Sunday, April 12, 2009

Pain is what they say it is.

We're going through this weird thing at work right now where the DON wants every request for pain medication (even Tylenol) to be reviewed by the charge nurse. So, when a resident tells me they're having shoulder pain and it's a 5/10 on the pain scale, I now have to get my nurse to approve their pain medication. Which basically means the nurse goes down and asks the resident what their pain level is and tells me what to give them.

I've watched some of the nurses do their assessments. The residents always tell them the same thing they told me and generally, the nurse will tell me to give the same medication (assuming they have several to choose from) that I would have given. I do tend to err on the side of a stronger med, just because, if it were me, that's what I'd want my nurse to do.

Once in a while, the nurses will try to talk the resident out of taking a pain pill. I will never understand this. If the resident says they're in pain, why should we doubt them? Frankly, if the resident is in for Long Term Care (versus someone who's just there for physical therapy until they can walk out on their own), give them what they want. It's not like they're going to go out and drive or anything. And as far as addiction goes, I'm told by our Hospice nurses that you cannot get addicted to pain medication when you are actually taking it for pain. (I think it's a non-issue anyway just because we don't need to worry about these folks functioning in society.)

Pain is what the resident says it is. There should be no second guessing or talking them out of it. Give them their pain pill and let them feel comfortable, at least for a little bit.

1 comment:

Dr. Eleanor Barbera said...

I agree, K Tree, especially because so often as a psychologist I've heard the opposite from the residents - they are under-requesting rather than over-requesting pain meds. They don't ask because they don't want to bother the staff, or because they're worried they'll get addicted, or they didn't realize they could ask for pain meds, among other reasons.

Eleanor Feldman Barbera, PhD