Post-op Pain protocol

Published Feb 5, 2018

161 Posts

I've always had an interest in PACU ,, However, I have a personal questions that has been bothering me a while. I dont understand it and am hoping you guys can explain it to me.

I had a major shoulder surgery in an outpatient clinic (major surgery due to injury sustained at my [then] dialysis job ((side note I was the second teammate out of 15 to require major shoulder surgery within a 4 month time frame)). ... but i digress....

I had a great surgeon. I spoke with the surgery center nurses before hand. I specifically asked if pain control post op would be a priority.. "oh of course it is" is the answer I got.

I did get a intrathecal nerve block with made me eye droop, stuffy nose, numb skin.. but that is IT!!!!! did NOThing for pain control.

I went in under general.. who knows what i got during.. the surgeon later said they must have gotten 'behind' on my pain control.

Anyway... when I finally woke up in PACU, other than the horrible throat pain... my shoulder was wrapped up, in a sling, and in INSTANT horrific pain!!!! she gave me 100 mcg fentanyl in divided doses that did absolutely NOTHING!! then she seemed very reluctant and had to discuss with another nurse rather to give me the dilaudid. I got a total of 2 mg in divided doses. My pain was still at a 7 after all the meds.

The PACU nurse said that is the maximum amount of pain meds we can give we will hve to send you back out to get some percocets. I was very irritated because i was in horrible pain and the job of the PACU is to CONTROL pain!! I was worried that had i asked for anything more.. i would have gotten "that LOOK" most nurses like to give and then cut you off completely out of spite and "instant unfounded suspicion " of drug seekers just because you want some relief (And I have seen this attitude and negligence more times than i care to say..makes me sick!)

Had I been in my right mind I would have asked to speak to the anesthesiologist because i KNOW they can easily over ride orders!

By the time i was sent back out...i ended up needing 2 doses of labatolol because my BP went from 118 (pre op) to 170-180's post op. PAIN!!!!!!!

It was the most horrific pain and has been the longest most painful surgery ever!

My problem is i will need my other shoulder done (thank you nursing for destroying my body).

I am scared to death I will have to go through that again. Is that NORMAL to send patients on their way while still in such pain? Is pain such an insignificant issue as it is in most units that patients just have to deal with suffering? Cuz we ALLLL now how ice and sniffing some aromatherapy will cure everything!! Even after surgery i had to beg for pain meds. Not as a seeker.. as someone who couldnt even get off the couch for 5 weeks because of pain... 23 weeks out from surgery.. still in significant pain. Which isn neither here nor there... just ranting..

My question is... is it really like this? get pretty major surgery that is extremely painful (now i do understand some deal with it better than others.. I have a neurological disorder and the nerve block did NOT work) is your priority to treat them and street them while charting just enough to cover your own butts?

Should i have asked to speak with the anesthesiologist? What can a patient do or say at this point to advocate for themselves when they are in excruciating pain and you can tell the nurses just want you OUT so they can get the next case going????