Update to Mom as a Patient--Need Advice!!!

[Cattitude]

Ok we have some problems now... I still don't have all the information. Me and my other sister talked to the Social Worker, the Nurse Mgr. wasn't in today but there definitely WAS an issue with overmedicating last night.

Apparently she got both Methadone and Percocet as I mentioned in my other thread. We think that the night nurse just gave them maybe not realizing that she was supposed to get Methadone for pain control as standing and percocet prn. AND only ONE percocet NOT TWO. Mom SWEARS she received TWO percocet every time she got her methadone pill as well. She had great pain control!

She also did not have any respiratory depression or hypotension.

Apparently the day nurse caught the med error and rushed right in to assess along with the Dr. Ok, no problem.

So they take her off Methadone and cut the percocet down to ONE Q3H prn. It's not working so late this afternoon they change it back to TWO Q4H prn. She received ONE perc at 1 pm. The day nurse giving report to the night nurse at 4 pm told the nurse "Go ahead and give the TWO now, they just changed the order." The night nurse says "No she has to wait until 5, it has to be 4 hrs"

This same nurse has also made my Mom wait over an hour past her due time for meds before. I know this time the due time was kind of gray. Technically the nurse wasn't really wrong OR right. She really could have given them especially being that the order was increased. BUT my Mom didn't even make a big deal, she just said OK I'll wait.

So at 5, she asked again, the nurse said I'll bring them in when I have a chance. The nurse came in to my Mom's room and my Mom was sitting on the floor. My Mom HAD fallen and luckily didn't really injure herself as far as we know. She said the nurse did NOT get anybody to help her get up just waited for her to get up on her own!!

Now, let me say that I am steamed. My mother can be a royal PITA and I know she has been a challenge with pain control BUT this is BS. She really would be a whole lot calmer if this one would just bring her the meds within 20-25 minutes of asking for them. She's not even looking for perfection.

So, I'm really going to have to talk to the supervisor about this and I'm thinking about calling tonight. I know the Nurse Mgr. for the unit won't be around until Monday so I'm stuck talking to a higher up.

I need to calm down a little before I make the call. I just think that this nurse has my mother labelled as an addict (true but so what) and a PITA (again true but you still have to give good care). I myself have patients who test my patience. I still don't treat them in this manner. Most of the other stuff she's said, I blow off. This, I tend to take a little more seriously.

Ok, advice please???? Thanks in advance!!!!

[fakebee]

I'm confused.Your mom is in a hospital not nursing home, correct? No way does an RN not know which pain medicine is a scheduled med and which one was PRN. I'm even more confused about the withdrawl of the methadone as used for pain control. Apparently, the combination of methadone and percocet gave your mom excellent pain control without over sedation, respiratory depression, or hypotension. Why was it stopped? A check of the MAR and the narcotics sign out sheet or the Pyxis record will confirm or deny

that your mom was given additional Percocet above what was ordered. There should be a paper trail regarding the wrongful dispensing of narcotics. As to your troubles with the nurse regarding the timely giving of pain meds, I wasn't there so I have to assume that any nurse who isn't doing so is tending to someone c chest pain, coding,etc. that has a higher do it now priority. Hope everything is resolved to your satisfaction and mom gets better.

[vamedic4, EMT-P]

cat, i'm so sorry to hear that your mother is being treated like this. i would definitely talk to the nm, but i'd start with the charge rn for that shift. it's painfully obvious that someone up in that hospital hasn't a clue how to do their job.

when it comes to patients being admitted for pain management, or who are there for pain control secondary to a procedure, then it needs to happen in a timely manner, period.

and the fall needs to be written up, just in case there are repercussions for your mom,...like aggravating the surgical site or injuring another part of the body..et cetera. color]

vamedic4;)

[TazziRN, RN]

Hmm......my post blew up.......

Since you've had a problem with this nurse before, you and your mom would be within your rights to request that she not be assigned to your mom anymore.

[Tweety, BSN, RN]

Definately calm down first. But yes, this nurse needs some education. That can be a grey area and if the nurse was uncomfortable a simple call to the doc to get an order to give two now would have sufficed.

It's almost cruel to know that one percocet q3h doesn't control the pain but yet make her wait 4 hours for the next dose. DUH. You called to get it increased but refuse to give it????

[SuesquatchRN, BSN, RN]

I've known nurses who simply don't like controlled substances and assume that their use - no matter how legitimate - is abuse. This nurse sounds like one of those.

[Cattitude]

i'm confused.your mom is in a hospital not nursing home, correct? no way does an rn not know which pain medicine is a scheduled med and which one was prn..

the whole issue is that it's a med error. she wasn't supposed to get as much medication as she did but the hospital is being very "hush hush" about what happened. i told the social worker that we are really not looking to make any trouble because my mom is ok. mistakes do happen and i understand.

when it comes to patients being admitted for pain management, or who are there for pain control secondary to a procedure, then it needs to happen in a timely manner, period.

vamedic4;)

exactly. again, not a big deal when it wasn't on time to the minute but more than an hour late? last night went much better. i think now that we were more verbal about her care, things really improved with this particular nurse.

hmm......my post blew up.......

since you've had a problem with this nurse before, you and your mom would be within your rights to request that she not be assigned to your mom anymore.

yes, any further issues and we will.

definately calm down first. but yes, this nurse needs some education. that can be a grey area and if the nurse was uncomfortable a simple call to the doc to get an order to give two now would have sufficed.

it's almost cruel to know that one percocet q3h doesn't control the pain but yet make her wait 4 hours for the next dose. duh. you called to get it increased but refuse to give it????

ugh, i know!

i've known nurses who simply don't like controlled substances and assume that their use - no matter how legitimate - is abuse. this nurse sounds like one of those.

i do believe this was the issue. again, last much better and i instructed my mom to call me if she doesn't get meds within 30 min. of asking. i think 30 minutes is reasonable if she is due.

thanks everyone!!! i told my mom that i get to get annoyed by her and be pissy with her but no one else does!

[Dalzac, LPN, LVN, RN]

Even if your mom is an addict, addicts still have legitimate pain and should be treated for it, period. I get so mad when I hear about nurses delaying pain meds because the patient is an addict. Do they just think that they are the moral ethic committee and can make that kind of judgement call??

I have to say I have been in your position with the mistreatment of my loved one I was on the phone to everybody and was a nurse nightmare andmade his nurses life hell. His blatant lack of care resulted in the nurses dismissal. It was that bad. The nurse manager came in the next morning and saw with her eyes all the documented things that had happened.

The nurse mistreated him because he(DH) is an old biker in to have a liver transplant He had been clean for 10 years and was a drug and alcohol couselor for teenagers that were incorificerated, but she thought because of the way he looked he didn't deserve a liver. She postponed all the required preop almost to the point of losing the viablity of the donor liver.

So any way document everything and call the house supervisor and make her document as well. And anybody else that was witness and even you put it on paper

[TazziRN, RN]

she thought because of the way he looked he didn't deserve a liver. She postponed all the required preop almost to the point of losing the viablity of the donor liver.

So any way document everything and call the house supervisor and make her document as well. And anybody else that was witness and even you put it on paper

Oh.......................my...........................gawd.........................