Monitoring patients on pain medication, comment

Pain management and overdose is an interesting topic. I notice that some providers provide a patient with unlimited amounts of medication and others put their foot down and say they will limit the amount. Often in the Emergency Department, there are some people who have a nickname of “seekers”. This refers to them as patients who come to the ED and all they want is pain medication. They refuse and get angry if labwork or radiology reports are ordered, they state ” just give me a pain shot so I can go home”, are comfortable and then become Al Pacino when you walk in the room and are rolling around on the floor in pain (Literally) and then watch TV calmly when you leave the room. No one takes the time find out what is at the root of the problem, refer them to pain management or have empathy. Can we help these patients? So, you give a patient a narcotic and then they have respiratory arrest. What are we doing? We are not treating the problem. We need more education as nurses and need to learn about how to teach those patients with pain how to treat it properly. There is no absolute answer to resolve this very complicated issue. More research needs to be done on this topic.

Original Post

May 3, 2010

Title: Medication safety

It is completely devastating to make any type of medication error, even if there is no negative outcome to the patient. Although there are guidelines in place to check and recheck before giving medications, we are human and can easily overlook some steps. I agree that newborns are at risk and that there should be additional steps in place to even triple check medications given to them. Of course textbooks can tell us to check the patients name, dose, route, and allergies, but can they be missed. Yes! They can easily be missed. Often, many of the stories I have read about involve new graduate nurses still in training and student nurses. Although they are not the only ones, many nurses and varying degrees of experience can make errors. I myself made an error when I was still in training as a new nurse that completely turned my life around. There was no negative outcome, but I sure did learn the biggest lesson I could imagine. Why was the error made? I was in a hurry, didn’t follow all the steps to verify the correct medication and patient. I read the patients name on the medication and quickly hung the IV piggy back. Something popped in my head just moments later to check everything the pharmacist had typed on the bag. Quickly I turned off IV pump just in time. The medication was 4 times the needed dose for an infant! The pharmacist had made an error in the weight of the patient and gave me medication that was way more than what was needed. Thankfully this ended well. Never again am I in too much of a hurry to look at every detail of a medication.

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