Explaining post op pain to patients - page 2
by ReginaPhalange | 8,089 Views | 14 Comments
Hello, I work in PACU and have found that most of our patients have unrealistic expectations when it comes to post op pain. Many believe that surgery will not hurt because their doctor told them it's a "painless" or "minor"... Read More
- 0Sep 6, '11 by nyrn5125Quote from xtxrnVery true with the lap surgeries. They don't tell pt's how painful it is and that only walking helps to relieve that Co2 pain. Pt's think if they lay there and never move it will go away. It's best to prevent the pain than to try to catch up to it. Give the prn automatically and if it isn't enough call MD and get it adjusted, don't wait. We get pt 4 hours post op lap sx,vascular bypasses. Some docs hate giving too much pain meds yet want them up and oob.I've had surgery both with the IM pain meds and PCA. I h a t e PCAs....just doze off feeling a bit better, and then wake up with the IV stuff worn off and have to keep pushing the stupid button q10 minutes to get ahead of it, only to doze off again- from the drugs, not having adequate pain control....I have chronic pain- I'm used to sleeping with pain (the contact with the bed actually hurts- and the bed is fine- it's any bed I've been on) so the "if you doze off, you're ok" theory is crap. With IM meds, they last for 3-4 hours, and it's possible to actually get comfortable with less meds.
Lap choleys are a big issue w/pain control at places I've worked- the Co2 moving into the shoulder/collarbone area isn't explained well enough and patients don't want to move (which is the only real 'fix') to get it dissipated.
Patients also don't want to have to feel anything (sorry bud- someone just stuck a knife half way to the other side of you- think it's gonna tickle? ).
There's a serious wuss situation with surgical pain- at least with some . There are those who suck it up (and really should get more pain meds to facilitate mobility) and then there are the "I'm too good to put up with pain" folks who are never satisfied.
Education is definitely lacking with some folks- but there are also a lot of unrealistic expectations.
- 1Oct 15, '11 by RaineyRN"I hate to be blunt but are you or your anesthesiologists letting your patients pain get ahead of them?"
Anticipate that there will be pain! Pain meds shouldn't be relient on a pt telling you they're hurting. You know they will be, so load em up! It's always easier to control pain before they are fired up... stop the cascade before it starts... :-)
- 0Oct 16, '11 by NicuGalI had a lap. chole and my surgeon was pretty up front with the shoulder/neck pain. They loaded me up with fentanyl and a vicodin for the road, thank goodness lol I thought...well, this isn't so bad, huh. But those first few days...oh my goooodneessss!!!! I wanted to stay glued to the couch and suck down the whole bottle of vicodin, but I knew better and got up, walked and took a hot shower. But it was miserable and I am no slouch when it comes to pain lol Truly thought I was going to birth an alien from my neck lol
- 0Oct 24, '11 by turnforthenurseRNProper education is crucial. I find that surgeons are doing less education for surgical procedures nowadays. I had a patient undergoing an I&D procedure. The surgeon came by to take a look at the area, told the patient to plan on having surgery the next morning, gave me orders (changing the antibiotic dose/frequency, NPO after 0000, get a CT done and have the patient sign the informed consent) without even discussing the procedure to the patient. The surgeon was on his merry little way. Part of informed consent (which is the surgeon's job) is to explain all of the risks related to the procedure. I brought in the consent form and the patient was reading through it and after going through all of the risks listed, stated to me, "I'm not sure if I even want to have this procedure done now!" I offered to have the surgeon come back and talk to the patient but the patient declined and signed the form.
I also hate how surgeons/physicians expect a "simple" procedure to produce very little pain afterwards. I try to educate my patients on pain, rating pain and that there will be medications ordered to provide pain relief after the procedure to help ease their fears...
- 1Oct 24, '11 by turnforthenurseRNQuote from RaineyRNAbsolutely! It is much easier to control pain when it is minimal instead of waiting until the patient is in agony and complaining of pain 10/10 - much harder to get under control when you wait.It's always easier to control pain before they are fired up... stop the cascade before it starts... :-)