Published May 28, 2012
DroogieRN
304 Posts
How do I handle this? Patient in pain, neuropathy and decubitus ulcers, confused, crying out in pain when meds wear off. Pulmonologist aggravated (at me!) for giving prn pain meds, saying it aggravates her respiratory depression. Am I supposed to let my patient remain in pain? How do I respond?
Double-Helix, BSN, RN
3,377 Posts
Ignore the doctor? Sometimes specialists can only focus on their particular area of expertise and have a hard time seeing the patient as a whole.
If your patient is in that much pain, then it sounds like the pain control regime isn't working very effectively. So I'd talk to the primary doctor about changing the pain medication to better manage it.
dscrn
525 Posts
Agree with specialists having somewhat "localized" vision. Years back, I was taking Inderol for migraine prophalaxis...sp...developed pneumonia with nasty asthmatic comp. Pulmonary said :no more beta blockers,,you just have to "get used to" the headaches...after a chat with my neuro, he decided maybe I should just try a ca channel blocker for the headaches...
MunoRN, RN
8,058 Posts
The pulmonologist was doing pretty much what he's supposed to do; say what would be best for the patient's breathing (and nothing else), which is a big reason why the patient has a Nurse, to remind the MD that there's more to this patient than just their lungs.
Merlyn
852 Posts
Tell the guy to take a long walk off a short pier. The patient was in pain, Patient had pain med ordered. You gave the med. Only one question remains : Did you get someone to change the doctor?
Biffbradford
1,097 Posts
Did you supress the respiratory drive? If not ... then you did a good job.