Consult yelled at me for giving pen pain meds...

Specialties MICU

Published

How do I handle this? Patient in pain, neuropathy and decubitus ulcers, confused, crying out in pain when meds wear off. Pulmonologist aggravated (at me!) for giving prn pain meds, saying it aggravates her respiratory depression. Am I supposed to let my patient remain in pain? How do I respond?

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Specializes in PICU, Sedation/Radiology, PACU.

Ignore the doctor? Sometimes specialists can only focus on their particular area of expertise and have a hard time seeing the patient as a whole.

If your patient is in that much pain, then it sounds like the pain control regime isn't working very effectively. So I'd talk to the primary doctor about changing the pain medication to better manage it.

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Agree with specialists having somewhat "localized" vision. Years back, I was taking Inderol for migraine prophalaxis...sp...developed pneumonia with nasty asthmatic comp. Pulmonary said :no more beta blockers,,you just have to "get used to" the headaches...after a chat with my neuro, he decided maybe I should just try a ca channel blocker for the headaches...

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Specializes in Critical Care.

The pulmonologist was doing pretty much what he's supposed to do; say what would be best for the patient's breathing (and nothing else), which is a big reason why the patient has a Nurse, to remind the MD that there's more to this patient than just their lungs.

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Specializes in none.

Tell the guy to take a long walk off a short pier. The patient was in pain, Patient had pain med ordered. You gave the med. Only one question remains : Did you get someone to change the doctor?

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Specializes in ICU.

Did you supress the respiratory drive? If not ... then you did a good job.

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