Saturday, January 9, 2010

Pain

Last night was okay. Nobody was hurt, sick, or injured, which is always good. The outgoing evening shift complained that the day shift complained that the usual night nurse did not give out enough pain medication. So I administered pain meds to lots of patients for the 6 a.m. pass. When the day shift came in, I told them to look up the last administration time before giving more percocet. The residents have a tendency to forget accurate time.
I have two scenarios on the lack of pain meds: 1- a resident is asked about pain and denies pain, so the nurse goes on to the next patient. The patient now has the idea of pain in her head, and when the day nurse arrives and starts rounds, the patient tells her that she has pain and has been waiting for the medication. 2- At 6:00 or 7:00 a.m. as I arrive to give the scheduled med, a resident will ask for "the pain pill for rehab." I have no problem giving them a pain pill, but the pill will wear off before they go for rehab at 9:00 a.m., and they can't have another pill until 10:00 or 11. The alert residents realize this and decide to not take a pill at 6 a.m. That is not the story that they tell the incoming day shift nurse, however. They state that they have been waiting for their pain pill for rehab, when what they have been waiting for is the passage of time so that the pill is most effective for rehab.
A resident started screaming at about 5:30 a.m. that she was in agony and needed a pill. I was nearby, but helping another resident take her pain pill, so she had to wait three minutes. When I got to her room, she was snoring. Usually, if someone is in agony, they are unable to sleep. I awoke her to take the pill. She stated, "I've been up all night begging for a pain pill." This is not true. Yet that is the story that her family and administration will believe.

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