NBR: pain medication after surgery question for nurses

angeltennis3

I won't go into the gory details, but I have posted in the randoms thread about my mom needing an emergency surgery after getting an infection following a hernia repair.

What I am curious about, is why her nurses keep denying her pain medication. Maybe my mom is out of it and forgetting when she last had medication, but this is the second time she has told me she has been denied pain meds. The first was when she first got out of surgery on Friday, and then again today. The only thing the nurses will say is she can't be on the iv pain meds at home. I understand that, but we have been told she will at minimum be in the hospital through Friday.

So really I am just curious if that is normal and what is the reason behind it. I am not a nurse and have no medical background, and I am sure there is a reason...but her nurses are just doing a poor job of explaining it to us. I am sure every patient is different, too, but I was hoping to gain some insight as to why they would be withholding pain medication after abdominal surgery when the very earliest she would be discharged is Friday. Can anyone help me out!?

I should note, my dad is on his way back to the hospital and does have a meeting with her surgeon and he plans to ask, as well, so hopefully we get more clear answers from him.

Thanks!

LightBright515

Very patient specific. I'm sure there is more to this story though.

They usually start off with patient controlled pain medication and then put on PO meds.

But to put things in perspective, open heart patients at my hospital are transitioned from patient controlled narcotics to Percocet pills for pain.

LightBright515

And she may have been over sedated at some point...

angeltennis3

Thank you @LightBright515‌ and @Cantisa‌ !! It's so hard to see my mom in pain, but I am trying to trust the nurses know what is best and are following the care plan set by her doctor. I can't imagine that anyone in that profession would purposefully withhold medication she needs.

Hopefully once my dad meets with the surgeon we will have better answers. I think I could handle it better as long as I understand the why, no matter how much it stinks to see her go through that. The ultimate goal is to end up healthy!

angeltennis3

Cantisa said:

So, if mom had abdominal surgery giving her narcotic pain medication can slow the bowel down or even temporarily paralyze it (a post-operative complication called an ileus). It depends on the surgeon as to whether or not they will give anything for pain.

Another thought is that pain medication is usually ordered every 4-6 hours and possibly mom is asking for it too soon. However, her nurses should be communicating with her the reason. i.e. It's not ordered for you because of this reason, or it's too soon for another dose, etc. If they won't give any reason at all, please have mom ask to speak with a charge nurse. 

ETA: It is wise for her to try and take oral pain medications as opposed to IV medications as long as she is tolerating normal food without nausea or vomiting. However, if her pain is above an 8, IV may be neccesary. 

This actually makes a lot of sense. She did get put back on an ice chip only diet because of a change in the color of some fluid being drained from her abdomen. If pain meds can slow her digestion, I could see why they would want to slow down or stop the pain meds while they figure out why the color changed, especially since she had two small holes in her small intestine that needed repair, which was the cause of her infection. Thank you!

LightBright515

We literally have nothing to gain by withholding pain meds.

Feeling/recognizing pain > being in a complete stupor and oblivious to it. At some point a regimen will need to be established for when she goes home. You have to figure out what works. And like PP said, the bowel needs to prove that it can work and actually recover..

angeltennis3

Thank you so much for the replies. You ladies have a hard job - seeing my mom in pain has been so hard, I can't imagine having to help patients through pain like that on a regular basis. I am very thankful there are individuals out there with your skills to do such a difficult job!

sabby2

Basically what they all said.

Be sure to communicate to the surgeon that she is having pain control issues. She may need a change in medication or there might be other pain management options she can try i.e. ice packs, massage, aroma therapy

Ask the nurses to be clear about what the plan is to help your mom reach a reasonable level of pain. She has a right to know the plan and options available to her.