okay, this could be a stupid question/story, but my degree is not in nursing - i start this summer
so, when i was in the hospital after a c-section (with my 2nd child) and my son was in NICU - i was prescribed to lortabs (2 every four hours). since i was staying in the hospital, i didn't have to go out and get a prescription - the nurse brought it to me...while i was there.
when i had my first child, i was released from the hospital the next day after my c-section - went to the pharmacy, and took MAYBE 5 or 6 pills once i was home. the rest stayed in my med. cabinet.
but with my 2nd child being in NICU and me being stuck at the hospital without being able to breastfeed, hold him, and do all the things new mothers usually do - i was a nervous wreck and stir crazy - wanting to walk to see him, wanting to walk to the ice machine, wanting to put on make up, wanting to go develop pictures - wanting to do ANYTHING besides sit in the hospital bed without my baby!
point being - since i was doing so much running around, i actually needed the pain meds this time. so, after about 6-7 hours without, i asked the nurse if i could have some and she was nice and brought them to me. i suspected that she'd bring me some 4-5 hours later. when she didn't, i asked again. she brought them to me. i asked if they could just bring them to me when they had the chance (around the time i was prescribed) because i would be needing them and i didn't want to bother them - and she said no, and that i had to ask for them. i felt like a drug addict begging for meds every 4-5 hours! i hated it. and after a few times of asking, i felt like THEY were treating me like one!
why do you have to ASK for pain meds in the hospital when they're prescribed after surgery? i'm sure there's a reason - it just made no sense at the time.
that's if i have a change of perspective. the majority here doesn't seem to think it's as big of an issue as you and a very select couple of others.[/quote
You may not change at all....some folks aren't troubled by facts or education.
that's if i have a change of perspective. the majority here doesn't seem to think it's as big of an issue as you and a very select couple of others.[/quote
You may not change at all....some folks aren't troubled by facts or education.
I wish you the best in your endeavors.
:yeah:
Some people aren't troubled by common sense or compassion. I personally can't imagine going through an entire shift without ever asking a patient who has been polite and hasn't made any requests for so much as ICE, "how are you feeling? do you need anything? how's the pain?" but that's just me.
that's if i have a change of perspective. the majority here doesn't seem to think it's as big of an issue as you and a very select couple of others.[/quote
You may not change at all....some folks aren't troubled by facts or education.
I wish you the best in your endeavors.
Some people aren't bothered by facts, true enough, even when the evidence points to the need for aggressive pain management.
Who was suggesting automatic dosing for the patient? Is there a reason not to assess the patient's pain q4? You're suggesting that because the patient would like to be asked about her pain medication needs that she needs education, and that because she said her mind won't be changed that means she isn't bothered by facts or education, did you not? Shall I provide quotes? The exchange is just a few posts back.
Specializes in pediatrics, palliative, pain management.
There seems to be some confusion here. We all agree that pain needs to be assessed prior to medicating, I don't think anyone is saying that you should just walk in the room and plop down pain meds every 4 hours and leave without saying word. And prn and scheduled are not different, pain still needs to be assessed prior to scheduled pain med administration as well.
The question is who is primarily responsible for initiating the pain assessment that goes along with every pain med administration. There are many times that it takes a call light to initiate that assessment because we are busy, but if we know a patient is having persistent pain and the pain med we gave them 4 hours ago is probably not adequate at this point, it's our responsibility to initiate that assessment when possible. Nursing care shouldn't be something that patients get only when they ask for specifically and repeatedly.
YES! Exactly!!! You said it perfectly ... especially "Nursing care shouldn't be something that patients get only when the ask specifically and repeatedly" If I could 100X Kudos your post I would!
Specializes in MPH Student Fall/14, Emergency, Research.
Well, this thread is certainly entertaining. I've seen debate over semantics, PRN vs scheduled vs ATC, patient education, sleeping, pain assessments, and pain control, and something about African Americans and red heads.
As a student, it's very interesting and insightful to be able to really see various nursing processes like this thread has shown! Perhaps most helpful was the OP's initial perspective as a patient. This thread is of particular interest to me as I venture into the wild and wacky world of L&D in a few weeks.
One thing that struck me, and I say this as (god I hope not) an unintentionally self-righteous nursing student observation, is that it -appears- that the OP's ongoing acute pain was not effectively handled by PRN meds and would have been better suited to scheduled meds.
One of my clinical rotations was on a surgical floor last year. We rounded q1h to assess the site, pain scale, and intervention effectiveness. Mostly the PRN meds were there for breakthrough pain because the scheduled meds were providing adequate relief.
I guess that if I had a pt who wanted to schedule her breakthrough pain meds -although *technically* I could give them as ordered- I would prefer the doc to order scheduled meds so that everyone was aware the pain was not being effectively managed as PRN. The other concern I'd have is - by maxing out her PRN dose, the OP would not have a ready option for breakthrough pain, which is really the point of PRN, isn't it? Within the confines of the described situation, it just doesn't sound like it was well controlled, to me. Strictly conjecture, of course.
YES! Exactly!!! You said it perfectly ... especially "Nursing care shouldn't be something that patients get only when the ask specifically and repeatedly" If I could 100X Kudos your post I
I would just like to say that I read most of this thread, and find it rather comical that everyone is so thoroughly debating semantics. PRN stands for "pro re nata" which translates to "per the need." The job of an RN is to assess the patient. If the patient needs the PRN med, you give the PRN med. Many RN's wait for the patient to ask, and many RN's are more proactive. I, personally, believe in taking care of my patients, with some patients that means assessing them whenever the next dose is available. If a patient asks me to assess them whenever the next dose is available, there's no reason not to perform that assessment. I'm not going to judge a patient that recently had surgery for their perceived pain just because I have a higher pain threshold, and I certainly won't write them off as drug seeking on post-op day one or two.
Additionally, failure to provide ongoing assessment of changing patient needs might, in some instances, be considered nursing malpractice.
I've had that same surgery, and I know what it feels like. It is uncomfortable, I took motrin for several days afterward, and that is sayig something because I am loathe to take drugs of any kind.
So, as someone who loathes taking drugs of any kind, the pain was significant enough for you to seek pharmaceutical respite...And yet, it could most aptly be described as merely uncomfortable?
:yeah:
CuriousMe
2,642 Posts
It will be interesting to see the OP's change of perspective after some education.