Withholding Pain Meds???

Nurses General Nursing

Published

Our DON has decided that a patient cannot give consent for any surgican procedure if they have been medicated for pain within FOUR hours prior to signing. So... if you come to our facility you will not have any opiates for pain four hours before signing your consent; regardless of the source of pain. Does this strike anyone else as barbaric? Doesn't pain impair the mind, sometimes more than any opiate might? Could denying a patient pain relief until after signing a consent be considered a form of coercion? What do you think???

T.:stone

Tweety, BSN, RN

34,218 Posts

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

JACHO strikes again.

One is considered impaired under the influence of opiates. We have to get consent from next of kin when a patient is under the influence of pain medicine and we don't withold pain medicine just to get consent.

I notice too that when the police interview victims or criminals they always ask when the last pain medication was administered.

nessajune21

133 Posts

I guess it is more acceptable to be physically impaired (by pain) than to be chemically impaired. Ere on the side of caution.

But, I am glad to see that you are concerned. I think it is a little cruel to withhold the meds.

woody62, RN

928 Posts

Specializes in icu, er, transplant, case management, ps.

I wonder what the DON would do if surgeons said their patients were to received pain medication regardless of HER rule? I can understand it not being given then a patient being asked to sign for consent immediately or shortly after receiving it. I have gotten MS, in the ER, then signed consent for treatment and some procedures. And my state of mind was never questioned. My daughter did throw a deputy out of my ER room, following pain medication for major trauma, while waiting for me to go to the OR. Considering I never could remember him being there, any response I had made would most likely been thrown out of court, or so my attorney told me.

I question the legal footing this DON is on. People receive pain medication and sign consents all the time. If a person is too confused by medication, they are generally too confused to respond correctly or sign permission for anything.

Woody:twocents:

Specializes in Med/Surg, Home Health.

wow. I agree that pain definitely impairs the mind, maybe as much or more than an opiate. When I hurt bad enough, my mind is only on getting rid of the pain...not able to concentrate on much else. Thats sad.

correctlywrong

53 Posts

There is a difference between being adequately medicated to address pain and being sedated.

Admittedly, you shouldn't drive on opiates. But I was not aware that signing a consent required rapid reaction time or quick reflexes. If the patient is able to understand what is being discussed, as evidenced by return verbalization, and is oriented and not confused, they ought to be able to consent.

Recieving pain relief is a human right.

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