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Here's a paper from October's (2009) Annals.
To sum it up patients like it better when someone came and asked them every 15 minutes if they wanted more Dilaudid and gave it to them when they did. This was as opposed to the "physician driven" way where they get a hit at first and then they call the nurse every 15 minutes to ask for more and the nurse has to clear it with the dealer... er, doctor.
So is this helpful? I would argue it is not. Clearly patients enjoy more attention and more narcotics. Institution of these pain protocols is not so much a question of what will make patients happier. As I mentioned, they will. The two questions are should we be expending scarce resources this way (ED nursing) and should we be working toward the end of giving more narcotics.
Just for the sake of disclosure my hospitals have these protocols and I use them and I like them. They make my life easier as they help my Gallup scores and the nurses don't bug me about redosing the narcs. But are they really good for Emergency Medicine and for society and our over utilization of the ED. Not so much.
To sum it up patients like it better when someone came and asked them every 15 minutes if they wanted more Dilaudid and gave it to them when they did. This was as opposed to the "physician driven" way where they get a hit at first and then they call the nurse every 15 minutes to ask for more and the nurse has to clear it with the dealer... er, doctor.
So is this helpful? I would argue it is not. Clearly patients enjoy more attention and more narcotics. Institution of these pain protocols is not so much a question of what will make patients happier. As I mentioned, they will. The two questions are should we be expending scarce resources this way (ED nursing) and should we be working toward the end of giving more narcotics.
Just for the sake of disclosure my hospitals have these protocols and I use them and I like them. They make my life easier as they help my Gallup scores and the nurses don't bug me about redosing the narcs. But are they really good for Emergency Medicine and for society and our over utilization of the ED. Not so much.