Lately, in that ever-elusive quest for the perfect patient satisfaction scores, our NM has decreed that all pain meds are to be offered at exactly the time the patient could have them. That is to say, if they are ordered prn q 3, then we offer them q 3, without the patient having to request them.
Now she has declared that for post-op patients, they will be given q 3 (or whatever), even if that means waking the patient. This, she says, will improve patient satisfaction because pain will be more controlled.
I'm old, but if an order says PRN, that still means AS NEEDED, and that is the way I'm going to do it. If a nurse woke me up to give me a pain pill, I can guarantee that WOULD NOT improve my patient satisfaction. In addition, while I am not sure the docs know (yet) that this is being done, I feel if we are not following the orders as written, we are setting ourselves up for some nastiness from them, and maybe from the BON.
Anybody else coming up against this?
I usually tell the patients I won't be waking them up to offer pain meds unless they want me to. I let the patients decide if they want to be left alone to sleep or not. Your manager sounds like mine. I've had a few patients request to be woken up to receive the pain meds but most say they want to sleep. However, if they do get up to go to the bathroom I will go in to ask if they need something. I do agree though that if it is ordered as PRN it should not just be given as a scheduled med. Of course, if they are in pain, or have been having issues through the day with pain, I talk to my patient and come up with a plan based on their needs and what is ordered.
Last edit by Melinurse on Nov 30, '08
: Reason: just got off 3rd shift and can't sleep