Sickle Cell Policy

[seatkin]

Just wondering if anyone works at a hospital where there is any kind of policy for treating sickle cell patients. The hospital I work at seems to do a terrible job (in my opinion) of treating these patients. We have no criteria that the pt's must meet for admission, we don't require them to take any of their oral pain meds, we don't wean them off of the IV meds, etc. My last SS pt was there for 3 weeks on Q3hr dilaudid up until time of discharge...this just doesn't seem right to me and I'm thinking of trying to create some sort of policy...

If anyone knows of a policy or has any suggestions please let me know!

[Penguin67]

Is this a pediatric or adult client?

[linearthinker, DNP, RN]

Are you talking about creating a care path for sickle cell patients? I am not sure that would work because ss crisis manifest differently in every patient.

[ChristineN, BSN, RN]

At a previous hospital I worked (peds and adolescents), the patients all had individual pain plans on file in the ER. That way from the moment they presented the ER dr's were aware with what had worked in the past for this pt, and what hadn't. Any need to deviate from the pain plan had to first be cleared with the Heme attending, even off hours.

[NRSKarenRN, BSN, RN]

sickle cell: the problem of pain

several links here: sickle cell crisis and pain management?

https://allnurses.com/general-nursing-discussion/sickle-cell-crisis-464696-page2.html#post4200969

[Tinknurse2B]

Just wondering if anyone works at a hospital where there is any kind of policy for treating sickle cell patients. The hospital I work at seems to do a terrible job (in my opinion) of treating these patients. We have no criteria that the pt's must meet for admission, we don't require them to take any of their oral pain meds, we don't wean them off of the IV meds, etc. My last SS pt was there for 3 weeks on Q3hr dilaudid up until time of discharge...this just doesn't seem right to me and I'm thinking of trying to create some sort of policy...

If anyone knows of a policy or has any suggestions please let me know!

Although that is very thoughtful :redbeathe.....like the other poster said ss crisis is different for every sickler ...my daughter has sickle cell disease and it seems that each time the she goes into a crisis as of late ....something new happens...her lastest ...crisis included seizures in which she's never had before....I'm so thankful that Texas Children hospital is very familar with sicklers and the proper protocol for each individual and they do wean the patient way before discharge.

[shoegalRN, RN]

I work at a hospital that has a large sickle cell population, even a clinic for them.

There is really no protocol while they are admitted. Fluids, oxygen, and Dilaudid q 3 hours. I've seen as much as Dilaudid 8 mg IV given and the pt walked right out of the room and to the bus stop to "smoke" after I gave it to her.

Some of the sickle cell pts stay as long as two weeks, and still be on IV Dilaudid right before discharge.