This is a vent. I got cornered by a surveyor yesterday. Patient was 98, post op ortho, lost a liter of blood in the OR, got transfused but needed a dose of a pressor after he dumped his pressure upon arrival to the PACU. White as the sheet. Anesthesia encourages me to start small with any pain meds I give. Did I mention the history of kidney disease?
Here comes the JC to question me about my care. ALL they cared about was if I was following the 1-10 pain scale, and if the pain meds were ordered according to that pain scale. (They were) They didn't like my mention of nursing judgement regarding the low BP upon arrival and my choice to start at the lower dose (which was within ordered parameters.) they demanded to see the orders for the parameters for the low BP r/t the pain meds. A co-worker jumped in to intervene at that point; she was quicker at pulling up the info they wanted.
I transferred the patient to the ICU then went to lunch. I was then told that the JC had demanded to see my file to assess my competencies. Director sent them to HR, as I am on orientation, and she didn't have anything to show them. I was pretty upset at that, even though everyone told me not to worry. Anesthesia MD said to me that if we are ONLY going to medicate according to the 1-10 pain scale without looking at the whole picture of what's going on with the patient we would kill a lot of patients. A robot could medicate that way. Do you think the JC will be there to have our backs after that kind of fallout? I doubt it. For the record, I did medicate the patient for pain twice, and he was comfortable and safe when he left my care.
