Stopping patient care for another patient - page 5

Ok I have a question.... Here's the scenario ... I was in the middle of patient care with one patient who was requesting pain medication. It was time for her scheduled meds so I was doing the... Read More

  1. Visit  Been there,done that profile page
    0
    Quote from bluemushroom
    I think you are letting your emotions about your father get in the way of seeing this in a rational way. Someone having to wait a few minutes for their pain meds is not the same as ignoring them and not addressing the problem.

    Pain control is not number one. I'm more concerned about that whole breathing thing that people need to be doing.



    Wow. That's rude.

    Yeah, pain is what the patient says it is, but no one is saying that the patient wasn't in pain, so that's not the issue here. The issue is that patients/families think you should stop what you're doing to bring them/their loved one pain meds right now, and that's unrealistic. I can't stop what I'm doing every time someone says they want pain meds. I did that during one of the very first shifts I ever worked. I would leave someone's room, and they'd be on the call bell less than 3 minutes later, while I was getting someone else's medication, saying they wanted pain meds. Why couldn't they have said that when I was in there? They didn't just suddenly start having pain. Once I would take care of that person, more people would be asking for pain meds. I quickly learned that I couldn't keep being interrupted, that it would be impossible to get medications passed, and that I'd go crazy or make a serious mistake if I kept stopping and running up and down the hall to take care of someone else's pain at that moment. They simply would have to wait their turn. It may sound harsh (though it's not meant to), but no one has ever died of pain.
    I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)
    I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

    No.. no one ever died from pain.. they just wished they would.
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  3. Visit  emtb2rn profile page
    4
    Quote from Been there,done that

    I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)
    I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

    No.. no one ever died from pain.. they just wished they would.
    That nursing 101 crack is pretty snarky. And now we're back to interrupting a med pass.
  4. Visit  JZ_RN profile page
    2
    You think you know it all and are super nurse and insult the rest of us. I feel sorry for the patient who gets the wrong meds or worse from you when you make a mistake. It can happen to anyone. I'd rather be safe than sorry.
  5. Visit  evilolive profile page
    2
    I would have done the same thing as the OP. How would it make the resident feel if the nurse dropped what she was doing for patient care for a pain med that could wait 10 minutes or so? If I were a resident receiving incontinent care, or having a dressing change done, I'd be royally P.O.'d. To me, this isn't just nursing prioritization, it's common courtesy.
    JZ_RN and nrsang97 like this.
  6. Visit  Pets to People profile page
    2
    Quote from Been there,done that
    Let me explain in more specific terms. I am currently a float nurse, that can go to most units..in multiple facilities in the largest health care system in a large city.

    I have no problem pulling any narcotic I need from the pyxis , at the same time..even if it is for two different patients. I am a professional. I am expected to give narcotic A to patient A and narcotic B to patient B.

    I can administer the correct medication to the first patient... walk down the hall and medicate the other patient PDQ. I fail to see how that would be a safety violation.
    I have also started a blood transfusion on two patients at the same time. I can read.

    30 years of experience will do that for ya.
    Unless the two patients you started a blood transfusion on were either in the same room or in a room right next to each other, this is not something to be proud of. If you start a transfusion on one patient, then walk down the hall to start one on another, the first pt. could be having the beginning symptoms of anaphalaxis before you make it back. With all your experience you should know this, as the pt. is supposed to be checked every 15 minutes for the first hour of starting a transfusion.

    Maybe this could be possible, if the pt's were in the same room or in rooms right next to each other, and if neither pt has any questions, family members, reactions, request an extra pillow or more ice, etc. that would keep you from hoping right back to the other room.
    redhead_NURSE98! and JZ_RN like this.
  7. Visit  Pets to People profile page
    4
    Quote from Been there,done that
    My statement was meant to point out that ... in the case of a patient experiencing pain.. that is indeed THEIR priority.

    I am simply stating that the nurse needs to juggle the administration of pain medication...without her workflow foremost in mind.
    Just because it was THEIR priority, doesn't make it YOUR priority.

    When a nurse is juggling the admin of meds she needs to keep her workflow FOREMOST in mind, she will not do her pt's any service otherwise, because she will be running around like a chicken with her head cut off, getting half the work done in twice the time and most likely to make multiple mistakes.
  8. Visit  strawberryfields profile page
    0
    This is incredibly unfortunate.. my DON is the same way, if we are wrong we take it .. but when we aren't and the patient is clearly giving us a run around all day our DON never sticks up for her staff. We have excellent understanding patients most of the time.. but every once in a while we have one that is clearly out of there mind and we don't treat them any different.. we get to them when we do at my facility and they complain complain.. sigh. Sometimes I have 25 patients... and one ME and one CNA. Tube feedings, colostomys, iv fluids, etc Right now I even have one pt that has the whole nine yards colostomy, iv in PICC, wound vac for decub wound on sacrum, foley.. oh yeah and I have 25 pts... and 4 pts ask for pain meds on the dot all night. I had one on IV pain med Q15min.

    Sorry for venting.. but it's impossible to accommodate everyone , I wish I had a clone. Nursing needs to change!! I'm afraid of protesting because I need a job, I feel like we are all easily replaceable because of all the new RNs begging for jobs.
  9. Visit  bluemushroom profile page
    3
    Quote from Been there,done that
    I don't know why they did not ask for pain medication when you were in the room. Did you ASK if they needed anything for pain while you were at the bedside?(Nursing 101)
    I have found that patients surely realize that ''damn .. I should of asked for that while she was here.. she won't be back for awhile." Grab her before she gets too far away.

    No.. no one ever died from pain.. they just wished they would.
    Nope, I sure didn't ask them if they needed pain meds. When I have 20-something people to pass meds to, I'm not going to ask every single one of them if they need pain meds, especially when nearly all of them are able to (and do) say what they need. Heck, even if I had one-fourth of that amount, I'm not going to ask every single one of them if they need pain meds if they're capable of making it known. If their pain was so bad that they wished they would die from it, I don't think they'd hesitate to say they need something for it. Nursing 101? Other than some important skills and important information, the majority of what I learned in Fundamentals was a lot of BS like butt-kissing demanding patients and families, therapeutic communication (see aforementioned butt-kissing), and how we should all strive to be little angelic clones of Flo. But I'm wasting my time with this. You think you're perfect. I don't want to get the OP's thread locked, so I'm letting this go.

    OP, I agree with you. I wouldn't have stopped what I was doing for another patient if it wasn't an emergency. People just have to wait sometimes.
  10. Visit  redhead_NURSE98! profile page
    4
    Quote from Been there,done that
    You know.. they were! Blood bank did not want to issue two units to me at the same time.

    However, they realized it was an emergent situation for both patients .. knew me to be a professional and issued both units.
    I see you are also an attorney.Therefore , herein.. and forthwith.. you are referring to my statement regarding pain control as an "exhibit".
    I am most certainly aware that there are higher priorities in nursing care.
    My statement was meant to point out that ... in the case of a patient experiencing pain.. that is indeed THEIR priority.

    I am simply stating that the nurse needs to juggle the administration of pain medication...without her workflow foremost in mind.
    Actually you said "Pain control is NUMBER ONE of all nursing priorities." That is why everyone is expressing that they think you are one off. If that's not what you meant, sorry but that's what you wrote.
  11. Visit  redhead_NURSE98! profile page
    0
    Quote from Pets to People
    Unless the two patients you started a blood transfusion on were either in the same room or in a room right next to each other, this is not something to be proud of. If you start a transfusion on one patient, then walk down the hall to start one on another, the first pt. could be having the beginning symptoms of anaphalaxis before you make it back. With all your experience you should know this, as the pt. is supposed to be checked every 15 minutes for the first hour of starting a transfusion.
    That is why I asked if they were in the same room, lol
  12. Visit  michelle126 profile page
    0
    Wowsa...7 pages on this already? Getting back to the OP...

    It comes down to nursing judgment. My 2 cents comes from a LTC/ heavy rehab experience. Some days when I'm on the cart it seems like all I do is prns. If you are in this setting, sometimes you can get a good bit of your res on the same-ish prn schedule so that you are not running in circles. Sounds like you were doing your assessments at the start of the shift? Those assessments usually include asking about pain. Great. If you can medicate at the start of the shift then middle then towards the end..it makes it easier. There are the ones that will ask for the PRNs..when someone asks for a PRN for pain I try to get it to them within 10 or 15 minutes if not quicker. Using nursing judgment in your above situation..could you have gotten your assessment and meds done on pt A done within that time frame then peeked your head into pt B and let them know you will be along asap?

    Most will be satified with just being told I will be back in xyz minutes asap. Laying around in pain and not knowing the request was recognized is when you get and upset family etc.
  13. Visit  Pets to People profile page
    1
    Quote from redhead_NURSE98!
    That is why I asked if they were in the same room, lol
    Yup, soon as I posted I came across your comment...we were thinking the same thing. Even having them in the same room, if one starts to have a problem, goodness forbid going into anaphalaxis, the other patient will still get practically ignored and you will have to call in someone else to watch him/her...so it's an ok idea until the crap hits the fan, then everyones screwed.
    Piglet08 likes this.
  14. Visit  DeLanaHarvickWannabe profile page
    2
    Quote from strawberryfields
    I had one on IV pain med Q15min.
    Why is this patient not in a higher level of care environment?
    JZ_RN and dudette10 like this.


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