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.
Next time you hear a patient complain about "that horrible nurse", believe none of what you hear and half of what you see.
Specializes in Infusion Nursing, Home Health Infusion.
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.
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.
Why you give wrong information to a patient about insurance not covering a stay is really not clear to me. Of course they pay as long as the patient stay meets the criteria for reimbursement (which the CM keeps track of). The fact that there is some narcotic crisis does not mean that every person is a drug seeker. I am sure you did a non-judgemental objective assessment ? Perhaps also suggest follow up with a pain management clinic to the physician so they can find out if the patient needs a follow up to address chronic pain .
Why you give wrong information to a patient about insurance not covering a stay is really not clear to me. Of course they pay as long as the patient stay meets the criteria for reimbursement (which the CM keeps track of). The fact that there is some narcotic crisis does not mean that every person is a drug seeker. I am sure you did a non-judgemental objective assessment ? Perhaps also suggest follow up with a pain management clinic to the physician so they can find out if the patient needs a follow up to address chronic pain .
Specializes in Huntingtons, LTC, Ortho, Acute Care.
I can understand your frustration... There will be times where we get those patients that no matter what we do... If it isn't what they want they will not be happy, and be sure to complain about it.
i think medicine in general has gone too far into the "customer service" industry than sanely necessary. Patients should not be calling the shots on what is being ordered for them and done for them at the extent it is! Physicians being bullied into unnecessary tests or writing scripts they aren't comfortable with for the sake of not having a "customer is always right" lashing from management..
Basing so much off of satisfaction scores, and even recently reimbursements by satisfaction?! You didn't die how about that for satisfaction? (Sorry for the sass). In cases like this all you can do is document as completely as possible, keep it moving, and try not to take the "what you could have should have done" criticisms drive you further down. Deep breaths and recharge, we can ALL learn from one another even if it's sometimes not what we want to hear in the moment.
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.
Pardon ME for offering a suggestion for your future reference.
Carry on and good luck with the next drug/attention seeking patient.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
exactly....
Ha! Good luck with that! Everyone has an opinion & is entitled to post theirs as long as it abides by the TOS. If the OP expecting a hug or pat on the back, they came to the wrong place.
iluvivt, BSN, RN
2,774 Posts
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.