Case Study Of Patient Controlled Analgesia

Nurse Laura receives bedside shift report on her post-operative patient, Mrs. Jones, who underwent lumbar surgery this afternoon. The patient’s husband is at the bedside and the patient is complaining of nausea and 7/10 pain to her back. The off-going nurse explains that she educated Mrs. Jones on how to properly use her Patient Controlled Analgesia (PCA), but the off-going nurse reports that Mrs. Jones has upper extremity weakness and may not be physically able to use the PCA efficiently. To ensure Mrs. Jones is not in pain, the off-going nurse has administered Percocet 7.5mg by mouth to Mrs. Jones, which was effective for about three hours. Mrs. Jones’ adult daughter was at the bedside most of the shift because Mr. Jones was at work.
After shift report, Mr. Jones calls Nurse Laura into the room. Mrs. Jones is still …show more content…
The nurses involved realized that anyone pressing the PCA button other than the patient was not legal; however, this was not sufficiently expressed to the patient’s family members. Upon suspicion that the patient herself may not be able to press the PCA button due to her upper extremity weakness, the nurses had an ethical obligation to present this problem to the patient’s doctor. “When nurses become aware of inappropriate or questionable practice, the concern must be expressed to the person involved, focusing on the patient’s best interest as well as on the integrity of nursing practice,” (American Nurses Association, 2015). The economic factor could include the nurse-patient ratio, which does affect how much time the nurse has to spend at the patient’s bedside educating the patient and family on the PCA and how much time the nurse has to spend at the patient’s bedside assessing the patient’s pain. Had the nurses involved been able to be at the patient’s bedside more, a nurse may have been able to observe the daughter pressing the PCA button for the