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Do you interrupt report to give pain meds?

Specializes in NICU, Peds, Med-Surg.

Just to clarify, I'm not talking about a fresh post-op patient who needs IV Morphine like clockwork or something that *acute* where you would not make them wait., we give a lot of PO mainly......and LOTS and LOTS of Oxy IR, which SO many of our patients want the MINUTE they can have it again!

If we're in report, MOST of my coworkers will tell whoever answered the light "the nurses are in report, but I let him/her know you needed pain meds". For me, altho I HATE having report interrupted (and who doesn't? :uhoh3: )

I feel that pain is a PRIORITY, and I'll stop report to go give it.

On the other hand, interruptions lead to forgetting something, and also, once you go to give that pain med "really quickly"..maybe two other patients see you and yell out for something. Happens to me all. the. time. If there's none of the oncoming staff available and it's not urgent, of course I tell them "use your call light and someone will be with you."

But...again with the PAIN issue, I just don't think a patient should have to wait 10, 15, 20 minutes longer just because we're in report...not fair to them. What do you think? :nurse:

noahsmama

Specializes in pediatrics, public health.

When I was working in a hospital, I tried to avoid this issue by checking in with any of my patients who were on PRN pain meds 15 to 30 minutes before it was time to go into report, and giving pain meds right before report.

I always appreciated it when the nurse on the previous shift did this too -- instead of having to rush out after report and give the pain med, it was nice to know that was taken care of.

This way I rarely got interrupted during report for this issue, but if I did, I would make them wait, for all the reasons you stated.

SilentfadesRPA

Specializes in ER/ MEDICAL ICU / CCU/OB-GYN /CORRECTION.

"But...again with the PAIN issue, I just don't think a patient should have to wait 10, 15, 20 minutes longer just because we're in report...not fair to them. What do you think? "

I totally agree with you that a patient in pain should not have to wait till report concludes to be medicated.

It is against all standards of practice, I am sure your facilities policies, and as well, could become a very serious legal issue to come back on you someday. You are right - it is not fair to THE PATIENT.

Marc

When I was working in a hospital, I tried to avoid this issue by checking in with any of my patients who were on PRN pain meds 15 to 30 minutes before it was time to go into report, and giving pain meds right before report.

I always appreciated it when the nurse on the previous shift did this too -- instead of having to rush out after report and give the pain med, it was nice to know that was taken care of.

This way I rarely got interrupted during report for this issue, but if I did, I would make them wait, for all the reasons you stated.

Love it! How kind it would be for the off-going nurse to make sure the pts are all current on their pain meds, especially if they know the call lights will be going off right around shift change. In my experience the nurses do not jump up in the middle of report and go give pain meds. Report normally only takes a few minutes.

punkydoodlesRN, BSN, RN

Specializes in Psych, OB-GYN.

When I was working in a hospital, I tried to avoid this issue by checking in with any of my patients who were on PRN pain meds 15 to 30 minutes before it was time to go into report, and giving pain meds right before report.

I always appreciated it when the nurse on the previous shift did this too -- instead of having to rush out after report and give the pain med, it was nice to know that was taken care of.

This way I rarely got interrupted during report for this issue, but if I did, I would make them wait, for all the reasons you stated.

Yup - this. It's an unspoken rule on our unit - medicate *before* the next shift comes in... and it never fails, we have a pt that denies any meds at 6:40, but at 7:10, they want it now and I mean Now. Um, they have to wait. I typically tell my pt (when asking at 0640) that we are coming up on shift change and if they need anything, please let me know now, as it will be around 0730 before their next nurse gets to the room. For the most part, they do speak up then.

i think each case should be looked at individually. if the pt is in severe pain, then absolutely would i stop and give them something. however at our 7am report we do not answer call bells and have a sing up that says "do not disturb nurses while at report" people walk up see the sign and walk away. you can tell if it is important and then we will stop for them. typically the first person who is leaving is done giving report on their pt’s they go and get the call bell. at our 7pm report we have a nurse on 8h's who gets the bells.

if you have lots of call bells and things happening during report it sounds like maybe something needs to change at your hospital.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

When I was working in a hospital, I tried to avoid this issue by checking in with any of my patients who were on PRN pain meds 15 to 30 minutes before it was time to go into report, and giving pain meds right before report.

I always appreciated it when the nurse on the previous shift did this too -- instead of having to rush out after report and give the pain med, it was nice to know that was taken care of.

This way I rarely got interrupted during report for this issue, but if I did, I would make them wait, for all the reasons you stated.

This was a practice that I always practiced.....My last rounds would be any last minute concerns and pain requsts. I would be very specific that I was going into report and to"ask now" or wait until I was done. Although there would be the rare time I could not due to someone going down the tubes or a fresh admit.....It worke dout so well that my co-workers began doing the same because then I would get out on time and they didn't start behind the eight ball.

When I became a manager I instituted this practice and it went over very well and became the standard pretty quickly......man did out patient satisfaction skyrocket!!!

In a LTC facility, we had a LOL who was obviously a person with a dependency problem. She never showed any signs of pain behavior, nor would she respond with a verbal request to verify her need for a pain med. She went on the call light promptly at shift change, every night, like clockwork. Her attitude was as negative as could be considering she refused to speak a word. It was safe to wait until report was over to give her fix. I left before getting a chance to approach her doctor for an order for routine administration to dispense with the charade and her interruptions. Something tells me she would have kept up the call light routine.

punkydoodlesRN, BSN, RN

Specializes in Psych, OB-GYN.

This was a practice that I always practiced.....My last rounds would be any last minute concerns and pain requsts. I would be very specific that I was going into report and to"ask now" or wait until I was done. Although there would be the rare time I could not due to someone going down the tubes or a fresh admit.....It worke dout so well that my co-workers began doing the same because then I would get out on time and they didn't start behind the eight ball.

When I became a manager I instituted this practice and it went over very well and became the standard pretty quickly......man did out patient satisfaction skyrocket!!!

I guess I'm just a naive new nurse, but I thought this was standard - common sense, and how everyone did it. This was something my preceptor hounded into me - towards the end of every shift "check pain, check pain, check pain!"

Altra, BSN, RN

Specializes in Emergency & Trauma/Adult ICU.

I would not interrupt report to give a p.o. med.

Yes, I do. Plain and simple. Our manager even expected us to interrupt the narc count to let someone get a pain med out..which can cause an error. I know its annoying and we all want to get out of work because we have our own lives...but leaving someone in pain is just not right.

I usually try to medicate my patients before the change of shift...especially if I know they will be due at change of shift...even if its PRN. I do not always wait for a patient to ask for a PRN pain med. I ask them if they are in pain..just good practice. And no I am not enabling them..if you think that is where you are going to head me off with a debate.

In a LTC facility, we had a LOL who was obviously a person with a dependency problem. She never showed any signs of pain behavior, nor would she respond with a verbal request to verify her need for a pain med. She went on the call light promptly at shift change, every night, like clockwork. Her attitude was as negative as could be considering she refused to speak a word. It was safe to wait until report was over to give her fix. I left before getting a chance to approach her doctor for an order for routine administration to dispense with the charade and her interruptions. Something tells me she would have kept up the call light routine.

I think it is inappropriate to say someone is addicted. Pain is subjective and still remains to be subjective. As nurses we are not qualified to diagnose someone with addiction. Not looking for a debate and I will not debate this issue. We are to assess, plan, implement, and evaluate...that is it.

:)

Edited by nurse.sandi
correction

jnrsmommy

Specializes in LTC/Rehab,Med/Surg, OB/GYN, Ortho, Neuro.

I too am one of those nurses that medicate before shift change, and let the pts know that shift change will be happening at such and such times. I do not interrupt report to medicate. To me, it's no different than if I was in a room w/ another pt, the first one would have to wait until I could get there. If there's an emergency, different story altogether.

jmtndl

Specializes in NICU,ICU,ER,MS,CHG.SUP,PSYCH,GERI.

Absolutely. It meets the paients needs and saves a lot of trouble in the long run.:o

DogWmn

Specializes in LTC Family Practice.

Welll, when I used to work in a hospital environment we had team nursing, and one team would give report while the other covered at shift change, so it was never an issue, there was always someone on the floor who could medicate and address any issues and not disrupt report.

Angie O'Plasty

Specializes in acute care.

I too am one of those nurses that medicate before shift change, and let the pts know that shift change will be happening at such and such times. I do not interrupt report to medicate. To me, it's no different than if I was in a room w/ another pt, the first one would have to wait until I could get there. If there's an emergency, different story altogether.

That's the best way to handle this issue--plan things so that the patients are taken care of before report. That way nobody has to wait around in pain, and report can be uninterrupted (I happen to be of the opinion that report is not to be interrupted unless there is a true emergency--it's just too easy for errors to be made or information to be forgotten).

Heidi the nurse, BSN, RN

Specializes in School Nurse.

I remember one hospital I worked at had report taped so while the oncoming shift was listening the offgoing shift could cover any issues on the floor. We could meet up after everyone listened if there were other questions.

I'm also in the camp of topping everyone off before I give report. Check do they need anything. Of course, I've learned you can't go in right before report. What happens is they don't need anything then, but you get the wheels turning and they need something as soon as you're in report. So I do this early enough that they will come up with their requests BEFORE report starts. I do the same before I go eat lunch, a round long enough before that they don't call as soon as I pull my food out of the microwave. :D

imintrouble, BSN, RN

Specializes in LTC Rehab Med/Surg.

No. I too try to medicate before shift change. In this situation there is a nurse ready to go home, and a nurse ready to get started. Neither one of those things can happen until report is over. It may not be very nurse-like, but for those 15-25 min it takes to give report I put myself and my replacement first.

Just read what I wrote and it sounds self centered.:uhoh3:

JustaGypsy

Specializes in ER, SANE, Home Health, Forensic.

Multiple studies have been completed regarding nurse interruptions and mistakes being made because of it. Evidence-based practice dictates certain times that a nurse should not be interrupted and during report is one of them. Do rounds an hour before shift end, even enlist your aide to help; they are perfectly capable of asking re: pain/position/toileting and reporting back to you. Obviously in emergency situations all the rules can change... and do sometimes...

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