Request for pain meds and then asleep

PANurseRN1 · Jun 28, 2006

I would have given the pain med. Sleep can be an escape mechanism when pts. have pain, and it's also possible the pt. was exhausted from her pain.

She must not have been sleeping that soundly if she woke up 10 minutes later.

Sleep does not= absence of pain.

leslie :-D · Jun 28, 2006

i would wake them up, just as i would wake anyone up who requested a pain med.

i wouldn't treat a pt of a staff member any differently than any other pt i had.

often, pts aren't in pain but are fearful about being in pain, and request a prn to stay ahead of it.

and if that is the case, then i'm all for staying ahead vs chasing the pain.

leslie

Antikigirl, ASN, RN · Jun 28, 2006

What I have done in those situations is ask the pt what they would wish! Do you want me to wake you for pain meds, or let you sleep! Also reminding them that if they are very asleep or resps are down...I am not giving because of protocol and their resp safety! That usually does the trick!

If you have a pt that is sleeping soundly, you don't have to give pain meds! I mean...it is rational...if they are sleeping..resps down and no way to judge the effectiveness in 30 minutes...well...I don't give unless I have asked the pt and documented that fact. HOWEVER...AND big HOWEVER>>>>>

There are pts that can sleep only because they have pain control...so experience and good assessment will guide you! You can see that clearly with patients on PCA's...they fall asleep but wake up in 10/10 pain because they were too sleepy to press the PCA button. That is when I guage things...and hopefully the RN before you has good notes on pain managment to help!

Despite trying to make a staff member happy...the responsiblity is to your pt..and you have the judgement to take care of them right?!?!? Watch your pt carefully, and you can figure it out....and TRUST your judgment and pass it on (PLEASE!).

rpv_rn · Jun 28, 2006

I agree with earle58.

All patients have a right to pain relief.

You need to assess her pain level (0-10 scale), location, quality, etc., prior to giving her analgesia. Sleeping is a form of distraction from the pain.

SouthernLPN2RN, MSN, RN, APRN, NP · Jun 28, 2006

This particular pt wasn't actually in pain, just wanted something to help with sleep. I was afraid of an additive effect since I had already given a sleeping pill an hour prior. I felt fully justified in my decision, I was just afraid the other staff member would get mad about it.

5781cedonia · Jun 28, 2006

I

leslie :-D · Jun 28, 2006

This particular pt wasn't actually in pain, just wanted something to help with sleep.

then you were right in not giving it.

plus the pt fell asleep w/o the pain med anway.

if you worry about your colleague, then have him/her take it up w/the dr.

it's your license, your judgement, your decision.

we won't even get into doing things for the sake of another staff person.

right? right.

leslie

beautifulb · Jun 28, 2006

If a pt. had asked me for a pain medication and then I left to prepare it (which at times could take 5mins or more) then go to the pt's room to find the pt. sleeping, I would gently shake the pt's shoulder and say "Ms. jj, I have your pain medication." Usually the pt. would wake right up and then take the pill. If they don't wake up after that, I will waste the med until the next time they asked.

But I do as TriageRN does. When I come in for my midnight shift and do the initial assessments, we talk about pain control. "Would you like me to wake you up when your pain med is due or would you rather be left asleep?"

PANurseRN1 · Jun 28, 2006

This particular pt wasn't actually in pain, just wanted something to help with sleep. I was afraid of an additive effect since I had already given a sleeping pill an hour prior. I felt fully justified in my decision, I was just afraid the other staff member would get mad about it.

I would have answered differently if this had been clearer the first time.

catlady, BSN, RN · Jun 28, 2006

This particular pt wasn't actually in pain, just wanted something to help with sleep. I was afraid of an additive effect since I had already given a sleeping pill an hour prior. I felt fully justified in my decision, I was just afraid the other staff member would get mad about it.

I'm a little confused here. If you assessed her to have a pain level of zero, why would you have prepared a pain medication for her, as you mention in the original post? And why would you treat this patient any differently than any other patient? She either should have gotten the medication or she shouldn't. The staff/family member is irrelevant.

If she did have pain, the medication would likely have helped her gain a more restful sleep, even if the sedative had already done its job. She should have been gently roused, if it had really only been five minutes since she asked for it.

SouthernLPN2RN, MSN, RN, APRN, NP · Jun 28, 2006

Her pain level was assessed. Upon her awakening, she asked for a non pain med by name instead of the pain med she requested (also by name) 15 or 20 mins prior. Case-specific, I'm justified. My question is do folks do one thing or another across the board. I don't wake patients when they're snoring so loud I can hear them up the hall. If they're dozing and respond when I call their name (normal voice, not loud) then I give it. Otherwise I take it back for later. This is in the case of a requested prn. Now if it's scheduled and their status is good, I wake them up.

In cases where I ask questions about real life events, I keep the details to a very minimum to avoid any repercussions, so please excuse any details that are left out. I didn't mean for it to be dissected so much as I did for it to provide an example.