That Nurse

Yesterday, I was that nurse. That nurse that your patient will one day complain to you about. That nurse who wouldn't give her pain meds even though she "really needed them." That nurse that was an example of everything that a good nurse isn't.

Well, that nurse heard the patient say things like "I want pain meds so I can sleep" and also "You must not care about me because you won't give me pain meds." That nurse also paged the doctor and related all these things to her as well as the patient's repeated requests for narcotics. That nurse offered alternative pain relief measures all of which the patient refused.

Well, was the patient experiencing pain that made it difficult to go to sleep?

If you think not, what did you base that belief on? What type of pain did the patient say that they had? Acute or chronic? Where? Severity? Were they regularly taking any narcotic pain medications prior to being hospitalized? What were they hospitalized for? Do you think that the alternative pain relief measures you offered would have been effective in treating the patient's pain? How did you present the patient's case when you talked to the physician? How did s/he respond? What meds, if any, did s/he order?

I have no idea if you were "that" nurse/a "horrible" nurse, but from what little information you've provided it is possible that you undertreated pain.

Next time you hear a patient complain about "that horrible nurse", believe none of what you hear and half of what you see.

I seldom believe everything I hear, especially if I'm only getting one side of the story. I do however tend to trust what I witness with my own two eyes, I just keep in mind that I might not be aware of events that led up to/preceded what I'm now seeing, meaning that I could be missing pertinent facts.

I assessed her to the fullest. Her pain she described seemed chronic. She was not on meds at home. She was not hospitalized for any reason for the pain. I presented her case factually to the physician three times and charge called as well. At least four interventions were presented to her to treat the pain that were not narcotics to which she refused them all. And by the way, most of the shift when I went into her room she was sleeping. She also threatened to leave AMA if narcotics were not given to her and only stayed when I told her insurance would not cover her stay if she left. So no, I don't feel like I undertreated her pain and feel I do my best to provide pain relief for my patients.

I also want to add that this is a vent. I am not looking for all the possibilities of what I could have possibly done right or wrong. I have just had a rough week or so at work and am venting. That is all.

So it's either say what you want to hear, or don't comment?

Why post on this website if you are going to try to dictate the content of the responses? AN is based on the whole concept of posters giving feedback to the starter of a new thread. You should be prepared to hear all kinds of responses when you start a thread.

BTW, people with severe chronic pain DO sleep. That does not mean that they are not in severe, debilitating pain.

I also want to add that this is a vent. I am not looking for all the possibilities of what I could have possibly done right or wrong. I have just had a rough week or so at work and am venting. That is all.

eagle,have_one_on_the_mods_edit_(vent)into_your_heading...

I assessed her to the fullest. Her pain she described seemed chronic. She was not on meds at home. She was not hospitalized for any reason for the pain. I presented her case factually to the physician three times and charge called as well. At least four interventions were presented to her to treat the pain that were not narcotics to which she refused them all. And by the way, most of the shift when I went into her room she was sleeping. She also threatened to leave AMA if narcotics were not given to her and only stayed when I told her insurance would not cover her stay if she left. So no, I don't feel like I undertreated her pain and feel I do my best to provide pain relief for my patients.

That's actually not true either. It's a common myth but it's just not correct.

Do patients pay when they leave against medical advice? - The University of Chicago Medicine

http://www.annemergmed.com/article/S0196-0644(09)01798-3/fulltext

I also want to add that this is a vent. I am not looking for all the possibilities of what I could have possibly done right or wrong. I have just had a rough week or so at work and am venting. That is all.

I'm sorry that you've had a rough week at work and hope that you have some time off due soon to recharge your batteries.

You know, morte is correct. It would probably have been a good idea if you'd indicated that this was a vent for the sake of clarity. However, that wouldn't have stopped me from replying to you. That's what people do on a forum.

Your post didn't strike me as a vent. I saw it as you us telling about something that happened at work and you're asking us, based solely on your version of events (which hardly has any detailed information), that we accept that you were in the right, and the patient wanted narcotics for other reasons than pain. That's what your last paragraph in your OP was all about, wasn't it?

Next time you hear a patient complain about "that horrible nurse", believe none of what you hear and half of what you see.

Well it was more of me saying I did everything in my power to relate the concerns of the patients as well as my assessment to the doctor and that after four pages the doctor still did not feel the situation warranted an order for narcotics.

What at I mean about this is a vent is that I am not looking for someone to dwelve so deep into the topic that you are having me answer questions I already assessed and know the answer to. Whoever posted that this is an Internet forum is correct, people can post whatever they want. Including myself. I came here to vent because I figured it is a good way to let out my frustrations at work but maybe I need to reflect in a real life perspective rather than on an anonymous forum where everyone is right in their own mind. Thanks for the thoughts and considerations.

I have learned a lot from this site, including that many people become completely different on the internet than they are in person. This thead is probably going nowhere fast so I am out âœŒí ¼í¿¼ï¸.

I assessed her to the fullest. Her pain she described seemed chronic. She was not on meds at home. She was not hospitalized for any reason for the pain. I presented her case factually to the physician three times and charge called as well. At least four interventions were presented to her to treat the pain that were not narcotics to which she refused them all. And by the way, most of the shift when I went into her room she was sleeping. She also threatened to leave AMA if narcotics were not given to her and only stayed when I told her insurance would not cover her stay if she left. So no, I don't feel like I undertreated her pain and feel I do my best to provide pain relief for my patients.

Unclear if she was drug seeking or attention seeking.

As long as you documented everything.. YOU will be fine.

In the future , let them leave AMA. Don't play the insurance card... insurance still pays.

I have learned a lot from this site, including that many people become completely different on the internet than they are in person.

Well, that probably includes YOU, right?

Many patients do want narcotics whether they need them or not. Many need them and do not get them.For nurses that can not prescribe we assess and then report to providers and hope that those with acute and chronic pain get what they need. It sounds like you did assess and report and the provider did not believe the patient needed narcotics.