Mrs. Betty Gannon fell in her home while using the bathroom in the dark. She slipped on some water that was left from her earlier shower. The following day, Betty went to the hospital and saw Dr. Pang. She was told she had a broken fibula and would need an ORIF (Open Reduction and Internal Fixation Surgery) to repair the damage in her left fibula. The surgery would cause at least 2 to 3 weeks of pain, and require 12 months of therapy to heal. Dr. Pang recommended that Betty stay at an Assisted Living Facility temporarily to have access to Physical Therapy on a daily basis. Betty agreed to both the surgery and her temporary stay at Sunrise Senior Center (SSC). While at the SSC, After two weeks, Betty started attending daily therapy BID (twice a day). She was still in quiet a bit of pain even between her pain medication dosages prescribed by Dr. Pang. The patient was prescribed an oral pain medication to be given Q6H (every 6 hours). However, Mrs. Gannon was in extreme pain only after a few hours after taking her medication. Betty demanded that her attending CNA, Julie, get her more pain medication. Julie, knew she needed to speak with her nurse to figure out a solution. Julie talked with Nurse Nancy and explained her patients pain issue and the patients demand for medication. Unfortunately, Nurse Nancy is unable to offer anything more than what the patient was already given. Nurse Nancy would be unable to give more medication or an alternative without consent from Dr. Pang. Mrs. Gannon would have to wait until 8 AM for the Q6H to pass, or await word from her physician for a change to her RX. Nurse Nancy files the appropriate paperwork needed to have the medication changed to PRN (as needed) and have a possible alternative medication to use between dosages. In the meantime, both Nancy and Julie work to find a position that alleviates the patients pain until they hear back from Dr. Pang and an changes made to her medication dosage.
This is Mrs. Gannon. She slipped and fell while using the bathroom in the dark.
Betty was seen by Dr. Pang at her local hospital and told she had broken her fibula. It was recommended that she undergo surgery and then seek therapy at a local senior center under the care of a physical therapist.
Her prescribing Physician wrote an RX for pain medication to be taken PO, Q6H
I've felt better, but this will help me sleep. Thank you!
Sorry to wake you Mrs. Gannon. I'm Nurse Nancy. I'm here to give you your 2 AM pain medication dose. How is your pain right now?
I need my pain medication right now! How can I sleep if I'm in pain all the time? Why can't you just give it to me?
I'm sorry that you're in pain. I will go check with your nurse to see how we can help.
"Hi, Nurse Nancy. I'm Julie the CNA on your wing tonight." "How can I help you Julie?""I was just doing my rounds and the patient in 101 would like her pain medication.""Unfortunately, her doctor has orders for her to take her dose every 6 hours and she just got one at 2AM. Unless I can get it changed to PRN, or get permission for a substitute between doses, she will have to wait until her next dose at 8am".