Isn't pain whatever the patient says it is???

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momcats3

36 Posts

Not sure if I made it clear, I'm a Hospice nurse, work in LTC, and my original post was related to a Hospice patient. Pain management in Hospice is a unique specialty (yup, it really is). I've had many nurses who've stated to me "Well, they look comfortable, it's only when you move them that it hurts"..... I've seen patients who deny pain constantly. Then, when the family isn't there, they admit it to me. They don't want their families to be worried, or be perceived as a "baby". I had one patient who'd told me "No, I don't hurt" and "No, I'm not having any pain". I'd ask her in many different ways during my assessment, and she always denied it. Yet when I asked her how her knee is feeling today, she told me "Oh, it really aches today" and confirms she'd like some medicine. Staff are unable or unwilling to take the time to really ask the right questions, and listen, and use proper assessment skills. I've had patients actively dying, with HR 120, RR48 & labored, whose NP's refuse to schedule MSIR, instead leaving in PRN's because they're afraid of snowing the patient. Sorry, but using PRN's in LTC with Hospice patients is a joke. It just doesn't get utilized despite our best efforts at teaching. The staff, usually agency, don't want to deal with it. Call it simplistic, but what it comes down to me when I see my patients in such distress is "Would I want this for my mother? (or father, friend, etc"). :nurse:

leslie :-D

11,191 Posts

i agree with you 100% momcat....

prn's are a joke, unless it's prescribed for breakthrough pain but you still need a scheduled pain regimen.

but prns don't mean a darned thing if nurses are not going to properly assess pain rather than just stating "patient denies".

SO much more education in pain mgmt. is needed for the mds and many nurses. it is so infuriating.

leslie

You sound like a good nurse - one that realizes that asking a patient one, simple question about pain is not a pain assessment.

Specializes in ER, ICU, L&D, OR.

Im a firm believer

just give them a menu to choose from

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