The 5th vital sign

CMERN · Dec 3, 2002

ehh?? PAIN is pain 100% of the time last time I had IT...?

CMERN · Dec 3, 2002

ok xcuse my smarty mouth.. i need to go to bed..up 24/hr...guess im addicted to allnurses/ not pain meds...... honestly... this nurse thinks pain is undertreated..... we are working on it tho...on a scale of 0-10 ( 0-being no treatment,and 10 being 100% treatment) I'd say we're about a 6. :) peace out.

ohbet · Dec 3, 2002

Ok,so far its one vote for pain is undertreated,and I agree,that makes 2 votes for undertreated pain,any one else with an observation?

K O'Malley · Dec 3, 2002

From personal experience I vote for undertreated pain. I lay in an ER from 5 PM till 1230 AM with a ruptured appendix with no pain meds. When I asked for something I was told that the ER doc wouldn't authorize it yet. Was finally given some MS when I was moved to the floor to wait for the surgeon who was tied up across town. If my pts say they are hurting I give them something pronto or call for an order if I don't have one.

darius000 · Dec 3, 2002

I think that pain is undertreated. Many a time I have heard a nurse comment that the patient says he's in pain, or they rate a patients pain using the 0 - 10 scale and then do nothing about it. Some try to compare the ratings to vital signs, but this has been proven to be an ineffective method. Personally, I try to alleviate pain ASAP. I have no problem with giving out pain meds and I always check the med charts and ask why prn meds haven't been given. Fortunately where I work, the Docs in ED listen to us, (well most of the time), so getting a stat order for analgesic is not a problem. Of course we also can initiate certain analgesics prn.

RN2B2005 · Dec 3, 2002

I think it varies wildly. In my personal experience, I was told by a nurse (actually a nurse-midwife!) that my doctor hadn't left orders for pain medication post-partum. When I told her that I was quite certain my doctor HAD left standing orders for pain meds, she said I could have some Advil (gee, thanks). The nurse made me feel insignificant and that my pain was an annoyance.

In the end, though, another nurse came on who read the chart correctly or called the doctor, and got me the meds. She snorted when I told her about the offer of Advil--I'd done an unmedicated, 2 1/2 hour prima delivery with multiple lady partsl lacerations (my son was in a hurry to get out, and I was in a hurry to be done being pregnant, and so he did some damage on his way out).

On the other hand, about a year ago, I was seen in the ER for a persistent headache related to a benign brain tumour. They had me hooked up to fluids and Dilaudid and some sort of anti-emetic within minutes of walking through the door. It may be that since the headache has a clear source--and that source can be seen on a CT--I was treated differently than I might have been had I just come in complaining of a headache.

acaringnurse · Dec 3, 2002

definately undertreated.

fergus51 · Dec 3, 2002

Undertreated because of our overexaggerated fear of addiction.

proudtobeanurse · Dec 3, 2002

I always try to medicate patients for their pain based on their experience, not mine. When I had a c-section 15 years ago, the anesthesiology resident was SUPPOSED to but epidural MS in the epidural before pulling it in the OR. Unfortunately, he did not. So, when the block wore off, I was suddenly in excruciating 10+!! pain. And of course, no one believed me, since he had charted that he gave it. The recovery nurse just blew me off saying, "youve had all you can" until I was SCREAMING and crying, then finally she called the resident and whaddya know--he forgot to give it. I always believe patients. When the pain is under control and kept under control without escalating -meaning meds are given almost without asking-- patients recover quicker and are off pain drugs sooner IMHO

emily_mom · Dec 4, 2002

I believe educating our patients is the key. Many don't want to take pain meds q 4-6 hours b/c they are afraid of addiction. We need to educate them that is not so. People wait too long and then it's hard to get it under control. By having to use more you get into all of the bad side effects. People are so afraid of what you offer these days.

Kristy

mark_LD_RN · Dec 4, 2002

at leat where i am from and as far as my patients are concerned. I believe pain is what the patient says it is and i always do my best to relieve their pain. often it requires teaching them about pain meds and relief and that they will not get addicted to narcotic with short term use.