I have already decided that if I am ever to be admitted to the hospital... I will refuse to go to my own floor. I may perhaps just stick with McKenzie Willamette; they've been good to me in the past!
In my position, I have the ultimate ability to eavesdrop. Sometimes I don't even have to try. There's just personal information about every patient being spewed within earshot. I don't listen because I'm curious about the patients, I listen to learn from what I hear.
I hear nurses asking physicians for advice, nurses asking charge nurses for advice, or physicians asking other physicians for advice. I love it!
However, one thing I hate hearing are the words, "Clock watcher." I think most people working in the healthcare field would understand this term. Patients know how often they can receive pain medication and in turn watch the clock and call the nurse when they know it's time.
Now for some reason, this will get you labeled as a drug seeker, or a complainer, a pain, a wimp, liar, dependent, or a busy patient. Maybe I'm naive, but I think it should label you as someone whose pain isn't being well controlled.
Let's recap: Patient is in pain, gets pain medication, four hours later knows it's time for another dose and calls the nurse because still in pain or pain has returned, nurse "assesses" pain, and if pattern continues nurse is reluctant to give medication and does not believe the report of pain.
I say "assess" because the justification I hear next for being labeled a "clock watcher" is this...
"The patient said his pain level was a 6 out of 10. But his vitals are stable, they're watching TV quietly, and are not grimacing or gaurding. I just gave him something for pain 2 hours ago."
What they have "assessed" is the physiological changes that CAN occur with pain. However, the first thing you learn about pain is...
According to the American Pain Society, "Pain is always subjective. Objective observations such as grimacing, limping, or tachycardia may be helpful in assessing patients, but these signs are often absent in patients with chronic pain caused by structural lesions. No neurophysiological or laboratory test can measure pain. The clinician must accept the patient's report of pain."
Now... I'm not suggesting that no one every abuses pain medication and asks for it when in fact they aren't in pain. However, I'm not a drug counselor, I don't know this patient's dependency history, and my job is to relieve pain if there is a report of pain. An addiction to pain medication will not be cured or prevented in a three day admission by with-holding medication. "Opioid addiction in acute care patients with no history of substance abuse is a risk estimated at less than 1%." (:Lewis, Medical Surgical Nursing, 2008).
How about a more personal example. My brother-in-law was admitted for pneumonia and was in the ICU. He was experiencing a lot of pain in his lungs every time he'd breathe. He knew exactly when his next dose was due. So if when that time came and he was in pain, he would call the nurse - sometimes 10 minutes early giving her time to prepare it. He thought he was being helpful at first. But instead he got attitude. Heavy sighs, eye rolling, "It's not time" (10 min early mind you), "I just gave you something", etc.
This was especially frustrating for me, but allowed me to see the patient's perspective. The nurse's attitude toward his "clock watching" made him reluctant to ask for pain medication even though he was still in a great deal of pain. Now don't get me wrong, I'm not bashing on nurses here. It's just a reminder, an insite, or sharing of my personal experience, of how hurtful the label "clock watcher" can be.
Moral of the story.... #1) The clinician must accept the patent's report of pain. #2) This girl is going somewhere where I don't know anyone because I will be a clock-watcher, but I don't want the label.
In my position, I have the ultimate ability to eavesdrop. Sometimes I don't even have to try. There's just personal information about every patient being spewed within earshot. I don't listen because I'm curious about the patients, I listen to learn from what I hear.
I hear nurses asking physicians for advice, nurses asking charge nurses for advice, or physicians asking other physicians for advice. I love it!
However, one thing I hate hearing are the words, "Clock watcher." I think most people working in the healthcare field would understand this term. Patients know how often they can receive pain medication and in turn watch the clock and call the nurse when they know it's time.
Now for some reason, this will get you labeled as a drug seeker, or a complainer, a pain, a wimp, liar, dependent, or a busy patient. Maybe I'm naive, but I think it should label you as someone whose pain isn't being well controlled.
Let's recap: Patient is in pain, gets pain medication, four hours later knows it's time for another dose and calls the nurse because still in pain or pain has returned, nurse "assesses" pain, and if pattern continues nurse is reluctant to give medication and does not believe the report of pain.
I say "assess" because the justification I hear next for being labeled a "clock watcher" is this...
"The patient said his pain level was a 6 out of 10. But his vitals are stable, they're watching TV quietly, and are not grimacing or gaurding. I just gave him something for pain 2 hours ago."
What they have "assessed" is the physiological changes that CAN occur with pain. However, the first thing you learn about pain is...
According to the American Pain Society, "Pain is always subjective. Objective observations such as grimacing, limping, or tachycardia may be helpful in assessing patients, but these signs are often absent in patients with chronic pain caused by structural lesions. No neurophysiological or laboratory test can measure pain. The clinician must accept the patient's report of pain."
Now... I'm not suggesting that no one every abuses pain medication and asks for it when in fact they aren't in pain. However, I'm not a drug counselor, I don't know this patient's dependency history, and my job is to relieve pain if there is a report of pain. An addiction to pain medication will not be cured or prevented in a three day admission by with-holding medication. "Opioid addiction in acute care patients with no history of substance abuse is a risk estimated at less than 1%." (:Lewis, Medical Surgical Nursing, 2008).
How about a more personal example. My brother-in-law was admitted for pneumonia and was in the ICU. He was experiencing a lot of pain in his lungs every time he'd breathe. He knew exactly when his next dose was due. So if when that time came and he was in pain, he would call the nurse - sometimes 10 minutes early giving her time to prepare it. He thought he was being helpful at first. But instead he got attitude. Heavy sighs, eye rolling, "It's not time" (10 min early mind you), "I just gave you something", etc.
This was especially frustrating for me, but allowed me to see the patient's perspective. The nurse's attitude toward his "clock watching" made him reluctant to ask for pain medication even though he was still in a great deal of pain. Now don't get me wrong, I'm not bashing on nurses here. It's just a reminder, an insite, or sharing of my personal experience, of how hurtful the label "clock watcher" can be.
Moral of the story.... #1) The clinician must accept the patent's report of pain. #2) This girl is going somewhere where I don't know anyone because I will be a clock-watcher, but I don't want the label.
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