Hello. My name is Jenny. I'm one of the Registered Nurses on duty today.
Oh hello, Jenny. I see in your notes that you've come in with back pain. Is that right?
Yes. I've got terrible back pain. It's so sore. I see. Can you tell me how
you hurt your back? Yes, sure. I've got a little boy. He was crying in the next
room and I rushed to see why he was crying. I slipped over one of his toy
cars. Oh, that's a shame. Can you tell me where the pain is? Well it's mostly in my
lower back. You know, right across my back. And what's the pain like? It's really awful.
It's so painful . What type of pain is it? Is it a sharp pain or a dull ache, for example?
Oh, I see. It's a sharp pain. It's worse when I try to move. OK.
How would you rate your pain on a scale between 0 and 10. Zero is no pain and
10 is the worst pain you've ever experienced. Oh, I'm not sure. It's really bad
but I am not sure which number it is. 1 to 3 is mild pai.n It's just a
niggling pain that is a bit annoying. Well it's more than that. 4 to 6 is
considered moderate pain. That's when the pain interferes with your daily
activities. I mean when you can't concentrate on a book or if you find it
difficult to get dressed or have a wash. Pain that's worse than that is severe
pain. That can be any number between 7 and 10. I understand now. The pain
is really bad. I would rate it as an 8. OK. I'll explain what will happen
now. The emergency doctor will examine you first. You might have an x-ray. I'll
get you some painkillers and some anti-inflammatories as well. I've already
had some painkillers. I took some at home but they didn't do anything. We'll give
you some slightly stronger ones as well as the anti-inflammatories. Why do I need
anti- inflammatory tablets? My skin isn't inflamed.
The anti-inflammatories are used to reduce the inflammation in the tissues
around the painful area. That helps ease the discomfort. So you're saying they
work with the painkillers? Yes, that's right. The other thing that
may help the pain is to do some gentle exercise. You should try to keep moving
as much as possible. I'll get you a leaflet which explains what the
exercises are like. The physio can help you too. OK, but I really need strong
painkillers. Can I just have some extra strong painkillers now? I understand that
it is very difficult when you are in a lot of pain but it's best to start with
simple painkillers and anti-inflammatories. They work well together.
If you find that the painkillers are not strong enough you
need to come back to A&E. I don't know. That's going to be no help at all.
I've got small kids at home. I have to be able to look after them. I just want the
strong painkillers. I know it's hard when you have small
children to look after but it's not possible to start with the strongest
painkillers. Would you be willing to try the medication for a day and see if it
helps? I suppose so. So, if the tablets are not strong enough I can get different
ones? Yes. But it's important to start with the tablets we are giving you now.
There are a few things I need to tell you about the medication. First you
should always take the tablets with food. That's to stop you feeling sick. Also,
make sure you don't take more than the recommended dose. The maximum number of
tablets per day is on the label on the box. All right. I understand.
Take the tablets with food and only as many as it says on the box.
That's right. It would be very helpful if you did the exercises on the leaflet I gave you.
You can also use heat packs on your lower back to relieve the pain. OK. I'll try.
That's great. I'll get your medication
for you before you go home.