Nurse questioning pain med

BD-RN, BSN, RN · May 3, 2015

Ahhh but you see young grasshopper (not you, the other nurse), lying on an operating table in most likely an awkward position can cause all sorts of joint and back pain. So technically, it could also be related to the procedure. Boom.

That's not true anyway. Pain is pain is pain, and it should be treated.

KatieMI, BSN, MSN, RN · May 3, 2015

There is nothing criminal in asking physician for separate orders for different kinds of pain, especially if patient already takes pain mess for chronic pain.

Like:

Morphine 1 mg IVP Q4H PRN for moderate pain (related to the place where incision was)

Oxycodone 5 mg po Q8H (for baseline low back pain)

allnurses Guide · May 3, 2015

There is nothing criminal in asking physician for separate orders for different kinds of pain, especially if patient already takes pain mess for chronic pain.
Like:
Morphine 1 mg IVP Q4H PRN for moderate pain (related to the place where incision was)
Oxycodone 5 mg po Q8H (for baseline low back pain)

As chronic pain sufferer (ulcerative colitis and fobromyalgia) I like the way you think. I only use narcotics (norco) if absolutely necessary and never when working. When I have been in the hospital for surgery (Three times) I always had baseline step orders for pain ie mild to mod (tylenol) Moderate to severe Norco) Only ever used morphine when I had 18 inches of my colon removed in 2012).

Pain needs to be treated - unfortunately too many nurses young and old refuse pain medications to patients because they have the mindset that they are not going to medicate med-seekers. IF you have an order and the pain is present and it's within the time frame just give the dam med! I have had new grads refuse to give pain meds to end stage hospice CA patients. Whe I ask for their rationale they say something like "I don't want them to looped up" or the veteran with an amputation - "He's med seeking" rediculous,

Hppy

BD-RN, BSN, RN · May 3, 2015

When controlled substances are used in a controlled environment for their intended purposes, the risk for addiction and unintended side effects are low. The key is using the appropriate medications, and the smallest effective dose. IVP dilaudid wouldn't be appropriate for chronic back pain. But slow release medications and 5-10mg oxycodone for breakthrough would be. Tylenol is a GREAT underused pain medication, especially when used with opioids, hence why we have norco and Vicodin.

Again, back or neck pain could be related to positioning on the OR table during surgery. I would definitely bring it to the attention to the physician, ask the patient about their history, and if it's acute treat it with the prescribed pain medications if I feel they are appropriate. If they're not, I'd ask the doc for something else.

If the patient does have a documented history of complicated pain control, I'd request the MD order a pain consult.

toomuchbaloney · May 4, 2015

I had a nurse question my giving a pain med for a patients back pain. The patient was admitted for an skin infection and had a I&D. The other nurse felt that the pain medication should only be given for the pain related to the procedure.

Thank you for treating your patient's pain rather than treating your co-worker's bias about pain medications.

Tenebrae, BSN, RN · May 4, 2015

What did the med order say?

I've never ever seen an order for analgesia that said "Only to be given for pain related to the surgical incision"

Did she explain her rationale? IMO pain is pain, unresolved pain has a huge impact on a patients body.

june2009 · May 5, 2015

Unless the actual order said give for pIn related to surgery (and like a previous poster said it could be if the pt. Was in an akward position on the table) I think you're ok. I just always make sure that I give the least amount of pain medication that will be effective for pain. That being said, you may need to get a separate order for a different pain med related to the back pain. Easy enough to do.

Here.I.Stand, BSN, RN · May 6, 2015

I've never ever seen an order for analgesia that said "Only to be given for pain related to the surgical incision"

Very true! ^^^

I agree with you completely. I mean, does a patient's chronic pain disappear when they're admitted for something unrelated? Do people never get a random headache when admitted for something unrelated? Heck do people never get a backache from those ooooooohhhhh so comfy hospital beds????? :sarcastic:

And there is no way I'm calling an MD to ask for separate Rx's for post-op pain, headaches, backaches. Honestly. We are professionals who went through rigorous programs and passed the NCLEX. Prescribing is outside our scope, but didn't we all learn how to assess our patients and treat accordingly with nursing interventions and certain medical interventions (think of that Venn diagram illustrating Nursing and Medicine)?