Observations and Assessments

Notions to small for a blog post, all in one place.

You need to take your pain medication. Once upon a time, TorontoEmerg had some fairly significant surgery on a major joint. It was (theoretically) exceeding painful, but fortunately TorontoEmerg’s orthopod was very generous in supplying TorontoEmerg with Percocets and Tylenol 3s, and thusly TorontoEmerge experienced very little pain. Even when going to (really) painful physio, TorontoEmerg was kept more-or-less comfortable and at the end had a full recovery —- all because of adequate pain control.

TorontoEmerg was an RN, and knew how to take pain medication effectively.

So when five patients show up at Triage in one with poor pain control post operatively, even with adequate analgesia prescribed, TorontoEmerg begins to think some surgical nurses know squat about pain control and/or failing to teach adequately about analgesia when discharging patients. It isn’t about throwing a script for some opioid at patients and telling them to take the med “when the pain is really bad.” Is there is some deficit in our training which makes us reluctant to counsel patients on pain control?

You need to take your stool softener. Same topic. Different angle. I had several patients come to Triage yesterday for constipation related to opiate use post-operatively. None of them had any instructions about preventing or addressing what to do about the (inevitable) constipation. Again, why are we screwing up our discharge instructions?

Myth of the Queen Bee. Some research probably pertinent to nurses aspiring to leadership positions.

Drop Me a Postcard. This is kind of cool: internet postcards you can drag and drop to email, Facebook/Twitter messages, which pose some pertinent, challenging, difficult questions. From droppingknowledge.org.

How to deal with difficult colleagues. It seems too simple.

“Please do not let them breed.” Yep.

Size does matter. I thought this story was interesting because it exemplifies the anti-science, anti-intellectual climate we seem to be labouring under. Shorter version: right-wing web sites excoriate supposedly taxpayer-funded study of penis size and gay men’s health as trivial and frivolous, except, as it turns out, the study was not directly funded by the U.S. government and there is in fact an important correlation between sexual health and penis size, which in turn has implications for reducing HIV transmission.

Speaking of bad foodDeep fried butter. Really. Move over cheeseburger-on-a-glazed-doughnut. As Sean says, I’m speechless.

Dumb road signs



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  1. #1 by Jenn Jilks on Thursday 18 August 2011 - 0904

    RE: pain management. Many of my senior hospice client do not take adequate pain meds. Then they end up miserable, and unable to indicate pain, but depressed. Criminal, if you ask me, that it isn’t explained to them.

  2. #2 by CC on Thursday 18 August 2011 - 1433

    The problem I have with nurses in ED assuming it’s the fault of the surgical nurse is that it just creates a lot of bad feelings and resentment between floors/nurses, and we really don’t need any more of that.

    As an old surgical nurse from way long past, we DO give correct med info to patients. However – it doesn’t always transfer very well to the patient for the following reasons:

    1. Post surgery is not the most optimum time to be doing teaching. Statistics show that. We do it anyways, but in an anesthesia-induced stupor, they either don’t hear it or it doesn’t sink in. I know I didn’t hear a thing right after my surgery. I had absolutely no recall of anything said to me.

    2. Patients think that if they take the medication, they falsely believe they are doomed to become an addict. It’s difficult to convince them otherwise and that it is ok to take as perscribed for the limited amount of time.

    3. Patients don’t realize that in the hospital, they aren’t really doing much of anything – compared to home where there are stairs to climb, bending down to get things, etc, and there is going to be some increased pain and they NEED their pain medications to allow mobility while healing.

    4. Patients think that the pain medication should take away ALL their pain when in fact, most of the time it’s to control the pain. Big difference. There may be some pain but the medication is taken to make it manageable. What they tend to do at that point is stop taking their meds or throw in the towel and run to ED.

    5. Patients, for the same reason as #4 – think that if the pain medications are better taken at low doses, so they will try to miss doses or only take one pill instead of two.

    I would just hate to think that ED nurses think that Surgical nurses don’t do teaching…..after all…do you believe EVERYTHING that is told to you by a patient coming into ED? :)

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