setting alarm clock to take pain meds?

Nurses General Nursing

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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!!!!!

Your (unanimous) answers are great. I guess I didn't appreciate bone pain???? Thanks, I will recommend setting the alarm without reservations.

this thread could be a great reminder, that any type of pain is best treated with scheduled/atc dosing.

do you think we can all keep this in mind when those pesky, med-seeking pts want their meds atc as well?

why is it "med-seeking", if the concept remains as staying ahead of the pain?

(i really don't expect an answer, knowing that we need to stay on topic. i am just encouraging some food for thought.)

leslie

I am not an ortho nurse but pretend I am in my own mind sometimes.

(couldn't resist)

The patient will find out quickly if they need to set their alarm clock ... or not. Years ago, I had a condition that when it was active was seriously 10/10. You betcha I set that alarm.

Specializes in Critical Care.
Your (unanimous) answers are great. I guess I didn't appreciate bone pain???? Thanks, I will recommend setting the alarm without reservations.

Another aspect to keep in mind re: ortho bone pain is the fact that if the pain is allowed to get out of control, the pt's won't be able to do the phsyical and occupational therapy they need to get back to completing their ADL's. SO much therapy is required, it's a lot of hard work. These patients just don't have time to lay in bed all day because they got behind on their pain meds.

When my mom had hip replacements years ago, her doc told her for the first couple of days I'll be scheduling your pain meds. Take them as I order and you'll get through the first few days and be able to do all we ask of you. Mom did that and came through it with flying colors, up ambulating independently in no time. Fast forward a couple of years, time to have other hip done by different doc. He wasn't as agressive with pain management, in fact was quite stingy with pain meds and she was in agony. Had a much more difficult course. And a few years later, the hip the second doc put in got infected, she went septic then died. Lesson for me: treat fresh post-op pain aggressively (now, I deal with cardiac surgery patients)- I just tell the paitent while I can't make it all go away I will make it managable because we've got work to do.

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).

I think the nurse was probably annoyed, not astounded that a physician would order a pain med qhr. Especially since telemetry units are usually quite busy and the pt load is not small.

but if your sleeping you are not in pain.

Couldn't resisst that one. I wake my pts to assess for pain and offer pain meds. I will also make sure they take meds in the am before getting out of bed or therapy and that might entail waking them up. No one has complained about me before:D

this thread could be a great reminder, that any type of pain is best treated with scheduled/atc dosing.

do you think we can all keep this in mind when those pesky, med-seeking pts want their meds atc as well?

why is it "med-seeking", if the concept remains as staying ahead of the pain?

(i really don't expect an answer, knowing that we need to stay on topic. i am just encouraging some food for thought.)

leslie

Good point! I work in the ED and recommend that my paitents with injuries, and sometimes other conditions, requiring pain meds take them as scheduled for at least the first 24-48 hours, then they can take them PRN if they want to.

Specializes in Critical Care.

It's pleasantly surprising to see responses that don't assume the patient is abusing pain meds by setting their alarm clock, so why do so many nurses label their patients in the hospital as 'drug seekers' when they set their cell phone to wake them up or ask that they be brought when they are due?

Specializes in Trauma Surgery, Nursing Management.
Good point! I work in the ED and recommend that my paitents with injuries, and sometimes other conditions, requiring pain meds take them as scheduled for at least the first 24-48 hours, then they can take them PRN if they want to.

I also instruct patients in this way regarding pain meds. Take the dose as prescribed the first 24-48 hours, pain or not. THEN the pt can taper off as needed. It is so much more difficult to get pain under control during those first 2 days post op.

I took care of my BFF when she had her L5-S1 decompression surgery. I would wake her to give her pain meds q4 h on POD #1. She was SO mad at me for waking her up. So the next day (POD#2), I let her sleep. She woke up in TEARS and got mad at me for NOT waking her!

Specializes in Emergency Dept. Trauma. Pediatrics.
I think the nurse was probably annoyed, not astounded that a physician would order a pain med qhr. Especially since telemetry units are usually quite busy and the pt load is not small.

I just spent 3 weeks on tele, 2 weeks on CVCU and 2 weeks on Ortho, I did see morphine ordered qhr regularly on Ortho, but the Ortho floor I was on was by far the busiest of all of those floors consistently. CVCU had their days, but also had many slow days (today was one of them) The patient loads were the same on the floor, but the Ortho patients required more care.

Just my experience.

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).

As a nurse on a busy medical/tele floor, what would frustrate me about that order is, if the patient truly needs pain meds, that's not sufficient.

If I'm in a room given IVP pain meds once every 30 minutes-1 hr why does the pt not have a PCA? That would be my frustration, and I suspect is the frustration of the nurse you witnessed. Believe me, we are used to giving large amounts of pain meds, too. 2mg of morphine? Might as well spit it at them. That's nothing.

Specializes in Med Office, Home Health, School Nurse.

Not ortho pain relief, but with my first c-section I thought i would be "super woman" and not take my pain med until I "needed" it...so I waited until I was almost in agony and then would take it. I had a terrible, hard, long recovery from that c/s. With my second c-section, my dr came into my room about 2 hours after delivery and said the following to me: "Sweetheart, I know you think you can tough it out, but try something for me. Take your medicine every 4 hours around the clock for the next few days. I guarantee you're going to do much better." So I set an alarm clock and my husband made sure I got my pain pills and my 800mg ibuprofen around the clock. Within a WEEK, I was almost completely back to normal. Now that I'm pregnant again and having to face another c/s, you can bet your bottom dollar that I'm pulling out the alarm clock again!!

Not ortho pain relief, but with my first c-section I thought i would be "super woman" and not take my pain med until I "needed" it...so I waited until I was almost in agony and then would take it. I had a terrible, hard, long recovery from that c/s. With my second c-section, my dr came into my room about 2 hours after delivery and said the following to me: "Sweetheart, I know you think you can tough it out, but try something for me. Take your medicine every 4 hours around the clock for the next few days. I guarantee you're going to do much better." So I set an alarm clock and my husband made sure I got my pain pills and my 800mg ibuprofen around the clock. Within a WEEK, I was almost completely back to normal. Now that I'm pregnant again and having to face another c/s, you can bet your bottom dollar that I'm pulling out the alarm clock again!!

same here. i had the same exact situation -tried to be superwoman the first time, hardly took meds, and "toughed out" the pain. the second time, i'd wake up and take my meds and it helped so much to make my mornings bearable/comfortable. pain is always worse in the morning.

i have patients who try to go without taking pain meds and beat around the bush about if they want it or not, make apologies, and explain that they "hate to take it" if they don't HAVE to. i always tell them, "it's OKAY. you've had surgery, you've been through _____, that's what it's FOR." i hate for patients to hesitate asking for pain medication because they feel like it makes them seem weak or makes them feel like a "drug addict" so i quickly erase that idea from their heads ASAP. usually once they know they aren't being judged, they have no problem asking for it right on time - every time, and i don't blame them.

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