Jump to content

Write Up's and Potential Termination for Pain Reassessments

Nurses   (3,867 Views 60 Comments)
by MiralaxOnIceRN MiralaxOnIceRN (New Member) New Member

188 Visitors; 5 Posts

advertisement

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? 

Share this post


Link to post
Share on other sites

JLRN5555 has 10 years experience as a BSN and works as a RN.

1 Follower; 78 Visitors; 15 Posts

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 

Share this post


Link to post
Share on other sites

JBudd has 38 years experience as a MSN and works as a ED nurse, community college adjunct faculty.

2 Followers; 1 Article; 35,004 Visitors; 3,690 Posts

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.

Share this post


Link to post
Share on other sites

4,119 Visitors; 339 Posts

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

Share this post


Link to post
Share on other sites

Sour Lemon has 9 years experience.

2 Followers; 29,023 Visitors; 4,103 Posts

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.

Share this post


Link to post
Share on other sites

8 Followers; 21,852 Visitors; 2,837 Posts

Plan B.

Figure it out, put it into action.

Share this post


Link to post
Share on other sites
advertisement

Here.I.Stand has 16 years experience as a BSN, RN and works as a RN.

1 Follower; 41,687 Visitors; 4,830 Posts

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.

Share this post


Link to post
Share on other sites

6,988 Visitors; 945 Posts

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

Share this post


Link to post
Share on other sites

CalicoKitty has 6 years experience as a BSN, RN and works as a Med-Surg Nurse.

1 Follower; 15,260 Visitors; 579 Posts

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.

Share this post


Link to post
Share on other sites

nrsang97 has 12 years experience and works as a Rapid response nurse.

36,849 Visitors; 2,566 Posts

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. 

Share this post


Link to post
Share on other sites

Jory has 10 years experience as a MSN, APRN, CNM.

1 Follower; 11,146 Visitors; 1,172 Posts

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.  

 

Share this post


Link to post
Share on other sites

ruby_jane has 10 years experience as a BSN, RN.

2 Followers; 7,420 Visitors; 2,113 Posts

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!

Share this post


Link to post
Share on other sites
×