Quote from momcats3
Thanks so much for the ideas and words of encouragement. Have looked at Elavil, Neurontin and others as adjuncts and for one reason or another, they didn't work out. I'm going to look into the Tegretol for her...Also talked to our NP who'd done a pain eval. for this patient last fall. We made recommendations then, which the facility/MD agree with, however, they will not agree w/our latest recommendation on increasing the med. And, BTW our NP told me that, at that time, these same nurses laughed, actually laughed, when they heard we were evaluating for pain control. So, am still fighting hard - have a great hospice team behind me, and we WILL get her pain undercontrol. Oh, and by the way, rumor has it that the state will be in there w/in the next 2 weeks. I've been documenting everything....If nothing gets resolved, will take it further.
Don't give up! You are on the right track. You have received a lot of great advice. THE biggest thing that needs to be done is a VERY thorough pain assessment. I have found that even the most confused or demented patient can let me know about their pain as long as I am observant and patient with them long enough.
I have been working on Pain managment for the past 29 years and have been a pain management Nurse specialist for the past 15 yrs. I see RED :angryfire when I encounter individuals whether they be nurses, or physicians or family members who discount a patient's pain complaints. BUT I try to use each incident as a chance to teach about the effects of untreated pain.
The research is out there that shows that when pain is not treated and is allowed to continue the nervous system changes and nerve endings that normally do not transmit pain are now being recruited to transmit pain messages. Thus the patient's pain grows and they will say I hurt all over and even my skin hurts. and confused patients will become agitated and combative when they are touched and turned.
I have had personal experience with severe pain that was not believed. I also had a sister who died (at the age of 42) from metastatic colon cancer because she was labeled as a drug seeker, neurotic over anxious female and NEVER really assessed for the pain that she had for three years.
Compassionate care demands that we treat each person as we would like to be treated if we were in the same circumstances. No one is immune from pain and my continued dream is that one day I will be called to the bedside of one on the "unbelievers" and have the opportunity to teach them about pain treatment, in a compassionate way OF COURSE!
I could go on and on about pain managment but I will stop here..
keep us posted! and good luck, you are in my thoughts!