Is my NM whack or is it just me? - page 3

I work on a busy orthopedic floor. We receive a lot of post-op patients. I work the night shift. The other night I medicated a patient of mine times 1 for some pain she having. After that, she was... Read More

  1. by   It'sMe, RN, BBA, MBA
    Quote from ruby vee
    i agree with you about pcas, but. the pca decisions are made above my pay grade: it takes a provider to order one and a management team to commit to using them and buy the machines, tubings, cassettes, etc. in the first place.
    you should recommend that they get them and use them. pcas are money makers for hospitals, big money makers. they are proven to reduce hospital stays and get patients out of the hospital sooner, which makes more money for the hospital. we rarely have patient stays of >24 hours due to well controlled pain with use of pcas. patients not using pcas have more pain and longer stays, which reduces reimbursement due to contractual lump payments.
  2. by   diane227
    She just does not want to deal with the problem. First of all as the manager I would tell the physician that I would investigate and I would have gone into the room with the MAR and would have reviewed what medications the patient had received. I would determine if she had called for meds and did not get them, the nursing record to see what the patient was doing when she made rounds on her patients and then discuss any issues with the nurse if needed. I would also educate the patient about pain control. To require a nurse to wake a patient up to see if they are in pain is stupid. Just ignore it.
  3. by   LilPeonNo1
    Quote from BmichelleRN
    The answer would be YES...BTW, most hospitals require a follow up to determine pain med effectiveness...some require you to ask the patient their current pain level on a scale of 1-10 within an hour of medicating. If your hospital does not, I would do it as my own personal nursing practice. And document their response. Finally, it irks me that this patient wouldn't call out for pain med if he/she were in pain. Most patients are skilled at using that call button.
    IMHO sleeping in a hospital should be solid evidence that this patient was very likely not in pain "all night". LOL

    ...don't be so sure of yourself. as someone who can't take most pain meds i know that sometimes sleep is my only haven. i am allergic to opiates, i've went into convulsive, projectile vomiting fits everytime one was tried on me. i developed ulcerative gastritis a few years ago and my gi doc told me "absolutely no nsaids", for someone with arthritic knees i thought i would surely die. i tried children's motrin suspension once, thinking how bad could that hurt me, a child's dose no less, and i couldn't eat for three days afterward. i also suffer from the occaisional migraine, and boy are those fun. unless i want to sit in the er for several hours just to get a shot of toradol i have to put an ice pack on my head and go to sleep. and, i'm usually down for at least 2 days. so, i am well aware of the solace of sleep to ignore the pain. the three days spent in the hospital for ug and 'mild pancreatitis' (who were they kidding, there's no such thing), had to be the worst pain i ever felt in my life. the nurses there were kind enough to offer me a heat pack to place on my abdomen to relieve some of the pain. and, some of them even woke me up in the night and asked if i wanted another when they got my vs. it was greatly appreciated.