I am a first year nursing student who just finished a class about pain management. We were taught, that everyone has an individual pain tolerance and it should be treated if the patient expresses their pain. Fine. I was afraid when I was going into my lady partsl hysterectomy, cystecele repair, rectocele repair combo surgery about pain managment. Everyone assurred me that the hospital would take care of it. The morning after my late afternoon surgery, I was told that I 'shouldn't be in so much pain', "I must have a low pain tolerance", the nurses told me there were no orders for anything but advil and oral diladid. I begged for pain medicine. The 'doctors' (who I found out later were 4th year residents) told me "some women have different pain thresholds and that mine must be low". Every single one of these people looked for my incisions on my abdomen when they did their brief assessment. By the end of that day, the residents and nurses finally realized that I had a lady partsl hysterectomy with as one put it 'wow you had a lot of extra work done - we must have gotten behind on your pain medicine'. Finally they put me back on IV diladid. But wait - the nurses were so busy that they didn't stay up on my pain schedule. I waited three hours past the time for my meds and I was sobbing when my husband came in.
Can ANYONE explain to me how this can happen? Apparently my surgeon wasn't able to follow up with me that morning because of a snow storm. Not one nurse assessed my pain, not one nurse asked where I hurt, what the pain was like. Everyone just kept looking at me like I had a third head. And get this, when I asked the nurses and the resident to check my catheter because it hurt really bad - no one did. Finally, I lost my mind and yelled and insisted. The resident literally came over and said something about 'pain tolerance' and jerked on my catheter - which sent me through the roof and he said 'see that shouldn't have hurt - you must have a low pain tolerance'.
It has now been three weeks since surgery and guess what - I still can not void on my own. That's right. I have severe pain down my left leg, and left perineal area. And I still can't pee. I am in nursing school and I can think of many things a nurse could have done for intervention. Much of what happened can also be placed on the ridiculous actions of the residents, but couldn't the nurses have been more proactive????? Any comments?
I am so sorry for your experience. I can relate somewhat having had an abdominal hysterectomy. I thought I was prepared because I had already had 3 C sections, but that was pain with a capital P!
And I too have had a severe ear infection, resulting in a ruptured eardrum, "wow, that must really hurt!", yeah, genius that's why I'm here. 3 nurses mentioned something about a topical analgesic before they irrigated the pus out of my ear, but it was never used. I did a get Vicodin once they were done irrigating and digging.
Unfortunately, some nurses get complacent about care and forget about the individual, sort of like that movie "Doctors" with William Hurt.
I am sure you will use this unfortunate experience in your nursing practice.
Please take care.
Yikes! Just one thing, your not supposed to irrigate and ear if the eardrum is ruptured. That must have really hurt. I've suffered all my life with ear infections and there are not pretty. Probably one of the worse pains ever!
My doctor didn't get there till day two and by then I was told my meds were taken care of. He didn't really react to my recount of events except to say he was sorry. Crazier still, both residents wrote orders for meds, the nurse threw one set out when she saw it and sent me home with meds that didn't work. By then the surgeon was on vacation and his emergency number wasn't working.
Kind of a crazy experience, I ended up with an impaction to boot. I've just been crying all day and recounting all that has happened and vowing as a nurse to never let someone go through what I have. I still hurt, I still can't pee - ha ha. Not really funny, but I'm just sad. I have to start classes again in a week and I don't feel ready to go back. I see the surgeon for the first time tomorrow since the surgery. He will get an earful.
I just felt like posting. Because for goodness sakes, where were my nurses?? We are the front line, the patient advocates! :) At least that's what I hope we are. I just keep wondering why they didn't do a better assessment?
you really need to report those nurses.... it would be almost negligent of you NOT to report them; even if its anonymous! Can you imagine all the OTHER PEOPLE THOSE NURSES AND DOCS ARE TREATING THAT WAY!!!!!!!!
If what happened was really what happened the way you said it did; the people who treated you were acting abusively.... they should NEVER have mentioned anything about pain tolerance, other peoples pain tolerance, ignored your calls ect ect ect.....
It would truly be a horrible thing if YOU didnt report them.... Im not saying you need to get your name involved!
AND DONT THINK THEY WILL JUST IGNORE YOUR COMMENTS... especially if you send a FEW copies to all the RIGHT people.....
If youre not dropping your name so that youre not getting yourself into it, then you have NOTHING to lose!
I'm so sorry to hear what you went through. Do you have a Eurologist? I'm not sure what I can say legally.
I am not recomemding and am only sharing a story.
A Eurologist (bladder & urinary tract doctor) was a God send for my friend. .
I have a friend with intetstycial cystitis. She needed help urinating, she had a lot of pain, and all her other doctors would treat her for just a bladder infection. It took a while before she was referred to her Eurologist who helped her to properly urinate with medication. She had something called IC (Interstycial Cystitis). This Dr even sent her to a physical therapist that specialized in helping her to properly use her core mucles to help her to urinate. I don't know if any of her story is helpful.
That happened to me too, although my urologist was a REAL jerk! I was pregnant, and they kept treating me for UTIs, and what I had was hydronephrosis! They're were stones blocking my ureters, and causing LOTS AND LOTS of pain....
Finally when they found out I had the hydronephrosis, they began to treat me pain... before that the nurses were like "now are you really in pain or are you just stressed out...." asking me questions trying to "pin me" with anxiety and attention getting....
Yikes! Just one thing, your not supposed to irrigate and ear if the eardrum is ruptured. That must have really hurt. I've suffered all my life with ear infections and there are not pretty. Probably one of the worse pains ever!
That's what I thought! I had been to the doc earlier that day, where they had irrigated and dug out the impacted wax. She told me it would probably rupture and would feel better after that. When it did burst, it felt better for an hour and then, whammo! But the ER doc and nurse rolled their eyes when I told them I thought I shouldn't irrigate again.
Specializes in Infusion Nursing, Home Health Infusion.
You received horrible care. Nurses are to assess your pain as the 6th vital sign. They should not be judging you...labeling you...or deciding if your pain level is appropriate for the type of surgery you had.......NO..NONE OF THESE THINGS SHOULD HAVE HAPPENED. They need to assess your pain using a scale and then administer the prescribed medication....re assess and if the pain is not relieved to your acceptable level (assuming your VS are stable) they should have called the MD for new orders. It is also a good idea to have an assigned advocate on your side. I have found that when you are in a hospital bed it can be very difficult to advocate for yourself. Every time a family member is in the hospital we have a family member be their advocate
My favorite anaesthesiologist walked in today, and said to me, "How would you like it if this happened to you...less than 24 hours after your hysterectomy the surgeon comes and cancels all your pain medications?" I think my jaw must have been very close to the floor, and all I could was "who the hell did that?" Turns out the guy he assisted the previous day with a total abdominal hysterectomy had done precisely that. I have rarely seen him so angry....
I am sorry you had to go through that. Sounds like the nurses weren't very professional. You have the right to have your pain assessed and treated. There is no guarantee of being pain free though, some people confuse that part. But they should have called for different orders, tried different meds, and definitley should have given you your meds on a regular schedule. Getting behind on pain control is a very bad idea, will take much more to relieve pain. Sounds like they needed to be more compassionate with you also. You should definitely complain to the administration about the poor pain control. But there is nothing to see a lawyer about, unless their was some malpractice that resulted in injury to you. Unfortunately being a bad nurse(in this manner) isn't illegal.
I hate seeing a person in pain, and I always assess-treat-reassess to help control pain. In someone who regularly takes high dosages of pain meds it is almost impossble to completely get rid of their pain. But the patient deserves good treatment and being treated well. I am not saying or assuming you take alot of pain meds, just that some nurses need to be reminded that just becuase someone needs more pain medicine then what they think is "normal", they shouldnt assume the person is a drug addict or "low tolerance" and then just stop treating. I dont think that telling somone they must have a low tolerance for pain is necesarily a bad thing, but it is completely non-productive and has no purpose to be mentioned in the first place.
Specializes in PICU, NICU, L&D, Public Health, Hospice.
Being a patient in a hospital does not mean that you can be assaulted at will by the medical staff. Assault is a crime...even when committed by a physician in the hospital.
Specializes in maternal child, public/community health.
I am sorry that you had such a bad experience. There is no excuse for it. It doesn't matter what your pain threshold is - you had just had major surgery. This is not a normal physiological process. Pain is expected and should be treated. You are right that your nurses (and the docs) should have done something to help you. I am sure you understand that it is unrealistic to expect to be pain-free after surgery but pain control is an important part of your care. It is the responsiblity of your providers to do what they can to manage your pain. I hope that the rest of your recovery goes smoothly. Take care of yourself.
It is also a good idea to have an assigned advocate on your side. I have found that when you are in a hospital bed it can be very difficult to advocate for yourself. Every time a family member is in the hospital we have a family member be their advocate
I agree that everyone needs someone to be their advocate. In most cases, this means it is best if they stay with the patient the entire time. Even with good nursing care, things can get missed and nowdays, if you are sick enough to be in the hospital, you are almost surely too sick to advocate for yourself.
I had a family member in the hospital who is older and has anxiety even when she isn't in the hospital. She was having surgery with significant risk the next day. I helped her talk to her doctor when he did rounds and asked for a private room (the noise and confusion of a roommate was making her more anxious) and for an increase in her prn anxiety meds for the next few days (the current order was less than her psychiatrist had her taking outpatient). He agreed. They got her moved but before bedtime, she needed an additional dose and asked her nurse (who was fabulous) who said she could not have more. She tried to explain it to him but couldn't. I came back from dinner and she was obviously very anxious. I went to her nurse and explained. He looked and said, "He didn't write the order." I said, "Okay, but this is definitely a problem. How do you suggest we get this straightened out?" he said, "Sometimes the docs put them in wrong and they are hard to find, I'll look. If I can't find it, I will call him." He was a great nurse and really was an advocate for his patients but if I had not been there, my family member would have had no idea what to do (and could have wound up with a bad psych situation).
That sounds like a pretty awful experience to me. I'm sorry you had to endure that. I am a big believer in pain management. Only the person feeling the pain can rate it. Hey, so what if you have a low pain tolerance? medicate for the pain YOU are feeling, not what the nurses and residents think you should be feeling. I hope no male resident was trying to understand your pain of your very female surgery!!
I take my patients pain very seriously. I have only had ot be careful in pain med administration because my patients were old, ICU patients who could stop breathing or their BP was already in the crapper.
I had one patient who every one though was drug seeking. he had abd surgery, was a 40 year old HD patient. Maybe little difficult, but not drug seekeing. He ended up having vasular steel syndrome and everyone started writing off his cries for pain and disorientaiton in this very oriented man to the pain meds. Guess what? He perforated. Ended up almost dead on 3 pressors. he recovered thank God!
Another patient with end stage abd CA. He needed surgery but needed ot be stabilized. BP was on the low end but he was in PAIN. He said, please give me my dilaudid, I really don't care if I stop breathing or my blood pressure goes low. Hospitalist was there, he said go ahead, and I was thankful, because the biggest smile came on this guys face as he watched me push it. His BP did drop, but he reported he was pain free! That's fine by me on a end stage CA patient!
I just keep wondering why they didn't do a better assessment?
Coulter630
136 Posts
Yikes! Just one thing, your not supposed to irrigate and ear if the eardrum is ruptured. That must have really hurt. I've suffered all my life with ear infections and there are not pretty. Probably one of the worse pains ever!