Fentanyl Consent?

[Whitesranch, BSN, RN]

Patient complained in post op phone call that he did not give his "consent" for Fentanyl in pacu for post op pain. He was my pt and did not object when instructed what I was giving him, what it is for, when it will start to work and how. I was called by my charge nurse and questioned about it. Never had this happen before, 21 years of nursing. Are we supposed to now document that pt agrees to pain medication administration? How far will we have to go to protect our practice? Please advise.

[Wuzzie]

Well that's just stupid and if the complaint goes anywhere that would be even more stupid. I'm sure he's freaking out because Fentanyl has been in the news so much lately. He probably doesn't understand that in the hospital setting it's an appropriate medication.

[Whitesranch, BSN, RN]

Yah, that's what I thought too! But my charge nurse said "well, did he?" I was offended that she was even entertaining the complaint. I said to her "well, he didn't object!" Uuuuuggghhh!

[offlabel]

Yah, that's what I thought too! But my charge nurse said "well, did he?"

The answer to that dumb question was "yes, he did, when he signed his consent for surgery and anesthesia". What's he supposed to do, go down the entire list of the meds he got that day and sign a consent for each one?

The charge nurse needs some training, IMO.

[HeySis, BSN, RN]

And you most likely didn't give him his first dose of fentanyl... our anesthesiologist use it in the OR all the time.

If my pt is awake I always ask if they'd like pain meds in their IV, I only chart when they refuse.

I have been told by quality control that if you have a standard practice and can relate that to how you chart, then you are covered. So I always chart the same things in similar ways, so I can look back at it and say... he was having pain and consented to pain meds, if he had not consented I would have charted that as having pain, refused medications.

[Whitesranch, BSN, RN]

Right, denies need for pain med at this time. Exactly. I have to believe this pt would have had an issue either way:/

[JKL33]

Yah, that's what I thought too! But my charge nurse said "well, did he?"

Oh for goodness' sake. I am completely serious when I say that I would have calmly told her that her line of questioning was inappropriate and that I will not discuss it over the phone and am hereby requesting that she email me with her inquiry.

That's how you handle that.

If you don't know the outcome (or what this CN wrote in her report/log) I could contact your manager and inform them of the inappropriate call and find out whether you need to provide a written statement or if the matter is closed.

[Whitesranch, BSN, RN]

The way I figure, he wouldn't be able to "consent " to anything after general anesthesia! People have lost their minds! I will definitely clarify all this at the Country Club Christmas Party! Lol

[Scififan]

Apparently this man couldn't think of anything else to complain about. If you had not given him the Fentanyl would probably complain that he was denied pain relief.

Unfortunately in the PACU setting patients often are confused and forgetful but can often fixate on something they believe did or didn't happen. Feel your Manager should be more supportive of you and your nursing decisions.