Ortho Docs and pain meds

[onyx77]

Have you ever encountered an Orthopedic MD that would NOT give a pt pain meds when they are clearly in a lot of pain, knowing that currently all that pt had for pain was tylenol and that they couldn't get in for a hip replacement for 4 months?

[beeker]

I've cared for patients POST hip replacement with nothing but tylenol, but that was because they were confused and the Dr was a jerk.

I would have to ask what else is going on with your patient? What kind of history do they have? Is there something important, like addiciton or pain pill seeking, or history of cancelling surgeries or something? What reason did the Dr give for not prescribing pain medication? Perhaps they could have Ultram or something?

[K+MgSO4, BSN]

I get ortho truama pts like that all the time with traumatic spinal fractures and possible brain injuries that cannot have anything bar paracetamol as anti inflammatories could exacerbate a bleed in the brain and narcotics could mask a drop in GCS

It is terrible!

[locolorenzo22, BSN, RN]

i have had non narcotic orhto patients due to confusion or other medical issues, but if this is the case the patient should ask for referral to a pain specialist to determine how to control pain before surgical intervention is available.

[onyx77]

MD simply stated he wouldn't give him pain meds and told him to see his primary. Mind you pt was seeing an ortho an hour away from home or his primary. Ortho MD wouldn't even contact the primary via phone or fax to make sure that pt left the facility with something for pain. (pt receives med via mail with the VA. but could've pick them up at the hospital he was seeing ortho in) Pt did not even want narcs. Just something stronger for the pain, so he could actually walk for the next 4 months! Pt is A&O x3 with COPD and CHF without hx of addicition or pill seeking. Just simply there on referral of his primary for a hip replacement.

I just found the situation extreemely frustrating.