A crying post op patient is upset about the PCA being discontinued and throws a meal tray when the nurse offers PO oxycodone. What is the most appropriate response?
Explanation
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• Asking another nurse to administer pain medication after this incident only puts the other nurse at risk. The primary goal is patient and nurse safety followed by an attempt to de-escalate (calm) the situation.
• After invasive surgical procedures, many patients will require IV pain medications. These patients are frequently placed on PCA pumps for better pain control. When these are discontinued, these patients can become anxious and irritable because of discomfort and/or fear of increasing pain.
• When a nurse is attacked, threatened, or verbally berated, he or she should first leave the patient’s room for safety. Then the nurse should immediately report the incident to the charge nurse and the patient's provider. At this point, the provider will assess the situation to decide if the patient needs a change in pain medication orders, an anxiolytic, security supervision, or even restraints.
• The drug should not be documented as refused unless the drug was refused. This patient was crying. The client should first be assessed by the provider to be sure the pain is being adequately addressed and pain medication should be offered again. It is unacceptable to leave a patient in pain and distress.