Waking resident to give pain injection?

Long Term Care Columnist / Guide · Mar 18, 2003

I would ask the MD to consider switching to an IV pain med, given through a saline or heparin lock, on a regular schedule to manage pain without creating unnecessary sleep interruptions or physical distress. As you are probably aware, pain meds work best when given around the clock rather than on a PRN basis, and this way you're making sure the resident is receiving them in timely fashion without disturbing his sleep, which is also important

in pain management (you might clue the family in to this as well).

Good luck.

RNonsense · Mar 18, 2003

What does the resident say?? Anyway, perhaps a fentanyl patch or whatnot would be a better regime for him...

aimeee, BSN, RN · Mar 18, 2003

What is the source of this resident's pain? If this person has around the clock pain, then he should have a long acting pain med scheduled like oxycontin or a duragesic patch and also have a prn dose for breakthrough pain.

kittyw · Mar 18, 2003

Let's see.... we want to wake someone who is sleeping well to give them a painful pain shot..... :rolleyes:

Definately advocate for some other method. I bet a little family teaching would go a long way. If this is long term, patches or a sustained release pain med would be better. Short term - a hep lock and an IV push med would work too. I would think that anything would be better than an IM shot.

graysonret · Mar 25, 2003

I agree with RNnonsense. Perhaps a patch would work much better for the patient. At least, you don't have to wake him and you only have to change it q3 days. :). Of course, it depends on what type of pain. Much better than a heplock which can carry the possibility of infection.

NancyRN · Mar 25, 2003

It really upsets me to hear about "family" telling a doctor how to practice medicine.

I had a cancer patient crying with pain all night and all I could give her was one percocet. When I called the doctor, he said "the family" didn't want her to be groggy when they came to visit (for 15 minutes a day). Puh-leeze!!

sassynurse78 · May 13, 2003

I agree with the patch or maybe an extended release med. I ran into this once before, I woke the person up the first couple of times, but after that i started charting the res appeared to be sleeping without s/s pain or discomfort routine pain med withheld. Once I started doing that other nurses did to, we finally got that order d/c'd and switched to a duragesic patch.

sbic56, BSN, RN · May 13, 2003

It is true that sleeping patients feel pain, but why wouldn't the doc respond to the needs of the patient by ordering a patch? I'd suggest it.

graysonret · May 13, 2003

As anyone noticed, in the medical field, that everyone is a "doctor" but the doctor? I'm talking about friends, families of the patients.

curlyqluli · Jun 15, 2003

I firmly believe that pain medication must be taken seriously. Even though a patient is sleeping DOESN'T mean that they are not in pain. However, I also don't think that you should just poke them for their med without letting them know first. Why don't you ask the Doc to change their med to IVP? Or maybe even a PCA pump?

nialloh, RN · Jun 15, 2003

Why not order the shot around the clock while awake. That way if he wakes up, give him a shot, if he is sleeping, let him sleep. It is hard enough for pts to get to sleep as it is, without waking them up.