Critical thinking

Is critical thinking in nursing really dead?

Sometimes, I wonder if it died recently, because many of the nurses who work at the Hotel tell strange stories.

What would you think of a rehab unit where...

1. Nursing staff don't want to get patients up to therapy after lunch? They went all morning, they say.

2. Nurses want scheduled pain medications because (I'm quoting because they actually said this) "He has to ask for prn meds and he never does, so we can't give it to him."

Pain is a part of rehab, but not taking care of it, especially in folks with addiction history, is criminal. Nursing is about alleviating suffering and promoting wellness.

Hmmm...wonder what part of the pain assessment they missed? How about the first part where the nurse actually talks to the patient. If Mr. Z. tells me is pain in his legs is a 10 after his first rehab session, even though he's got his long-acting on board, guess what I'm doing?

That's right...looking for PRNs. If those aren't appropriate, how about ordered adjuvants like cremes, gels or patches? Or my personal favorite: doing the interdisciplinary thing and calling your PTs (or whoever has them) and getting some warm packs if this might help (since we don't have a towel warmer like Saintarama).

If his pain isn't resolved, then we should consult the pain specialist group that is right down the way. They do take consults.

My $0.02 on this rainy night.