• Dilaudid 0.2 mg to 0.4 mg IV every
5 minutes
• Valium 5 mg PO PRN
• Demerol 25 mg per dose (up to
100 mg total) to manage break-
through pain.
The medical director might add
long-lasting Exparel (liposomal bupi-
vacaine) injections to the multimodal
protocol in preparation of launching a
total joints program.
Nurses' role
Lakeside's nurses don't write scripts
for post-op pain meds, but, like nurs-
es everywhere, they take their role as patient advocates very serious-
ly.
"Surgeons don't always have the time to review our protocols and
discuss the importance of managing pain with a limited amount of
opioids," says Ms. Rowe. "Our nurses fill that gap, and patients value
the education they receive from them."
Staff make copies of discharge prescriptions so nurses have a
record of the medications patients should be taking when they make
follow-up phone calls. "We always ask about their pain levels to find
out if the medications we sent them home with are working effective-
ly," says Ms. Rowe.
Communications with patients about the center's pain management
protocols also focus on the nerve blocks anesthesia providers place,
including:
• Interscalene blocks for notoriously painful shoulder surgeries.
S E P T E M B E R 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 5 5
• TEAM PLAYERS Louise Bergeron, BSN, RN, (left), and
Sarah Hatfield, BSN, RN, review Lakeside Surgery
Center's enhanced pain management protocols.
Laura
Rowe,
MSN,
RN
