pain medications post op day surgery

[bsmucker]

Can nurses give a pain medication from a prescription written for home to patients during their post op period in day surgery? Our surgeons will not write post op orders for pain medication during the post op period. Our facility is telling us we have to write the order from the script, fax it to pharmacy and then wait for them to put it on our MAR, then give it to the patient. Administration will not inforse surgeons to write post op orders.

signed, frustrated!

[roser13, ASN, RN]

That's an unusual way to function, in my experience, and very convoluted. How do the patients receive their pills to take home? I would think that those pain pills are meant to last x number of days and I'd hate to be using up their quota in the immediate post-op.

Given that surgeons are gonna be surgeons, our anesthesiologists write post-op pain control orders. PACU nurses have standing pain control orders from Anesthesia also.

[bsmucker]

Thanks, for your response. The patients receive their pills at home by a written prescription to take home. Our anesthesiologists only cover the PACU period not day surgery period. The surgeons are not wanting to write post op orders for the short time they are in Day Surgery until they go home. So, we have to copy the prescription, write a verbal order and sent it to pharmacy which makes a delay for the patient to get their medication. I feel like the surgeons should write post op orders, but admin will not make them.

[brownbook]

Our anesthesia orders cover the entire stay for our same day surgery patients but we recover and discharge in the same ward, we don't separate PACU to "day surgery area." We have no problem calling anesthesia and asking for such and such pain medication?

Do your patients go from PACU to a different discharge/recovery area when they are stable?

Well....the whole issue is to confusing to me.

I would think the head of anesthesiology would be a good person to take it up with?

Maybe just add a line to routine PACU orders for either the surgeon or anesthesiologist to mark off that patient may receive whatever prescription pain medication has been ordered for home while in day surgery area?

[bsmucker]

Yes, our patients leave the PACU area and go to a Day surgery area then home. The problem is that no one wants to "enter" the orders in the computer , which is required in order for nurses to get the pain medication out of the pyxis and then enter it in the e mar. Anesthesia, enters orders for PACU, but then is it the surgeon responsibility which does not make a lot of sense. I like the one line for surgeon to enter an order for the pain med, idea! thanks

[mmc51264, BSN, MSN, RN]

That's the stupidest policy I have ever heard. Do sx and then not medicate for pain? ugh. I am surprised that patients haven't caught on and quit coming. I'd be really angry.