 So today I'm going to be talking about pain management from a nursing perspective So this is going to be talking about, you know, how to know which medications to give to a patient and how to assess their pain levels Yada yada, we're going to talk about a lot of different topics here I'm going to try to not jump around too much, but let's just go ahead and get started So first things first as a nurse you have to follow the orders that are written for pain medications Now this can be difficult if you've got, you know, maybe non-opioids versus opioids And you're trying to figure out which pain medication to give to which patient So I'm not going to go into so much of like the pharmaceutical aspect of things But typically what I like to do and what most nurses will do is if I have a patient who is complaining of pain One first, you should always assess their pain Yada yada, where it's at, what type of pain, all that, what the number is on a scale of 0 to 10 Or whatever scale you use at your hospital That way you kind of have an idea or do they have like a myopedic where I can give them Tylenol Or is their pain a 10 out of 10 where I need to give them something stronger Now pain is a Personally perceived, I don't know how to say that But basically your 5 out of 10 pain is different from my 5 out of 10 pain and that's how it's going to be for your patients But whatever they say their pain is is what their pain is And I know it can be frustrating when you have someone whose pain is always a 10 out of 10 But maybe they're exhibiting other signs like they're really really super drowsy Yet they still say their pain's a 10 out of 10 So it's important when you're administering pain medication, especially if it's a narcotic Or something that's going to cut their respiratory drive, you have to make sure it's safe to give your patient that pain medication If I have someone who's breathing 10 times a minute And I have to go in and wake them up every time to assess them And they say their pain's a 10 out of 10 I'm probably not going to opt to give them the medication that's going to sedate them more because I just Don't find it safe. So the best thing to do if you have a patient that let's say their pain's a 7 out of 10 and You've got PO pain medicine IV pain medicine and you have not opioids and opioids is to Assess one their pain but also assess What have they received prior or what did they take at home prior to coming to the hospital and Did that work for them or did it not so if a patient says their pain 7 out of 10 I just saw that the previous nurse had administered two Percocets and I asked the patient did those two Percocets work for you and they say Yes, that really really worked for me or no that didn't work for me at all Then I'm going to go to my next step and either Administer that or maybe we try that in something else or if they say just didn't work for them at all Then maybe we need to talk to the doctor about getting more pain medication You can always talk to the doctor about getting more or less pain medication Depending on the patient sometimes the patient comes in and all they have is Tylenol ordered and they just had I don't know Some procedure and they're really uncomfortable and Tylenol didn't just didn't work for them You may need to call the doctor and get something a little stronger or Vice versa, maybe you have someone that has a ton of pain medication ordered on there on their mar And you have to call the doctor to say hey look this patient is taking a lot of pain medication And they're very drowsy and they're over sedated. I think we may be giving them too much Maybe we can cut back on the dosage. So it goes both ways But typically depending on the patient I like to start with administering PO medication and then Using the IV medication for breakthrough because when a patient goes home if they're just going to their general home or whatever They're only going to have PO pain medication available if the doc doctor writes a prescription the doctor's not going to write a prescription For IV pain medication unless they're going to like a specialized facility that can administer it And so I always talk to my patients about that if they're post-op and they say how will my knee really hurts I only want the IV pain medicine the PO pain medicine didn't work Then I would say hey, let's try the PO pain medication Maybe I'll give you a higher dose this time and let's give it about 45 minutes to an hour And if you're still in pain Then I'll give you the IV pain medication for breakthrough But I find so many times that nurses will just administer IV pain medication Which there's times where that is absolutely a hundred percent correct And that's all you have to administer or should administer But there's times where nurses kind of just I don't say get lazy But they're tired of hearing their patients complain of their pain or they're tired of hearing their patients say oh The PO didn't work and they just don't and the nurses won't even try and I can't tell you how many times I'll see a patient got Q2 hour delotted all night long and then I'm like well Did you try any PO pain medication? No, they said that a lot and worked really well for them, which is great It's what it's working for them, but you also want to make sure that you are educating your patients on the importance of Taking that PO pain medication first and then using the IV pain medication for backup now There's always instances where you have patients that come and they're just arriving in pain And you know you just need to give them something a little extra and so you give them the IV pain medication first There's unique situations for every patient every different medication that you have But typically I like to start with PO and then IV depending on the situation I know I've been saying that a lot, but it is really true The next thing is asking what patients take at home. So if a patient normally takes Percocet every six hours three times a day at home and Comes into the hospital and gets a procedure. Well typically Depending on the procedure in the patient taking their normal one Percocet every six hours is not going to cut it So you may need to be giving them that just as their baseline Foundation medication that they normally take and then giving them something additional on top of that So it's important to know what someone was taking at home if they're complaining at pain of pain pain is such a subjective thing that's the word I was looking for subjective and Every situation is truly unique. I could sit here and talk all day about you know When to give certain medications and when to not and yada yada But basically it comes down to nurses judgment and your orders and your order should say You know if a patient's pain is you know four to seven give them this medication if it's an eight to ten give them this medication some may not but on ours I know it does and Honestly, I don't really like that because I feel like everyone's pain is different But it's there as kind of a foundation in a baseline for you to assess your patients pain levels and give the correct medications And not over give medications Also, when you give pain medication always always always reassess your patients afterwards if it's IV pain medication You should be assessing within 30 minutes. If it's PO pain medication, you should be assessing within the hour One just to see the effectiveness of the pain medication But two to make sure your patient's still breathing and alive and that you didn't give them too much to where it's compromising their safety being an ICU nurse I most of my patients can't tell me what their pain level is they are You know intubated and sedated so I have to go off of a lot of you know objective information You know their vital signs is their heart rate higher? Are they breathing faster? Is their blood pressure up? Are they getting restless or scrimmy? Those are all indications that they may need pain medication or more pain medication Whereas you may have someone that's completely alert and oriented and can tell you you know Exactly that their left pinky toe hurts and it started last Friday And it's a 7 out of 10 and it's dole and it radiates and it's intermittent and it's you know stabbing throbbing whatever and It just varies from patient to patient. So I know this was kind of a lot of information Feel like I should make separate videos more in depth on this but this is kind of just a general overview So I hope you guys got something out of this and let me know if you would like to see more in-depth videos on this I don't know give this video a thumbs up and subscribe to my channel and I'll see you next time