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NO PAIN PUMP!Can i request NOT to have the pain pump?



  • Like I stated before....
    When you see your doc let him know your experience. Let him know your side effects to the morphine, how it didn't take away the pain etc etc etc. Ask HIM if he could us a different med such as dilaudid. For ME dilaudid works far better. Just be open and honest and tell him your concerns, experience and that you would like a different med in your pump. Again dilaudid is JUST A SUGGESTION!! That is about the only thing I can think of. Either that or tell him you dont want the pump BUT THEN you will be at the nurses and the pharmacy's mercy. That is why they try to have the patients use a pain pump, because for the hospital pharmacy and the nurse to be able to get into your room right at teh time to administer another injection may not happen. I remember when I asked for a shot of imitrex for my morphine headache it took 2 hours before the nurse came in with the injection. The nurses station wont have syringes upon syringes full of a narcotic just laying around. So anyway that is my opinion and I hope you and your doc can come up with a solution. Let us know how the apt goes. Good Luck MJ
  • Ugh, cant they have a drip constant in my IV? I know most nurses are jokes...ive had them talking about dates and or their weekends just standing around...maybe not all nurses are like this however the majority of ones ive had...have been like that! If there are people obviously who are gonna be in pain, one would think they could be a bit more prepared than that??? I hate waiting!
    Example....took my kid to putpacient for ear infection,mono,and strep other day...they had 2 departments open, ER and prompt care...werent that manny people...TOOK 4 HOURS! even the doctor came back around after we were seen and goes....your still here??? an hour after being seen...they went and jumped the nurse...even the doctor thought it was a bit much!I have been looking at many diffrent things to try and use other than pain pump...I was badly ignored after my surgery...not by the doctor...the nurses...SOOOOOOOOO, stressed ~X(
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  • Sorry you've had bad experiences with nurses, but I personally think they are great! They have more than YOU to take care of, ok? Sorry to be so blunt, but you touched a nerve. You wrote, "I know most nurses are jokes." Because of the shortage of nurses, sometimes they have as many as 15 patients (even more) to take care of. For the most part, they are very caring people who went into this field because they want to HELP people! I'm sure there are a few bad apples, as in ANY field!
  • It is terrible the experience you had and unacceptable!

    In answer to the question "yes" you can refuse the PCA pump that is one of your patient rights...paraphrasing here but, you have a right to be involved on pain management decisions, however it sounds like you haven't had the full benefit of a PCA.

    BionicWoman is absolutely right everyone is different and the pump is programmed for certain amts at set intervals with a max dose per hr but like she said for any meds we have to assess you before they go down your throat, in an IV or subcutaneously. The program set for you especially at first is usually weight based and because everyone is different a family member hitting the button for you could cause respiratory depression and kill you.

    It's happened and that's why we say don't do that at the same time if it's that bad and if a patient feels that's the only solution they are wrong & unfortunately you've had some crappy nursing care so you didn't have someone who should have worked with you to get the pain under control. Your doc also has to give a care too, we can't help manage pain without orders from them!

    Ok so what do you do? First you explain your experience to the doc if he is unwilling to help change that for the next time get a new doc. If he is not happy with what happened to you and is willing to work with you he can do several things.

    -He can change the PCA med to Dilaudid or Fentanyl(commonly used for epidurals but can be a PCA option as well)
    -If you try Morphine again He can start out orders with an increased dose and/or shorter intervals
    -If that doesn't work you can ask for an order to receive pain pills for what we call breakthrough pain. All of your pill form meds given routinely will depend on what you were admitted to the hospital taking. Your breakthrough med usually is what you take at home.
    -You should have a muscle relaxer ordered as needed either IV or by mouth for spasms every 4-6 hrs depending on the doc as far as how often of course.
    -some folks take Ambien for sleep with a PCA but we have to have a separate order from the doc to give it with the PCA!
    -The boluses have already been mentioned & usually there is a standing order for one when you first get up to the floor so you can inquire about that because a nurse may not "volunteer" that info or if it's a new nurse he/she may not know.
    -And yes PCA's are also able to be programmed for what we call a "basal" dose or a certain dose given every hr continuously.
    -If you wear a pain patch pls make sure it's off before you get a PCA.

    Hopefully these suggestions help you maybe try the PCA again but differently. We do not use them because we can't or don't want to get you pain meds. Most hospitals do not require going to the pharmacy everytime a pain med is needed. Some smaller hospitals maybe or some certain very expensive meds need to be ordered daily but we have floor stock or a PYXIS system which is a computer system to sign out your meds including narcotics. The PCA's are used routinely after major sometimes minor surgery because they have been proven to show most patients were happier with their pain control when they had options to take control of their pain (like hit the button) than without it.

    I have posted before and will again I'm sure that I hate hearing such aweful stories. I take them personally & not against anyone sharing the bad stories but of the nurses who were bad. I've been a RN for almost 17 years and I know it happens sometimes because they don't care or really sometimes they don't know. In either case I had an aweful 1st day post-op from PACU to the next morning....so it happens to everyone. My PACU nurse was an a$$, my evening nurse was slow & my night nurse was useless. So I didn't need the evening or night nurse again....That helped but overall there are other hospitals here put it that way.

    Which brings up my next suggestion. You do not and should not receive bad care. Whether it's pain control, nurses who are too lazy to change an IV or for whatever YOU feel you are not receiving good care for.

    Honestly sometimes personalities are all it is. You can ask for a different nurse. You can talk to the charge nurse if that doesn't change things you can ask for the floor supervisor or manager. That is the chain of command if all that fails there is always the DON (dept of nursing) head.

    So talk with the doc you should know we CANNOT take away ALL of the pain and try to keep patients realisitcally controlled to be able to walk, sit in a chair, participate in rehab etc.

    Take a proactive role, ignore snooty people at the hospital and expect better care.
    Good luck
  • advice Pettynme!!!! Very helpful for me too, since I MIGHT have another surgery after the first of the year!
    ~I have had ups and downs with nurses. Like I had stated before my night nurse was AWESOME! My day nurse...not so much. I seen her standing outside of my room and talking with another nurse. I heard there convo and it was all personal stuff and not patient/work related at all. Anyway I was pushing my nurse button to try to get someone in before I vomitted bile all over myself. I even tried to call out to her. My voice was hoarse but I know they heard me because they looked at me and moved over about 5 feet where I couldn't see them. I still heard them talking about their husbands, kids, daughters wedding yada yada.
    My hubby had the same type of experience after his spinal cord surgery. Night nurse was awesome day was not so much.

    Anyway! I would like to say that I have the utmost respect for nurses and doctors. I could do their jobs especially nurses. Nurses deal with so much stuff and sometimes patients are too demanding and I feel for them. HOWEVER the day nurse I had was just horrible. Possibly a bad week or whatever which we are all entitled too. I do not hold a grudge for my past experiences with the one day nurse I had. I still go in with a positive attitude and with the attitude that the nurse will and wants to help me.
    So Cherry please do not hold past experiences against your new nurses. If they get that vibe that you are crabby because of other experiences and are rude (which I am not saying you will be) BUT they may treat you the same way!!! My best advice is TREAT THOSE THAT ARE HELPING YOU LIKE YOU WOULD WANT YOUR MOTHER OR FATHER TO BE TREATED IF THEY WERE IN THEIR SITUATION!!!!
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  • Thanks!
    You're right those nurses were very rude ignoring you to have chit chat. We do chit chat but there is a time and place.

    I doesn't matter "how" a patient is although it's nicer if their not rude etc but when you're sick sometimes we can't help it & that's just the way it is. Sometimes I had to remind myself of that...lol

    It is a greulling job at times but especially floor nurses we chose that so if they don't like it there are alot of other nursing things to do.

    Some things that may help
    -discuss your plan of care w/your nurse when you are admitted
    -when you call consolidate your requests if you call every 5 minutes(not because you're sick) for ice 1 time 5 minutes later something for pain, get the pain med then ask for a coke...UGH. Now if you do this cause you're getting situated and it's not all the time that's one thing but trust me if you have a bad habit of this it's what I call the boy who cried wolf.( For me that is) so I have to tell myself this could be "real bad" this time, I can't take a chance.....

    -be proactive, like I said before meaning ask questions about your care, meds, plan for rehab., participate in rehab. If your IV has blown twice and the nurse is again being lazy ask for it to be changed and if she can't ask if someone else can if you have to explain the circumstances (calmly) to a charge nurse do so.
    -be realistic...if your nurse is MIA and there is comotion on the floor there may be someone crashing and that above else will trump anything going on at the time. Not that your needs are not important but if you were coding clearly you would want everyone's attention ;)

    So just some ideas for your patient/nurse relationship but again you are the sick one and should expect great care. We don't have a job w/out you. It doesn't matter what kind of week the nurse is having,although sometimes its hard to separate work from home, but everyday they are your nurse?...no

    so take care and yeah go in with a fresh start & I'm sure if you try some of this stuff you will be pleased.
  • Thanks pettynme...i have had maybe 2 good nurses over the last 10 years...and ta joy...sorry if i touched a nerve or close to home...however i said all nurses "HERE" were a joke.
    Anyways, pettyme. Thanks bunches, im sure your info will help...i just hope my doctors listens and or gives me a choice? I know no one or nothing but my doctor..never met my anesthesiologists either...ever... Just hope to come out of it in less pain! My boyfriend BTW said last time the nurses came in 45min to a half hour after HE would push the button cause i was screaming and crying and in so much pain it was ungodly! I almost woulda wanted to die at that moment...I understand there are more people than just "ME" :B :W but he bought went ta take a look to find out what was up! I was supposed to get a bar with chains to help myself up to bathroom. They NEVER brought it....i had no control over my muscles back there...couldn't get up or ever flip over with ought it being miserable...TRUST me i could have gotten ALOT better help ~X( maybe this next time?
  • I slightly remember having to read info about the pump and signing something saying I would now allow anyone to push my button and the nurses explained it to my husband as well. My husband is against pain meds anyway so he wouldn't push it if I'd asked. I kept a pretty good grip on that thing anyway so I don't think anyone would have a chance to take it away from me.
  • I think that was very offensive. What do you do for a living?
    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
  • need to apoplgize. like I said it's not the patient's who irk me it's the nurses...

    10 YEARS...is that the only hospital? or does that include all of them? Yikes!!!

    & yes someone should have checked on you, that's so aweful, and I've had the surgery. After they took the catheter out there was no way I was going all they way to the pot, so I asked for a bedside commode. Looking back now the pot wasn't that far but then? good heavens it seemed like an eternity! :))

    Bless your heart, and you're right your not necessarily looking for surgery and someone might say that's not an option but the same someone should help you along with a plan if it continues not to improve.
    have a good day
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