Nurse accuses patient of drug addiction!

vsigns · Apr 27, 2009

Sometimes-more pain meds cannot be given due to risk of overdose. Sometimes Versed is given humanely-so the patient won't (hopefiully) remember the pain and Sometimes we don't know if it was for the nurses benefit as we were not there. Pain sucks no matter who you are, I can't think of one person who wants to be in it.

GadgetRN71, ASN, RN · Apr 27, 2009

The PACU patient was acting disoriented and combative though. Screaming and yelling is not the behavior of a rational person in his/her right mind. Now, this pt couldn't help it, but you can not treat them the same as a person with all their wits about them. There's a reason they tell you not to sign any legal documents 24 hours after surgery..

I guess my main point was, things are done differently in a perioperative environment for good reason. There's a lot more leeway with restraint use, because safety is a big concern. It will do the pt no good if they start pulling out drains, IVs or compromising their incision.

And like the PP said, we don't know what the true story was because we weren't there.

Happygolucky47 · Apr 27, 2009

The PACU patient was acting disoriented and combative though. Screaming and yelling is not the behavior of a rational person in his/her right mind. Now, this pt couldn't help it, but you can not treat them the same as a person with all their wits about them. There's a reason they tell you not to sign any legal documents 24 hours after surgery..
I guess my main point was, things are done differently in a perioperative environment for good reason. There's a lot more leeway with restraint use, because safety is a big concern. It will do the pt no good if they start pulling out drains, IVs or compromising their incision.
And like the PP said, we don't know what the true story was because we weren't there.

Apparantly, I need to clarify, I reread my post, and you are correct, things didn't sound right to me after I reread it, in the PACU, it is a different world than working the floor, THE patient is coming up from anesthesia, they are disoriented, they are in pain, and they are waking up. I"ve always thought of it as being just below the surface of water and not being able to break thru. I have NO PROBLEM in medicating anyone, and I don't want them to be in pain, nor do I want them yelling and getting everyone else in a tiz. I had talked to the DR, and had asked him for more meds, I understand that the chronic painers have a higher tolerance for narcotics, and I understand that they know what works for them. BUt I also know that when a patient is yelling and carrying on, it's not gonna help with the pain either, when you can't relax, the pain meds won't work as well , it's gonna take more and more and then ....resp arrest, yes that can happen, especially in the pacu, I"ve bagged more than a few people after being over medicated, because eventually the meds catch up, be it in the PACU, or after they are on the floor, amb, wherever,. Giving Versed in the PACU, is twofold, 1) Put them back down and let them sleep thru that initial pain, most people after carrying on like that, and then receiving versed, wake up the second time in better control (which incidently is what happened to that patient) 2) Chemical restraint, well yes it is, however it is a safety issue as well, you can't have them pulling at tubes, and such, nor can you have them thrashing about on the carts, like I said they are disoriented, and in pain. So while many of you are appalled, i'm sorry for that, however I only have the patient in mind, and giving versed in the PACU, while on a monitor and someone to watch over you, watching your airway, to me is a better alternative, than giving more and more narcs. only to send you out of there to somewhere else and have you crash, when all the narcs hit. LIke I said, put them back down, let the narcs they already recieved take affect and when they wake up, they feel better. That's all I'm saying, :idea:

MichelleB34 · Apr 28, 2009

First, I am also disgusted by the actions of your coworker. It is never easy when you have to report a fellow worker. A few years ago there was a male nurse where I work that was either let go or asked to quit. There were a series of inappropriate behaviors toward staff and patients. We dealt with the situations directly with the staff member as they arose. We should have brought them to the attention of our director sooner. We put our boss in a bit of a difficult spot because when someone is let go it is helpful to have documentation of the disciplinary process. ie verbal warning, written warning, etc. Keep us posted.

RetiredTooSoon · Apr 28, 2009

There's a reason they tell you not to sign any legal documents 24 hours after surgery..

Our patients were told that they were legally impaired for a minimum of 48 hours post op. It could take that long for the person to recover from the effects of the anaesthetic medication in their system. Even with that 48 hour space, the patient is often still on narcotics, which can also affect one's ability to make legal decisions.

morte, LPN, LVN · Apr 28, 2009

Apparantly, I need to clarify, I reread my post, and you are correct, things didn't sound right to me after I reread it, in the PACU, it is a different world than working the floor, THE patient is coming up from anesthesia, they are disoriented, they are in pain, and they are waking up. I"ve always thought of it as being just below the surface of water and not being able to break thru. I have NO PROBLEM in medicating anyone, and I don't want them to be in pain, nor do I want them yelling and getting everyone else in a tiz. I had talked to the DR, and had asked him for more meds, I understand that the chronic painers have a higher tolerance for narcotics, and I understand that they know what works for them. BUt I also know that when a patient is yelling and carrying on, it's not gonna help with the pain either, when you can't relax, the pain meds won't work as well , it's gonna take more and more and then ....resp arrest, yes that can happen, especially in the pacu, I"ve bagged more than a few people after being over medicated, because eventually the meds catch up, be it in the PACU, or after they are on the floor, amb, wherever,. Giving Versed in the PACU, is twofold, 1) Put them back down and let them sleep thru that initial pain, most people after carrying on like that, and then receiving versed, wake up the second time in better control (which incidently is what happened to that patient) 2) Chemical restraint, well yes it is, however it is a safety issue as well, you can't have them pulling at tubes, and such, nor can you have them thrashing about on the carts, like I said they are disoriented, and in pain. So while many of you are appalled, i'm sorry for that, however I only have the patient in mind, and giving versed in the PACU, while on a monitor and someone to watch over you, watching your airway, to me is a better alternative, than giving more and more narcs. only to send you out of there to somewhere else and have you crash, when all the narcs hit. LIke I said, put them back down, let the narcs they already recieved take affect and when they wake up, they feel better. That's all I'm saying,

going back and "touching up" the story, only after someone agreed with you....is a little much.....and you still lied....were i come from that is assault