attentive to Margaret, she scanned the wounds and asked for a careful replay of events. As the sobs dissipated into a soft whimper, she finished with, “I am going to help you feel better. Would you like some ice? How about a drink of water?”

A few minutes later, the pain was gone and Margaret was ready to ride.

Empathetic pain management

Have you ever said, “I understand how you are feeling” or “I know just what you are saying”? That is empathy, and understanding

how a patient is feeling is a critical EMS skill.

Your willingness to provide pain management, especially pharmaceutical intervention, is a reflection of your ability to empathize with the patient. Too often I have heard paramedics explain that they were very stingy with pain medication administration until they had a kidney stone or low back strain of their own. Both injuries can be extremely painful, but there is no outward sign of injury. No deformity, bleeding or bruising to justify the underlying agony to others.

You can certainly know a man better if you have walked a mile in his shoes. But empathy does not require us to have experienced our own chronic back pain, limb loss or pancreatitis before we can intervene.

I know many of you are jaded from patients you felt were trying to game the system. Instead of starting your assessment as a skeptic, try understanding the patient’s pain as an empathetic advocate.

Phrases of caring and understanding

You can also borrow and adapt these phrases from the Mom Empathy Machine:

  • That looks really painful. I am going to make it less painful.
  • I am sure that hurts. How can I help it hurt less?
  • That sounds awful. For the next 15 minutes I am going to do all I can to make it less awful.
  • This is getting worse. Let’s see if we can work together to get ahead of it.

How has your own pain experience changed how you assess and treat pain? Leave your reply in the comments below.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.