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April 2005, Volume 35 Number 4 , p 17 - 17





  • Standards of practice

  • Prescribing problems

  • Dependence, tolerance, and addiction



    QUESTION: Can I be successfully sued if a patient's pain isn't adequately managed?

    ANSWER: Yes: Recent court cases illustrate that courts are willing to take on pain treatment issues. In 2001, for example, a California jury awarded $1.5 million to the family of an 85-year-old cancer patient who experienced severe pain before he died. The nurse caring for the patient had performed regular pain assessments and documented the patient's pain as 7 or above on the 0-to-10 pain scale, but the medication prescribed failed to control the patient's pain. The physician who undertreated the patient's pain was found liable; the hospital and nursing staff were settled before trial.

    So how can you protect yourself legally and make sure your patient receives optimal treatment for pain? Let's look at some key areas.

    Standards of practice

    First, make sure your nursing practice reflects the Joint Commission on Accreditation of Healthcare Organizations pain management standards, national standards on pain management, your state's nurse practice act, and your facility's policies.

    Remember that patients have the right to adequate pain assessment and management, and they rely on you to advocate for them. If your care deviates from the standards, thoroughly document the reason. For example, if a patient refuses pain medication, document the refusal and the reason, notify the prescriber, and request an alternative pain medication if appropriate. Document the actions you take to obtain another pain medication and your patient teaching.

    Prescribing problems

    Physicians, nurse practitioners, and physician assistants who prescribe pain medications may feel pressure to underprescribe ...

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