Write Up's and Potential Termination for Pain Reassessments

JLBSN55, BSN · Mar 24, 2019

Wow, this is news to me, I understand why reassessment is needed, but medications like these that treat chronic conditions and are daily medications should not be required to have reassessment. what is the pain scale going to look like 0/10 before and after medication was given? Really need to rethink if a pain assessment/reassessment is needed for scheduled medications. We do however need the assessment for prn pain medications

allnurses Guide · Mar 24, 2019

It is one of those accreditation things TPTB have come up with. We keep being "reminded" to chart a pain response within 30 minutes for IV meds, and 60 for po. The auditors don't look at real time work priorities, they just punch buttons to get graphs at how "well" we respond to pt complaints.

Our computer charting has added in count down columns and tags to say a pain reassess is overdue.

EllaBella1, BSN · Mar 24, 2019

My old unit got dinged at our JCAHO assessment last year for not reassessing our PRNs. Everything is so micromanaged these days.

Sour Lemon · Mar 24, 2019

1 hour ago, MiralaxOnIceRN said:
Just when you think nursing can't be scrutinized anymore than it already is, we are now being threatened write ups and termination for failing to reassess a pain score. This includes medication like colchicine, gabapentin and asprin. I've been a nurse for 10 years and I consider myself a pretty good one, but I am very uneasy about keeping my current job, which I've been at for 4 years because of this.
What do you think?

This has been "a thing" for at least ten years. That's when I first started nursing, so I don't know about before then.
It was beaten into my head so much as a new graduate that it's automatic now. I even do other people's reassessments when I have downtime.
That doesn't mean I actually speak to the patient or even look at the patient. I just fill in the form to be in compliance.

JKL33 · Mar 24, 2019

Plan B.

Figure it out, put it into action.

Here.I.Stand, BSN, RN · Mar 24, 2019

1 hour ago, EllaBella1 said:
My old unit got dinged at our JCAHO assessment last year for not reassessing our PRNs. Everything is so micromanaged these days.

I’ve never seen it for scheduled neuroleptics though, or ASA which usually isn’t even given for pain.

That seems like the kind of foolishness that takes us away from pt care... including actual assessment and intervention for pain.

LovingLife123 · Mar 24, 2019

I reassess for prn narcs. I do not for anything scheduled. I know it’s a JHACO thing.

**CalicoKitty, BSN, MSN, RN** · Mar 25, 2019

I get annoyed because it isn't easy in our system to chart the pain level when administering the medication. It is relatively easier to do the 'reassessment' from the MAR, but there is no scale that I can see when administering it. Maybe I'm missing that.

nrsang97, BSN, RN · Mar 25, 2019

I wouldn't think a reassessment for neurontin, colchecine, or ASA are needed. ASA usually isn't given for pain, and neurontin and colchecine are for chronic health issues aside from pain. This seems overboard.

Jory, MSN, APRN, CNM · Mar 25, 2019

I have heard the staff nurses talk they want a pain reassessment on ALL meds where you can register a response.

This even includes antiemetics.

The problem is that if they want nurses to do this, they need to have better staffing. When there is a delivery, nurses can sometimes be tied up in a room for an hour or more. So no, you are not getting your pain reassessment.

You aren't getting it if you have 10 patients on a med-surg floor either with one CNA and half that require total care.

ruby_jane, BSN, RN · Mar 25, 2019

In the BON one of the things they specifically call out is response to assessment, and charting what you did in response. And woe be to us who say someone has a headache and we didn't do anything...or we did something but did not circle back.

It is one of the few things the BON is specific about. Best of luck!