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.
Wow...all I can say is WOW! No actually, I can say more...It amazes me how high and mighty some of you sound in regards to issues that weren't even in the OP's post. This has sadly become so twisted and far from what was originally asked. As just a lowly student, I got to say it's embarrassing to see some of you "professionals" behaving so UNprofessional. I'm learning a lot on these boards, and sadly some of that knowledge is how NOT to act after I get my license.
Huh?? I have seen nothing whatsoever in this thread that even remotely resembles these remarks.
Certainly it's unfortunate that the way standing and PRN orders work wasn't explained to you at the time, which would have potentially alleivated this distressing aspect of what was undoubtedly an upsetting and stressful post-natal experience.
I appreciate that your idea was that making a request to receive your PRN meds regularly would make your nurses' lives easier; as the responses you've received demonstrate, that wouldn't have been the case. However, I am a little concerned that, despite the numerous explanations of PRN, you still write:
I wholly agree that all patients, regardless of whether or not they've had surgery, should be regularly assessed for pain. But there is no "due" for PRN medications. Many of my patients have PRN orders that are unused for days, sometimes even for their entire admission.
I thank you for bringing to my attention this reminder that the fact about aspects of the in-patient experience that are routine to me are often novel and unknown to my patients. I'll be incorporating this aspect of care into my future patient education.
sigh.....remember, the English language is not particularly exact.....I agree the use of "due" is problematic, but remember she is yet to be a nurse. And remember, she wasnt even assessed, never mind offered her meds, and, it would seem, she remained in the dark about that particular nurse's mode of practice surrounding administration of PRN meds.
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.
this post is so accurate that I just wanted to bump it
I appreciate that your idea was that making a request to receive your PRN meds regularly would make your nurses' lives easier; as the responses you've received demonstrate, that wouldn't have been the case. However, I am a little concerned that, despite the numerous explanations of PRN, you still write:
I wholly agree that all patients, regardless of whether or not they've had surgery, should be regularly assessed for pain. But there is no "due" for PRN medications. Many of my patients have PRN orders that are unused for days, sometimes even for their entire admission.
I thank you for bringing to my attention this reminder that the fact about aspects of the in-patient experience that are routine to me are often novel and unknown to my patients. I'll be incorporating this aspect of care into my future patient education.
Yep - 20 pages, 194 replies, and we are still at square one. Time to move on.
Guys I am new at this so if I am stepping in where I shouldn't please let me know. Pain is subjective and that is why we have scheduled and PRN pain meds. Some patients need meds around the clock on a scheduled basis and some have a higher threshold and don't need them as often. Assessment is the key. If my patient says they are in pain and need a pain med then they get a pain med, if they ask for me to bring it to them q4 then I give it to them assess in q4 and if they say they are in pain they get it. If it continues then I would just call the dr and get the med scheduled. I think in this day in age we as nurses worry to much about drug seekers, if that is what they truly are they will make themselves known and the dr will end up dc'ing their meds. I say if they are in pain give them the medication.
Specializes in Nurse Leader specializing in Labor & Delivery.
For a S/P C/S pt, I don't understand the rationale of people saying "If they need it q4h, then call the physician and get an order for a scheduled med." Why can't you just give the PRN med q4h? With a C/S, chances are high that in another 12-24 hours, they will no longer need that narcotic q4h, and I don't want to have to give them a narcotic on a scheduled dose, when the goal is to wean them down prior to discharge.
G I think in this day in age we as nurses worry to much about drug seekers, if that is what they truly are they will make themselves known and the dr will end up dc'ing their meds. I say if they are in pain give them the medication.
Not where I work, the drug addicts (seekers) seem to get what they want, it's amazing the way doctors will give the addicts 2mg of dilaudid q2h but the ortho pt only gets 4 of morphine q4. Doesn't make sense but I see it all too often. I've heard that some doctors do this just cause they don't want to listen to the addict gripe! It frustrates me to no end!
i thought it was silly to begin with, but wanted to know what the reason for the silliness might be. had there been some strict, unavoidable reason for it - i may have changed my mind. i didn't change my mind because the majority of people responding confirmed that it could/should be avoided simply by assessing and asking a simple, routine question.
the only real impression i get is that THIS is what you really wanted to say, and i was just a scapegoat/good opportunity for an intro:
As far as sissykim's post about AA and pain management, she has posted on other threads clearly stating her opinion that AA's are treated poorly in healthcare and all are discriminated against. Don't bother taking a bite out of THAT apple, it'll never be a constructive conversation.
*hahaha* *eyeroll* No, not really......I chose to post once rather than twice. I could have put up two separate posts to express both opinions, but was that necessary? You haven't been around here long enough to know that I am not going to use something else as a "lead in." Please. I needed no intro to the second paragraph, and would have posted what I said about YOUR post NO MATTER WHAT. So keep walking. Scapegoat, my big foot (and it is, size 11). In fact, I'm taking the liberty to unbold it, since my first point was my initial point, I added the second as an aside, as long as I had a window open. (Darn that logic, it so often gets in my way)
just because everyone hasn't "come around" to your point of view doesn't mean we're at "square one."
there has been a lot of interesting information/opinions shared IMO - even if they ARE wrong. :)
The only person who DOESN'T know what is wrong or not is YOU. You don't know how nursing works, you don't know the people on this site, and how they do/say things. YOU are also not the reason this thread is 20 pages, in case you were flattered. Pain management and philosophy regarding it has always been a big ticket, long-discussed nursing issue, and not every nurse will approach it the same, but different approaches (read: the ones you personally disagree with) doesn't make them "wrong." In fact, that is the LEAST of what makes them wrong.
Specializes in Nurse Leader specializing in Labor & Delivery.
That's kind of unnecessarily nasty.
The only reason why this thread is 20 pages long is because administration has unreasonably set the default to 10 posts per page. At other sites I've been to, this thread would only be 4-5 pages long. :)
Not where I work, the drug addicts (seekers) seem to get what they want, it's amazing the way doctors will give the addicts 2mg of dilaudid q2h but the ortho pt only gets 4 of morphine q4. Doesn't make sense but I see it all too often. I've heard that some doctors do this just cause they don't want to listen to the addict gripe! It frustrates me to no end!
Could it be bc the drug addicts have a high tolerance? I've known people who have taken narcotics for recreational use and took more on a regular day than I'd ever dream of taking or ever DID take when I have legit pain after surgery. For example, what about someone that takes "OC 80's" - obviously 10mg of lortab or whatever is not going to phase them in NO pain, so it def. wouldn't alleviate real pain. Just wondering.
*hahaha* *eyeroll* No, not really......I chose to post once rather than twice. I could have put up two separate posts to express both opinions, but was that necessary? You haven't been around here long enough to know that I am not going to use something else as a "lead in." Please. I needed no intro to the second paragraph, and would have posted what I said about YOUR post NO MATTER WHAT. So keep walking. Scapegoat, my big foot (and it is, size 11). In fact, I'm taking the liberty to unbold it, since my first point was my initial point, I added the second as an aside, as long as I had a window open. (Darn that logic, it so often gets in my way)
The only person who DOESN'T know what is wrong or not is YOU. You don't know how nursing works, you don't know the people on this site, and how they do/say things. YOU are also not the reason this thread is 20 pages, in case you were flattered. Pain management and philosophy regarding it has always been a big ticket, long-discussed nursing issue, and not every nurse will approach it the same, but different approaches (read: the ones you personally disagree with) doesn't make them "wrong." In fact, that is the LEAST of what makes them wrong.
Incase I was flattered? That is HYSTERICAL! Please, tell me WHERE you came up with THAT!
The ones I "personally disagree with" just so happen to be the ones with the most unpopular theory (read: most everyone disagrees with them as well). Of course, it's always the one with the "unique approach" who thinks it is the correct one.
Belle Epoque
156 Posts
Huh?? I have seen nothing whatsoever in this thread that even remotely resembles these remarks.