RN won't give pain meds

  1. 2 I am an LPN in a small facility. Many docs here order Morphine IV to be given to their pts. My problem is that as an LPN I cannot give IV push meds. When my pts ask for pain med for a pain level of 5/5 I have to ask the RN to give the med for me. Sometimes they will go and look in the room and if the pts is lying there with their eyes closed waiting for someone to come in and give them relief. They will come back and say I am not giving them anything because they are sleep and don't give them anything if they can sleep. (They are not asleep because they call fifteen minutes laterasking for pain med.) If the Doc ordered 1-3mg of Morphine q2h prn. And my pt has just come from surgery and I ask if they can give the pt that I am taking care of 2mg for the breakthrough and then hopefully in three hours when they get their first scheduled po med it will cover them. They will tell me well just wait until they get their po, they just woke up they can't be in that much pain.
    Am I being overly sensitive to this because I am a new nurse? Am I assessing my pts wrong when it comes to their pain? It makes me angry that I cannot be in control fully of medicating my pts when they are in pain.Am I wrong for wanting the RN to give my pt pain med when I ask or are they wrong for just assuming that my pts are not in that much pain.

    By the way in this facility I work nights and most of the time we have on 4-7 pts and the RN usually has 0-2 since they have more paperwork the LPN's take on the larger pt load.
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  3. Visit  Laught3r profile page

    About Laught3r

    From 'Arizona'; Joined Jun '06; Posts: 79; Likes: 50. You can follow Laught3r at My Website

    29 Comments so far...

  4. Visit  Tweety profile page
    3
    You are the one with the patients, and the RN should trust your assessment and judgement. If the patient is reporting the pain the RN should respect the patient rather than make a rash judgement based on appearances.

    Good luck. Continue to advocate for your patients in pain. They need you.
    HappyWife77, newhospicern, and tewdles like this.
  5. Visit  Laught3r profile page
    1
    Thanks Tweety I needed the reassurance that I was doing something right out here in this big nursing world
    :smiley_ab
    tewdles likes this.
  6. Visit  ginger58 profile page
    1
    As a palliative RN I think your RN needs an attitude adjustment!! You know the patient and she should respect what you tell her, as well as respecting the patient's right to be medicated for self disclosed pain reporting.
    tewdles likes this.
  7. Visit  Laught3r profile page
    1
    You have been so helpful. I now have more courage to speak up more for my patioents. I did bring it up to my unit manager and she said to document when these incidents happen and to write up the RNs that will not give the medication that i ask them to give. she stated that as long as it is within reason they chould be will ing to give the medication.
    mom4josh likes this.
  8. Visit  ginger58 profile page
    3
    Quote from nursepanther
    You have been so helpful. I now have more courage to speak up more for my patioents. I did bring it up to my unit manager and she said to document when these incidents happen and to write up the RNs that will not give the medication that i ask them to give. she stated that as long as it is within reason they chould be will ing to give the medication.
    Congratulations on taking steps to be a patient advocate. Patients have the right to have their pain treated and their self report believed. I'm proud of you. Your unit manager sounds supportive. Best wishes.
    tewdles, sharpeimom, and NRSKarenRN like this.
  9. Visit  tigereyeskp profile page
    1
    As a RN nursing student, I just want to say thank you for your post. Thank you for caring, thank you for being an advocate for your patients and thank you for not giving up. I pray that I am as fortunate to have a LPN, like you, working with me-- who cares about her patients and is a voice for them-- because I know that often times, you will see things that I will miss.

    I have followed RNs like this during clinicals. It's painful. It's so hard to go home knowing that you voiced your concerns all day long but are virtually powerless. I am happy to know that you and your patients have an additional advocate in your nurse manager.

    Good luck and thank you again.
    blueyesue likes this.
  10. Visit  elizabells profile page
    2


    You are a credit to our profession. I work on a unit with completely barbaric pain management policies, so as much as I beat my head against the wall, the residents and fellows are too afraid of the attendings to order appropriate meds. Keep fighting for your patients!
    tewdles and sharpeimom like this.
  11. Visit  Griff1950 profile page
    0
    As a pain management nurse in a LTCF, I would definitely adjust that nurse's attitude. She apparently needs to be in-serviced on pain and medication administration.
  12. Visit  litbitblack profile page
    3
    I went to RN school specifically for that reason. I had a pt that was crying in pain, first the doctors didn't believe she was in pain and ordered tylenol until her labs came back showing pancreatitis(ive had that and it is horribly painful)well i finally fought long enuf with them and they ordered iv pain med. THe rn to give it had it in her hand and was standing in the hallway talking to a nurse from another floor while i was standing outside my pts door trying to console the pt and hurry the nurse up. SHe waited an additional 15 min for her pain med. I was ****** and the very next day started registering to take my basics so I knew that i could give my pts the care they needed without having to wait. THat rn needs a pain management class.
    tsalagicara, CRIMSON, and SuesquatchRN like this.
  13. Visit  Vito Andolini profile page
    0
    I don't know that the RN should just accept your assessment. You are a new nurse and she, presumably is more experienced. Not trying to be ugly, just stating my view, for what it's worth. It can be a bad thing to not assess a patient for ourselves. You wouldn't necessarily take the work of an aide or family member, would you? You'd do your own assessment.

    I applaud you caring about your patients and I think the RN is wrong to go by merely seeing that the pt is lying there with closed eyes. Maybe the patient is meditating or praying or just trying to hang on until the med comes. Appearances can be quite deceiving.

    Perhaps you could speak frankly to her, perhaps not. Maybe she is lazy, slothful, fearful, whatever. Maybe she sincerely believes what she is telling you. Hard to say. Can your manager help?

    You might want to go to RN school so you can do your own pushes and not have to wait on RN's to do them.
  14. Visit  caliotter3 profile page
    0
    Quote from litbitblack
    I went to RN school specifically for that reason. I had a pt that was crying in pain, first the doctors didn't believe she was in pain and ordered tylenol until her labs came back showing pancreatitis(ive had that and it is horribly painful)well i finally fought long enuf with them and they ordered iv pain med. THe rn to give it had it in her hand and was standing in the hallway talking to a nurse from another floor while i was standing outside my pts door trying to console the pt and hurry the nurse up. SHe waited an additional 15 min for her pain med. I was ****** and the very next day started registering to take my basics so I knew that i could give my pts the care they needed without having to wait. THat rn needs a pain management class.
    I was thinking along these lines when I read your post. One of several good reasons to become an RN. Even if the RN in question were to get off her behind and assess the patient herself, that is extra time wasted when you could have already administered the med as you saw fit.
    Last edit by caliotter3 on Apr 19, '09
  15. Visit  Heogog53 profile page
    6
    I am outraged that an RN would hold back on adminstering pain meds for any patient. If she/he has any questions in regards to the patients SELF assessment for pain level, instead of simply staring in a doorway, the RN ought to be doing his/her own assessment by actually talking to the patient.
    I say this as someone who has been a nurse since 1982, who has had more than my fair share of illness and pain, have watched family members die, and feel that taking care of any patient should be like taking care of one of mine. I find that the biggest issue today in pain management is the disconnect that many health care "professionals" demonstrate partially because they are afraid of addiction issues(not usually a problem for short term acute pain care), or because the meds that the docs order don't cover the patients pain adaquately, and instead of asking the doc to increase the dose, or switch to something more potent, simply answer the patient with the old standby, "Doctor ordered this medication and you can have it in another _____ minutes." and that's supposed to help?
    Another problem, of course, is if someone comes into the hospital, in acute pain with some acute condition that they've suffered with before, and tell the nurse that X medication is the best pain medication for that condition. Instantly the mental bars go up- "OOOOOooooooOOOOO, WE know ALL about drug seekers", even if the patient is simply trying to expidite things.
    And worst of all, working in a university teaching center, is the fact that many of our health care professionals and students are young enough that they have never been ill enough to be in a hospital. They have NO idea how much pre-op and post-op pain hurts, or how nasty it is to have an NG tube shoved down your nose/throat...They are pretty much idiots were that's concerned. I once was working near a couple of medi students who were talking about a patient and the three of them were having a jocular talk about just "dropping a tube", as if it were no big deal. I turned and asked them, "Have any of you ever been ill enough to have a tube dropped?" No. No. And No. I said, "Well, perhaps you ought to try dropping a tube yourself and see how much fun that is." The three of them vanished....
    Sorry, got carried away about the topic of pain medication and the lack of understanding on the part of oh so many health care "professionals" about how to treat it, professionally.


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