[JellyBean1]

We are faced with this issue alot in our LTC. Even a doctors order for Tylenol four times a day is disregarded because it's thought the patient doesn't show any signs of pain. So some say anyway. She is frail with huge ulcers to the bone. At least it would make turning and washing more tolerable. I don't get why people won't even give Tylenol. Isn't this the very least we can do to at ease her journey?????

[2shihtzus]

I hate it when I see things like that. I imagine in long term care, some nurses think that tylenol is one of the less important drugs, considering how many meds they have to pass. However, if it were me, I would give it, especially considering how painful the dressing changes must be???

Where I work, I see some nurses that get in power struggles with patients regarding pain meds. Drives me crazy.

[iluvivt]

Not only are those ignorant nurses but they may also lack empathy. How come your facility does not consider pain the fifth vital sign? With each VS assessment if the pt is in pain there should be a nursing action including medicating the pt. Start an educational campaign to help the nurses that need education. Bring it up in a staff meeting and hold each other accountable. Peer pressure is a good thing in this case.

[morte]

Originally Posted by iluvivt

Not only are those ignorant nurses but they may also lack empathy. How come your facility does not consider pain the fifth vital sign? With each VS assessment if the pt is in pain there should be a nursing action including medicating the pt. Start an educational campaign to help the nurses that need education. Bring it up in a staff meeting and hold each other accountable. Peer pressure is a good thing in this case.

doing VS in LTC is not routine, except for MED A patients and an active med problem......so treating pain as the "fifth" one wont happen.....however if nurses arenot giving SCHEDULED meds, this is a med error, EVERY time they dont give it....good luck

[JellyBean1]

You're right doing VS in LTC is not routine, particularly if they are Palliative. We usually monitor the temp only and give Tylenol per standing order. We are beginning an educational campaign specific to this however there remains a few nurses who will do as they want only. Even if there is a Drs order as a nurse you are able to do your own assessment and choose not to give a drug!!! Personal opinion on what is in our facility...it is an additional walk down the hall to the patients room, if the option is there to give a Tylenol or not.......they choose not to because they can. Sad as that is. How do we get around that one.

[ncaissie]

Originally Posted by JellyBean1

... How do we get around that one.

Simple, Take the right for the Nurses to refuse meds away from them all.

I have chronic pain that was a couple weeks long a couple times a year.
Since seeing a chiropractor It has been constant for over 1 1/2 yeas now.

I just got into a PM clinic on the 20th of this month.

I'm tiered of people looking at me and even telling me to my face that I'm a seeker. Before my surgery I didn't even take regular Tylenol.
Yesterday I had to leave work because I was in so much pain I was vomiting. The PM clinic has me on Methadone and it doesn't seem to be doing anything for me.

[classicdame]

Ncaissie: My heart goes out to anyone in chronic pain.

I believe the nurses mentioned in this post are acting illegally if the medication is ordered. If it is prn, then there should be strict parameters on how to gauge discomfort. What pain scale do they use? Do they use more than one scale? Sounds like a bunch of lazy nurses to me.

[ncaissie]

I don't see the nurses anymore. But every time I went to the ER I was treated like that.
And during the month I was in recovery.

I'm always asked on a scale of 1-10.

[iluvivt]

OK never worked in a LTC facility. Have 2 jobs one in acute care one in home IV therapy. I would write up the incident as the oncoming nurse that the pt was left in pain. Get specific and soon a pattern will emerge and hopefully some heat will be placed on those caregivers and yes they might even be called into the managers office. A nurse must always remember that to advocate for their pt is crucial... So go fix it you guys can do it!!!!!

[blinks]

Failure to treat pain is abuse. Failure to assess pain is neglect. If the management of your facility does not take this seriously, does not intervene on behalf of the patients/residents, you may want to consider working elsewhere. I am certain your State Board of Nursing would be interested in this matter. The facility's Medical Director should be advocating as well. Communicate. Again, this is not a personality issue, this is abuse.

In the meanwhile, why not share your assessments regarding specific patients/residents with the primary care physician and request routine, around the clock analgesia orders?

Good luck.