Published Apr 7, 2011
brownbook
3,413 Posts
I occasionally float to an out patient orthopedic surgical center. I overhear co-workers giving patients discharge instructions. They often tell the patient to set their alarm clock to wake them after, (I would guess what ever their prescription says, i.e., two pills every four hours) to wake themselves up and take more pain pills.
It just seems odd to me but I am not a regular orthopedic nurse and I have never had orthopedic surgery. I understand they might, will, wake up later and be in a lot of pain. So I kind of get it, but still I think to myself if I were the patient I would not do it. If I am sleeping well, deeply, I'd hate to be woken up. I'd figure when the pain came back I'd awaken naturally?
Honestly I think I, and patients, might more accidentally overdose themselves? I have taken pills at night and 1/2 hour later thought to myself ?? Did I take my medicine? I'd be concerned they'd take two narcotic pain pills, return to sleep, kind of wake up two hours later not remember if they took their pills and take 2 more!!!!!
indigonurse
216 Posts
From what I understand ortho pain is deep & pain control as I'm sure you know is most effective if the person takes the pain med before the pain becomes so intense that it wakes them up. It would be nice if this was explained to the pt. and let them make a choice.
LPNweezy
188 Posts
I agree! I was just going to say this exact thing! pain is hard to eliminate once it is intense. :heartbeat
glutton4punishment
142 Posts
OD on 2 extra pain pills is not likely.
I think the point is that if you let the pain get too high, then the dose will not work.
GM2RN
1,850 Posts
I'm not an ortho nurse but I do understand pain since I live with it daily. Pain that is allowed to return full force is difficult to control, requiring more medication to alleviate it or get it back to a tolerable level.
If someone were to awaken naturally due to pain from surgery, then take their medication, they might spend hours getting that pain back under control, losing sleep in the process. Much better, in my opinion, to set an alarm and take prescribed medication before the pain gets that bad, then fall back to sleep much more easily.
Flo., BSN, RN
571 Posts
I am an ortho nurse and that is what we tell our pts. Bone pain is very deep and can get out of control quickly. So instead of trying to play catch up it is much more effective to stay on a routine.
proudnurseRN
187 Posts
I am also an ortho nurse, but since I work nights I do discharges very, very rarely (3/yr). However, I do tell people I may wake them in the middle of te night to check their pain level and offer pain medication. I also suggest taking pain medication right before bed even if pain is a minimum.
I notice ortho nurses have a different perspective of pain it seems. I once floated to a floor (telemetry?) where the nurse was astounded that the dr ordered 2mg MS IVP every hour as needed. It's not completely unusual to see our MS PCA pumps set at 5mg every 30 minutes (it's not the norm by any means, but I see a patient with this order every few months).
Esme12, ASN, BSN, RN
20,908 Posts
Ortho surgery can be amongst the most painful of surgeries. This is instructed at first to keep ahead of pain control because once out of control..... ortho pain can become next to impossible to re-control. Most patients are reluctant to take meds of any kind and if you tell them as needed.......they think they really do NEED it so they take none. If you tell them for the first x hours wake up and take it......they will do as they are told........and be pain free.
Otessa, BSN, RN
1,601 Posts
I occasionally float to an out patient orthopedic surgical center. I overhear co-workers giving patients discharge instructions. They often tell the patient to set their alarm clock to wake them after, (I would guess what ever their prescription says, i.e., two pills every four hours) to wake themselves up and take more pain pills. It just seems odd to me but I am not a regular orthopedic nurse and I have never had orthopedic surgery. I understand they might, will, wake up later and be in a lot of pain. So I kind of get it, but still I think to myself if I were the patient I would not do it. If I am sleeping well, deeply, I'd hate to be woken up. I'd figure when the pain came back I'd awaken naturally?Honestly I think I, and patients, might more accidentally overdose themselves? I have taken pills at night and 1/2 hour later thought to myself ?? Did I take my medicine? I'd be concerned they'd take two narcotic pain pills, return to sleep, kind of wake up two hours later not remember if they took their pills and take 2 more!!!!!
Have had more than one surgery. Used the alarm clock for every 4 hours to take pain meds so I wouldn't wake up in agony at hour 5 or 6 and take a half a day to get back on track with pain reduction. Had a piece of paper next to my bed so I could write down the time I took and how many.
Writing down helps you remember and reduce risk of overdose.
NicuGal, MSN, RN
2,743 Posts
You have to stay on top of the pain...I had an open reduction of tib/fib fracture with plates and screws and it was intensely painful. Bone pain is awful. Even after another surgery I set an alarm every 6 hours for the first 2 days. Makes life a lot better :)
samirish
198 Posts
When my son was going through numerous operations for a bone tumor, we were instructed to give him the pain meds on a schedule whether he felt he needed them or not. The reason being was to get "ahead of the pain".
The one time, we didnt follow instuctions, was because he truly felt he was not in any pain and didnt want to take any more pills (he was 13yrs old)...sure enough the pain got ahold of him and the meds did nothing for him at that point. They ended up having to do a nerve block on him in the hospital at that point because the pain was so unbearable even after he already took all the pain meds his body could handle.
Lesson learned: STAY AHEAD OF THE PAIN
Your (unanimous) answers are great. I guess I didn't appreciate bone pain???? Thanks, I will recommend setting the alarm without reservations.