It really hurts! And you asked for some painkillers ages ago. What’s taking so long? How hard can it be?
No nurse wants to see you experiencing pain.
Most of the time, analgesia will be given to you quickly, but there are many reasons why it might take a while.
The hospital is a busy place, and the nurse caring for you also has other patients and tasks requiring attention. Pain management is always given a high priority, but sometimes there are other things happening that must be sorted out first.
A patient’s condition may have suddenly deteriorated, or there may be a medical emergency, or the nurse may be getting analgesia for someone else first.
Some types of analgesics (such as narcotics) are locked in a cupboard or cabinet and require a strict procedure to retrieve them.
These procedures are a legal requirement and there are serious penalties for any nurse that does not follow them.
A second nurse is required to ‘check’ the required medication against the doctors order, count the number remaining after it has been removed, and then both sign it out in a drug registry. This process takes some time, and there may be additional delay if another nurse is not immediately available.
Many hospitals now have electronic medication cabinets. However it still requires a second nurse to check out the medications.
In busy periods there can actually be a queue at the drug cupboard/cabinet of nurses waiting to administer analgesia to multiple patients.
Once retrieved some medications require further preparation before they can be delivered to you. If the medication is to be injected the correct dose must be carefully drawn up into a syringe and this is then checked again by a second nurse.
Finally, two nurses will come to your bedside and ask your name, date of birth and if you have any drug allergies to complete the whole process before giving you the analgesia.
In some instances the nurses may have assessed that your current charted analgesia is not effective or may need an increased dose. This requires a doctor to amend or change your medication chart before it can be given. Tracking down the right doctor can lead to further delay.
what you can do
If pain is anticipated, you will usually be charted a medication or combination of medications that are offered at regular intervals to cover it.
There will also be medication charted in case you need extra analgesia for what is known as breakthrough pain.
Ask early. If your discomfort level is starting to rise, don’t wait until it is super distressing before asking for analgesia. Anticipate that there may be a lag in getting it.
Measure it. In order to decide the type and amount of analgesics to give you, your nurse will often ask you to rate the pain on a scale from zero ( no pain) to 10 (severe pain).
“Optimal pain management is the right of all patients and the responsibility of all health professionals”
The nurse may also ask you to describe it and locate your pain. It is important to let the nurse know if the pain has changed in nature, or it is now present in a new location.
Although objective assessments such as your pulse, respiration rate, blood pressure and other non-verbal cues are used in assessing your pain, these all come distant second to your own subjective experience.
Describing your pain, or rating it on a scale for that matter, can feel difficult. Don’t worry, just do your best and use your own words. There are no wrong answers here.
This article will give you some help in describing and rating your pain.
The nurse should also check back a little while after the analgesia has been given and ask you to rate it again to see how effective it has been.
Discuss it. If you feel you are not getting relief from the analgesics that have been charted for you, or you are experiencing unwanted side effects (such as nausea), talk about it with the medical staff. Many hospitals have dedicated pain management teams to specifically manage complex or persisting pain experiences.
And don’t forget there are many effective non-drug strategies for managing pain. Things such as repositioning, massage, heat/cold packs, distractions, laughter, splints, breathing exercises can all help minimise your discomfort. Again, you can discuss these complimentary treatments with your nurses.