I recently took care of a pt with a foot fracture and he only had Tylenol for pain. I don't have any experience yet but I feel that this does nothing for pain of a foot fracture. And the pt is complaining that Tylenol does nothing for his pain...... However, there is an order that specifically states "Do not call the on-call MD for pain meds"...... Why? So the MD is aware of the pt's pain.... but does not want to give any other pain meds?
Sorry but I don't understand this situation... why not?
I like this response a lot for several reasons. One, you still get to advocate for the patient. Two, you follow the directions in the "order". Three, it punishes the ******* MD for writing such a piece of **** order that should be considered neglect if followed as intended. I suggest you wait until 3am to boot.
I like this response a lot for several reasons. One, you still get to advocate for the patient. Two, you follow the directions in the "order". Three, it punishes the ******* MD for writing such a piece of **** order that should be considered neglect if followed as intended. I suggest you wait until 3am to boot.
You have a great deal to learn. Start by actually reading the thread.
In Portugal we really use a lot of IV acetaminophen, with some good results. But thankfully, the hospital where I attend my orthopedic clinical, have protocols for pain management, and nurses can give some drugs per protocol, without an MD prescription. That protocol includes acetaminophen (PO/IV), metamizol PO/IV (I don´t really know the english name), clonixin (PO/IV), ketorolac, and tramadol. I saw great results with metamizol and tramadol.
When the pain was hard to control with this meds, we should call anesthesia.
There must be a reason for that order. We cannot assume that he or she does not know what she is doing. Perhaps looking at their record and medical history it may help you understand why that order is written. If there is a history of drug abuse then it makes more sense, but the pt still needs to be assessed for their pain. If there was something that worked besides tylenol and was not a narcotic, or something that was given in conjunction with tylenol- is that something to try to help the patient? Clarify with the doctor about this order if you need more information.
I love these orders! Many of my on call drs do not like to give narcotics because they do not know the patient. Like someone else said many patients will wait until another dr is on call to try to play the system with a different person. If they are in pain i as a night nurse tells the patient to continue taking what i have for pain even if you dont think its helping and have a honest talk with your dr in the day when he comes to see you. There is nothing that I can do when it comes to pain meds.
jeseale123
6 Posts
I like this response a lot for several reasons. One, you still get to advocate for the patient. Two, you follow the directions in the "order". Three, it punishes the ******* MD for writing such a piece of **** order that should be considered neglect if followed as intended. I suggest you wait until 3am to boot.