Jump to content

C Section Post-Op Rx

Nurses   (3,999 Views | 40 Replies)

3 Followers; 36,253 Profile Views; 4,693 Posts

You are reading page 3 of C Section Post-Op Rx. If you want to start from the beginning Go to First Page.

3 Followers; 4,693 Posts; 36,253 Profile Views

I know this probably sounds evil, but it is normal to expect the mother to participate in and perform baby care after a c-section, even 1 or 2 days after. It's part of the care plan, in fact, to get the mother to participate in and take over care of her infant. Many hospitals are moving towards the model where there is no respite/"well baby" nursery, and babies stay with their mothers the entire time they are in hospital, even c-section moms. The nurses don't do all the care of the infant unless there is a medical reason why the mother cannot perform infant care (e.g., a mother on mag sulfate postpartum who is very sick and very lethargic and has no one with her to help).

Niece was primip and delighted to care for her baby but she feared dropping the babe, as her arms were still numb from her spinal anesthetic and her incisional pain was not well-controlled on what I thought was Demerol but now know was Toradol. Niece wasn't so young, perhaps didn't bounce back as quickly as someone closer to early 30's does.

When she first needed to use toilet, no one would walk with her to keep her from falling because "Your nurse is at lunch". She developed an incisional hernia from lifting the baby in and out of the bassinet, so she kept him on her bed after that, and got scolded for it - "The doctor won't like that". Of course, no doctor was there to help her, neither was any nurse or aide. The only person to come by was a night nurse slamming an unneeded bassinet into her room at 0300 or so and a nurse who wanted her to sign a permit for gender male mutilation, which she refused to do. Oh, and the Lactation Educator, who was great.

No 1 or 2 days went by after the CS. Mom and baby were in room by 0120, nurses left and that was that. Niece was on her own after her spouse and her parents left about an hour later. Niece had a long, lonely, uncomfortable, painful night.

Pendulum too far the other way if you ask me...

Share this post


Link to post
Share on other sites

quazar has 20 years experience.

603 Posts; 10,009 Profile Views

When she first needed to use toilet, no one would walk with her to keep her from falling because "Your nurse is at lunch". She developed an incisional hernia from lifting the baby in and out of the bassinet, so she kept him on her bed after that, and got scolded for it - "The doctor won't like that". Of course, no doctor was there to help her, neither was any nurse or aide.

Pendulum too far the other way if you ask me...

Okay, that's not "pendulum too far," that's negligence. The first time a c-section mom gets up to go to the bathroom, I don't care if her nurse is busy, then SOMEONE needs to be there to help her, be it an aide or another nurse. She shouldn't be alone. Also, if she developed an incisional hernia IN THE HOSPITAL barely on post op day 1 or 2, that is a huge red flag right there and I'd be calling the dang surgeon.

Having had 2 c-sections myself after the age of 30, and a post op hernia after the second one (but it took a few months to happen), I actually DO understand her pain on a visceral level. HOWEVER, the care (or lack thereof) that she received is inexcusable. Something stinks in that hospital. I hope she complained, in writing.

Share this post


Link to post
Share on other sites

klone has 14 years experience as a MSN, RN and specializes in Women's Health/OB Leadership.

6 Followers; 13,527 Posts; 118,318 Profile Views

Agree with Quazar. That was just ****** care. I'm sorry that happened to her.

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

We give Toradol IV, then transition to Percocet or Norco once they're on POs.

So no narcotic is available before oral Percocet? What if Toradol IV seems to not cover the pain?

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

My old hospital gave Ofirmiv in the OR (1 bottle--I think 1 gram? Not sure, I was the baby nurse lol), then as soon as mom started feeling discomfort they'd offer Motrin and do scheduled Motrin for 24 hours with either Percocet or Roxy and Tylenol for breakthrough pain (the Motrin + Percocet was standard for all new moms). Not sure what else they could offer if a section still had severe pain as I never cared for a fresh C-section.

Gee, how about a real narcotic pain killer IM or IV or via PCA or even orally, for the woman who's been sliced open and is expected to care for her newborn with no family present to help lift him up for her?

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

Personal experience here. I have had 2 c/s and both times received only Norco once out of surgery (no PCA) and was discharged 2 days post op with 600mg Mortin only.

It sounds a little barbaric. Or did you feel your pain was adequately treated? Did you have people to help you? Family? Friend? Not just crazy busy staff?

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

I was given Percocet after the epidural wore off. I can't imagine toradol being the main pain mgmt immediately post op and then switching to a narcotic. I would think narcotic post op and then just an NSAID when discharged.

I think the staff were trying to make the Toradol work, didn't want to have to sign out narcs, don't know why else they'd deprive her of adequate pain Rx, unless they were diverting. Or maybe they didn't want to bother calling the surgeon? Who knows?

Niece not much of a c/o'er, maybe we should have kicked up a fuss.

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

I know this probably sounds evil, but it is normal to expect the mother to participate in and perform baby care after a c-section, even 1 or 2 days after. It's part of the care plan, in fact, to get the mother to participate in and take over care of her infant. Many hospitals are moving towards the model where there is no respite/"well baby" nursery, and babies stay with their mothers the entire time they are in hospital, even c-section moms. The nurses don't do all the care of the infant unless there is a medical reason why the mother cannot perform infant care (e.g., a mother on mag sulfate postpartum who is very sick and very lethargic and has no one with her to help).

Fine, but let's do some adequate pain med. Let's wait til Mom is fully recovered from the spinal and her arms are no longer numb and she's not afraid she'll drop the babe from the numbness.

And if babies are rooming in 100%, fine, just we need to respect the fact that being sliced open hurts and that a mom getting OOB from a spinal for the first time might be just a touch dizzy/weak/scared and it would be so nice to walk to the potty with her.

It's been more than 30 years since this all happened and I still think about writing a letter to the ##$#%% who are in power at that stinking facility.

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

It's not found to increase risk of bleeding/hemorrhage, and it's highly effective for post-delivery uterine pain.

It is not contraindicated in breastfeeding women, not sure where you got that info.

post-delivery uterine pain is one thing. Pain after a belly/pelvic surgery is different, though.

Share this post


Link to post
Share on other sites

3 Followers; 4,693 Posts; 36,253 Profile Views

Okay, that's not "pendulum too far," that's negligence. The first time a c-section mom gets up to go to the bathroom, I don't care if her nurse is busy, then SOMEONE needs to be there to help her, be it an aide or another nurse. She shouldn't be alone. Also, if she developed an incisional hernia IN THE HOSPITAL barely on post op day 1 or 2, that is a huge red flag right there and I'd be calling the dang surgeon.

Having had 2 c-sections myself after the age of 30, and a post op hernia after the second one (but it took a few months to happen), I actually DO understand her pain on a visceral level. HOWEVER, the care (or lack thereof) that she received is inexcusable. Something stinks in that hospital. I hope she complained, in writing.

Thank you, I only wish I'd known she'd given birth. I would have gone there to be with her that first night.

She told me all of this about a week later when I got to see her and my nephew. And she didn't know what to do, of course, not being in the medical/nursing loop, so she just endured this really shameful care.

She said when the surgeon was informed of the hernia, he said, "Oh, well, we'll fix that when you have your next baby". Of course, she's only had the one child.

The more I think about this, the more I know I need to inform the hospital, get her to get a lawyer, whatever. It's probably been way too long ago for any legal action, but even an acknowledgement would help, I think. Anyway, it was at one of those, how do you call it, Magnet outfits!

Share this post


Link to post
Share on other sites

Here.I.Stand has 16 years experience as a BSN, RN and specializes in SICU, trauma, neuro.

1 Follower; 4,986 Posts; 43,003 Profile Views

This was 30 yrs ago you said? Hopefully they've made advances in pain control since then! I totally agree with you though -- any other abdominal surgery requires an IV narcotic, and a Cesarean delivery *is* abdominal surgery. Heck I am a "grand multip" and get excruciating postpartum cramping, and all of my OB/CNMs have sent me home with 20 or 30 Percocets.... and I didn't have any incisions!

And the rooming in? Sure they encourage it, if not require it (thinking of hospitals with no well baby nursery)... but the couplet still gets a nurse, and should reasonably expect help if she asks for it. Especially where pt safety is concerned.

Share this post


Link to post
Share on other sites

klone has 14 years experience as a MSN, RN and specializes in Women's Health/OB Leadership.

6 Followers; 13,527 Posts; 118,318 Profile Views

So no narcotic is available before oral Percocet? What if Toradol IV seems to not cover the pain?

Then we'd get an order for IV morphine or dilaudid, or PO oxycodone. But Toradol and Percocet are what's part of the post-op order set.

We wouldn't just let the woman lie there in pain. If we're giving Toradol q 6 and Percocet ii q 4 and it's not covering it, we'd call the provider and get an order for something more.

Share this post


Link to post
Share on other sites
×

This site uses cookies. By using this site, you consent to the placement of these cookies. Read our Privacy, Cookies, and Terms of Service Policies to learn more.