i have been working in the pacu of a surgery center for a few months now, feel like i've caught on pretty good and am confident in my work. however, recently had one pt who was a lap chole and had pain level of 0, but still gave her 2 lortab and transfered her to the discharge area. apparently during the move, she developed a pain level of 10, but her pain meds hadnt kicked in yet. they refused to take her and transfered her back for me to get her pain under control. as soon as she was back in bed and monitors on, her heartrate was in the 40's, bp 100/60, sleeping. when woken up, states pain as 10. my boss said to give her some meds. i dont feel comfortable with that, especially since my boss is usually the first one to encourage us to kick them out to discharge. if they are awake and talking, get em out. so i told her the pt's hr, bp, sleeping, etc, and she still said to give her meds. ended up giving her meds, she was fine and eventually pain level went to a 4, but still snoozing. how to straddle to line between a fake pain level and what we really know?? what would you have done?
btw, i worked in labor and delivery for 9 yrs and am very familiar with a pain level of '10', even with an epidural and a sleeping pt. but i am used to managing my pt myself without my boss hovering over my shoulder telling me to medicate them.