Pain

wong baker pain scale

I had spoken to the surgeon about the patient before she rolled into the recovery room. Getting a handle on any special needs the patient might have helps me take better care of them.  Some issues I find are important to know:    Are they crazy?  Do they have something with them like a stuffed animal or favorite blanket?  If the patient is a child that is hunky-dory….if an adult that is a bad sign.  RUN into the bathroom and don’t come out. Everyone knows that nurses run into the bathroom right before their patient comes out of the operating room……as if they are never going to be able to go to the bathroom again.   Based on experience, of course.  I digress.  More important things to know:  Any removable body parts?  Seriously.  I have discovered a wooden leg with a shoe attached under a stretcher that no one remembered to tell me about.  A long list of allergies? A long list of medications?  Do they smell?  Anything alive in their hair/beard?    The surgeon  told me that she was perfect!  She had her other knee done last year and she did great.  All good news to me.  Alrighty bring on the patient!

My patient arrives.  Sleeping.   I hook her up to the monitor.  Everything is perfect just like the doc said.  “Nothing untoward and nothing unusual” as one operating room nurse likes to say.   I get situated on my stool right next to her stretcher.  Things are peachy keen.

Moaning and groaning.  She’s waking up and having pain.  Unable to give me a number on the numeric pain scale I  judge that she is having considerable pain.  Her eyes remain closed her entire stay in PACU so I can’t use the Wong-Baker Faces.  No problem-o.  I give her pain medicine through her IV.

“You’re all done.  In the recovery room.  Everything went well”, I reassure her.

A few minutes later…..moaning and groaning.  An increase in restlessness.  I give more pain medicine.

She is not settling down.  Knee replacement surgery is very painful.  I give more medicine. Try to calm her.  Cold compress on her forehead.  My patience is non ending.  Florence Nightingale like.

Her hand goes to her forehead and she says, ” why did I do this….it hurts so much.  I feel terrible.  I’m so dry.”

Ever ready to met her every need I ask her, “do you want ice chips?  A sip of water?”

She doesn’t answer me.  I go with the ice chips.  I put them up to her lips.  With her eyes still closed, she says “wait.”

“Ok when you’re ready”, I reply.  She is my only priority.

I ask, “ready”?  She shakes her head yes.  I tell her to open her mouth.  She opens it a tiny crack.  I say, “open more”.  She opens it a teeny weeny bit more.  I squeeze the ice in.  She spits part of it out.  No problem.  I catch it before it goes down her neck.

She keeps asking, “why did I do this.”   I tell her it’s all done and she will be fine.

“Why did I do this…”, she whines.

Does she expect me to answer that question?  After about the 10th time of her asking “why did I do this” I answer the question.

“You did it because your knee hurt”,  I answer.  This goes on for about an hour.  Her asking ….me reassuring her in an increasing louder  voice.  “YOU DID IT BECAUSE YOUR KNEE HURT AND IT NEEDED TO BE REPLACED!  YOU DID YOUR OTHER KNEE AND IT TURNED OUT SO GOOD THAT YOU WANTED TO DO THIS ONE TOO”.

She responds back , “THE OTHER KNEE DIDN’T HURT LIKE THIS!”

“IT PROBABLY DID.  YOU JUST CAN’T REMEMBER”.

Is she yelling at me?  Are we yelling at each other?  Am I getting a headache?  I’m so thirsty.  In my mind I put some of her ice chips into my mouth.  I take a sip of her water.  I take a whiff of her oxygen.   Only in my twisted mind.

I’ve given her a lot of pain medication.  Her pain is better.  However the infamous nausea BUG has reared it’s ugly head.   She upchucks.

My heart does an about face.  I feel compassion for her again.  I sooth her.  Give her anti -emetic medication.  Help her rinse her mouth a couple of times.   We are friends again.

I transfer her to her room.  As we are sliding her off the stretcher onto her bed she opens her eyes for the first time.  She looks at me and says, ” thank you”.

That is why I’m a nurse.

TIDBIT  In the mid 1800’s surgery was more like a horror show.   Pain control was limited to doses of opium while surgeons seemed more intent on hacking off limbs than actually trying to save them.

 

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About florencewannabe

I'm a registered nurse trying to work 1000 hours in 2014 to earn my pension. Currently, May 28,2014, I'm 455.5 hours into my goal. I have until Dec. 31, 2014 to get 544.5 hours of work. The catch is that I work per Diem and I don't have any guaranteed time.
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