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Pain management in the hospital - suggestions on how to get it

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
A few posters have mentioned here that they have had difficulty with nurses giving them pain meds, etc... when in the hospital. I work in a local ER and when our night "house officer" otherwise known as the house supervisor came through last night - I asked her about this situation. She said if this happens to you, demand to speak to the lead charge RN or patient advocate. Those words will sends chills down the nurses backs because these people report directly to administration patient complaints such as the horrible ones described of late. These stories shocked me to the point of asking questions, because personally I have NEVER seen this in the hospital I work at - there are just too many doctors and other RN'S around who would not stand for it. Please be sure to take someone with you who can be strong and stand up and demand to have your needs met. My surgery is coming in March and I plan on doing the same thing. I only hope my advice works for me and I don't get some awful treatment myself. I have been reassurred by a friend here >:D< :H that I have picked a good hospital so that helps reassure me tremendously. What nurse you get tho is a crap shoot and there are good and bad in every hospital. Just remember, they all have a boss and someone who looks over their job that you can take your complaints to.

Oh and one last thing, most hospitals are monitored by the "Joint Commission" which monitors accredited hospitals (so be sure to pick one) and they have people who also plop in to check on this stuff. I know, we get them in the ER checking on us all the time. Threaten to turn them in for patient violations to the Joint Commission if you have to! Here is a link to their patient advocacy area and web site: http://www.jointcommission.org/GeneralPublic/Complaint/
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Comments

  • I was worrying about this just last night as my surgery is coming up in 2 weeks. I take percocets several times a week (some days I take nothing) and I have always had a high tolerance for pain meds - meaning it takes more than normal to touch my pain (my mom is also this way- just the way we are wired) The problem that I run into is that I am 5 feet nothing and weigh around 109 pounds so they always UNDER dose me.
    I explained this to all staff & Dr's before having my hysterectomy 2 years ago & I woke in the most horrid pain I have ever been in, I could barely talk,finally got the reocovery aides attention and they gave me something - still didn't work & they gave me some more -STILL didn't work, I managed to muster the strength to grab the chatty nurses & she said "we have a call into your DR. because we have given you as much as he ordered" I was p----d!

    I know this is lengthy- but I am scared to death about the pain management part. I am very careful to not take pain medication too often (not even daily) but I do have a natural tolerance!

    Thanks for the tips/advice!!!
  • I would definately not be shy about calling the lead charge nurse or someone else on your behalf. I had a horrible experience the one day where they even refused to call my Dr. to increase my meds. I was crying out in pain and no one even seemed to care. Once the charge nurse and other higher up patient staff advocate were notified then the situation changed. Please make sure to bring a friend/family member along who is not afraid to advcate for you.
  • http://www.jointcommission.org/PatientSafety/SpeakUp/Speak_up_pain_managment.htm

    This is part of their SPEAK UP program to get patients to be their own advocate and is a good booklet to look over regarding telling your nurses/doctor about your pain and expectations of what your pain meds are and can do. :D
  • One good sign around my aprts is the hospital and surgicenters here always do follow-up questionnaires on their service - and a good amount is devoted to whether your pain was controlled in the hospital/ssurgicenter and when you left; so at least someone is caring enough to ask.
  • I asked about pain relief at my pre-op visit with my surgeon and he said the hospital staff is used to the spine patients being much more tolerant to pain meds and deal with it accordingly. I never had to page the nurses, don't even think I ever used a call button! I remember them giving it to me but never had to use it. The nurses were all great, really great and deserve a pat on the back. They get crapped on so often, not always on purpose because the pain controls our temper sometimes. I loved it there! Too bad I was only in about 24 hours It was a great experience. My pain was controlled enough that I could walk down the hall within 4 hours of my 360 fusion. Consult your doctor before surgery and ask him to note in your records that you are pain medication tolerant and take someone with you to the hospital to stay overnight with you.
  • I totally agree with questionaires and surveys aftercare. But it is true there is always a charge Nurse on and during the day you can speak with the Nurse Manager. And I feel if it's a good hospital the Unit Manager spends a couple of minutes with each patient to make sure needs are being met during the client's stay there.
    Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Pain is the fifth vital sign. Nurses should be asking about it at least as often as they take your blood pressure if not more. By all means speak up for yourself. Talk to the pre-admit nurse, pre-op nurse, anesthesiologist, and your surgeon about your high tolerance prior to your surgery. You are more likely to get adequate relief if they realize it is a concern beforehand. Good-luck, Sue
  • a CE class I took a couple years ago dealt with this subject specifically, and how Drs & hospitals will likely be held liable for malpractice for NOT treating/managing a patients pain, that its a patients right to have their pain managed.

    Obviously the medical community has some work to do in this area, but I do see an improvement in the last few years.
  • I came out into recovery for PLIF L3-L5, crying and moaning. The nurse would give me an IV dose of something, but it didn't affect me. She gave me a little more and then asked if I took a lot of pain meds before surgery and I told her I was taking Lortab 7.5 4 times a day before. So they hooked up a demerol pain pump for every 6 minutes. That worked great but I got itchy. I had surgery at 10:30am on Thursday and they took the pain pump away from me Friday at noon, after that I could only have one percoset every 4 hours. I took the first one and it lasted maybe one hour, then I got to hurting bad again. The nurse said that was all she could give me and wouldn't ask to have it changed. I told her that I normally took Lortab 7.5 and percoset had never done much for me. Finally at 11pm Friday night, the RN got me Lortab and I got easy for a longer period of time.I went home at 9am Saturday morning and they wouldn't give me anything for the ride home unless I stayed an extra hour with them. I had a two hour ride home. Luckily I had my own pain meds and took some in the car. My NS had written me prescriptions for Lortab 10 and Soma every 4 hours and we got that filled in between the hospital and home. I don't like hurting and I don't think it's right to be treated like you have to take what's on your orders or else. Going from a 6 mins demerol pump to one percoset every 4 hours is a huge jump in meds. I was up walking and going to the bathroom and doing all the things I should have been doing, but those cause extra pain too.
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