I'm a new nurse and recently received my first "negative" comment on a patient survey.
Pt was a young woman s/p lap appendectomy; she complained that I "must have forgotten" about her pain meds and claimed that I medicated her once at 11pm and that she woke up in severe pain at 6am...saying it was too long to go without pain meds. According to a note I wrote in my documentation, I medicated her twice during my 11pm-7a shift...I didn't go back and consult the MAR, which would definitely have a more accurate record of when I gave the meds.
I can't help but feel bad about all this...I almost feel betrayed in a weird way, since I felt I had a good rapport with her. I remember being concerned about her pain, explaining that the PO meds were "long-acting" and that IV Dilaudid would be for breakthrough pain. I remember checking in on her a couple of times and she was asleep. I had other pts that were less stable, and figured if she's sleeping, she's relatively "OK'.
I *now* realize that just because a pt is sleeping, that does not mean they are not experiencing pain. I can't remember what the orders were, but I'm guessing the PO was q4 hrs...and if what she says is correct, that I medicated her at 11pm (actually unlikely, given that my shift starts at 11pm and by the time I finish taking report and looking over charts, I don't start rounding until closer to midnight), then I probably could have given her another PO around 4am, which I must have missed.
But would you wake a sleeping pt to give them a PO pain med? I guess that's my big question here...I feel a little weird giving any pain med to a sleeping pt (unless they are on a vent, sedated, etc.) - not because I think they are pain-free while asleep, but because I don't want to disturb their much-needed sleep and jostle them awake just so they can focus on their pain again - does that make sense? Or am I talking crazy here...
