PFryRN

Hi, My LTC/SNF has recently established a pain management comittee consisting of 3 RN's, 2 CNA's (all from different shifts), 1 activity coordinator and 1 representative form the World Health Organization. We are brainstorming for a better policy (one we don not have) for assessing and managing pain. Pain is most often undertreated and least recognized based on a recent study performed in my State. There are many, many issues involved in order for such a policy to work such as understaffing-which is almost unavoidable, MD's not willing to prescribe stronger pain meds &/or overmedicating, lack of knowledge among staff (ie. recognizing s/s of pain in patients not able to verbally express pain) etc...etc... the list goes on. I was hoping for some input from other RN's and does your facility have a policy, assessment forms, education programs etc??....and is it working. Thanks in advance for any help with this issue. PF

I am fairly new to the LTC scene as a "new" nurse of 1 year, but my FIRST thought, when I read the post, was possibly that a UTI may be involved here. I find that UTI symptoms come in many non-textbook forms ie. when a resident falls (thatis not typically at high risk), or all of a sudden become confused, c/o back pain rather than burning, urgency or frequency etc...there is a good chance a UTI may be contributing to her symptoms. I was also wondering Did she bang her head when she fell? Does she have osteoporosis? Does she take coumadin or ASA? Is her pain refered pain? etc.....From what I read in the post, my apporach now (after xrays, pain control etc) would to be to find the cause of the fall (assuming she was not a high risk pt)? Was her back injured before she fell? Is she afebrile? Does she have urinary c/o? etc.. etc.. Let me know how she made out..I hope I was helpful. Have a good day.