Setting Priorities...need help

[CeliaLPN2009]

hi all, love this site! i have two years experience as LPN in nursing home with long term care and rehab. when you are in the middle of an admission, taking vitals, full skin assesment, dealing with family, etc. and you are getting paperwork filled out and given to supervisor to round out the entire admission process and have about 20 minutes to go, you get a request from another resident for pain medication what do you do? do you stop the ongoing admission pt. and give your pain med to the other? do you let the other resident know you will be there shortly, finish your admission and then run to the other resident with their pain medication? i had this happen and i know pain is the other vital sign, but my new admit, very nervous, needed more vitals taken, family member asking lots of questions and nervous about her mom. my major concern was the new admits stability at the time, and just to mention my other resident needing pain medication already has two fentynl patches, plus multi-lortabs each pass and family brought in his pain meds from home that he was taking on his own.!!! help! need your input and ideas, was i right to finish with my new admit and have the pained resident wait 20 minutes?

- thanks, Celi

[Nurse424]

I have been a Nurse for 4 years! An Aide before that for 19 years. Personally if this was a scenario I would have been in.....I would have a stopping point a few minutes after being told someone needed pain meds. I would have finished with the process I was in with the new admission, excused myself, told new patient and family I would be back momentarily and excused myself to tend to the need of the pain patient. For one, the family and new patient would have seen you like to care for your patients in a timely manner and don't just let them sit. For two, you are taking care of a the patient who is already a patient there, control there pain before it gets ahead of them and then it takes longer to control and in turn ******* them off and the next day they report you to your DON because you let there pain get out of control. New Admissions in our facility do get taken care of promptly but it is also a 24 hour facility and if everything doesnt get completed on your shift, at least organize everything and flag what you could not get done. Do not let pain get out of control or you will have a very ****** off patient because now they are in horrible pain AND your new patient AND the family that is there with them see that you have patients under your care that are having difficulty controlling there pain so you wont only have one patient who is now out of control with pain but you also have family that will be watching your every move while you are there and they are visiting and your new patient will nit pick everything you do from here on out. Seen it done!! With Admissions, get priority stuff done, continuity of care, skin assessment, fall assessment, allergies, etc done. If minor end of admission stuff needs passed on, it is always a 24 hour facility.

[SpEdtacular, MSN, RN, EMT-P]

I would definitely have someone address the fact that the patient is taking extra pain medication brought in by the family because that could turn out very badly.

[CapeCodMermaid, RN]

If the new admission is stable, excuse yourself, give the other person pain meds and then go back to the admission.

The fact that the resident in pain has a family who brings in medication is not a reason to make him/her wait for an ordered medication.

[gentlegiver, ASN, LPN, RN]

It takes a minute to run pain meds down to a patient, I'd stop and do it. I agree that unless your new patient is not stable this is the best way to go. However, if you are send an unstable patient from the hospital, I'd send them right back lickity split! I'm not sure why this is happening, but lately we have been recieving patients from the hospital running high fevers, dangerously high BPs, resp. distress, you name it. Is it because the ins, companies don't want to pay for more hospital time? Or are the Nurses at the hospital not being told of these problems by the staff taking VS??