I can't believe what this resident said!

[ds178630]

I have just started nursing school. That being said my knowledge of hospitals and how things work within them are not too great. My brother was recently in a car accident and is currently in the ICU. When the Orthopedic Attending was in the room going over the surgery, the resident who has been the primary one in the ICU (nothing to do with the Orthopedic staff) looked at my brother and began to say that he needed to be in pain, along with some other very concerning things. This was all said with my mother next to him.

He has broken a fracture in each limb, one being his femur. He has not been stable enough for surgery. He wakes up fights everything that is in him and then rest. He is in constant pain and is only given a very small amount of morphine every 9 hours.

I was just wondering on other peoples thoughts/opinions on this. Thanks.

[akulahawkRN, ADN, RN, EMT-P]

Sorry to hear that... but there's not enough info there to really make an informed comment about the situation. What I will say is that if you're concerned about pain, you probably should talk to the resident about the rationale behind the decision and if you still do not understand the rationale, talk to the Attending ICU physician.

[TheCommuter, BSN, RN]

I was just wondering on other peoples thoughts/opinions on this. Thanks.

Welcome!

It will be immensely difficult for the membership to formulate informed opinions on these issues without laying eyes on your brother or knowing what type of surgery he will undergo.

The physicians involved in your brother's medical care should be the ones providing their thoughts and opinions since they're the ones who are treating. You should ask them the tough questions. We wish your brother the best.

[calivianya, BSN, RN]

I don't know enough about the situation to make a judgement - but I will say that there is no such thing as "pain free" when a person has really severe injuries. He will definitely be in SOME pain. The amount of pain medicine it would take for him to truly be pain free would probably be enough to stop his breathing and kill him, or at least have him end up on a ventilator if he's not on one already.

If he really isn't getting pain/sedating medications, I have seen that done intentionally on brain injuries where the staff is trying to assess neuro status. You can't tell what a patient's neuro status is like if you have the patient way too sleepy from too much narcotics.

Like others have said, picking the physicians' brains is going to be a lot more helpful than picking ours since we don't know what's going on with your brother.

[Penelope_Pitstop, BSN, RN]

He is in constant pain and is only given a very small amount of morphine every 9 hours.

I was just wondering on other peoples thoughts/opinions on this. Thanks.

Are you sure he's not on anything else for pain? Every nine hours is kind of a strange set of parameters. A lot of patients in ICUs are on fentanyl drips that deliver continuous doses of IV pain medications even if they receive doses of pain medications for "breakthrough" pain. Next time you're in his room, look at all of the IV bags hanging.