Pain tx options during post-op/ meds in gen.

Recently had a family member have back surgery (for the third time) and during her post -op time she immediately was in so much pain. She tried to get by on what she was told had been ordered by MD. The next day discovered that she had been ordered a PCA (self-administering pain-med pump) but she was never told this by the nurses. As an RN, the first thing I advised my pts. of was their pain tx options/ always let them know what was available per MD orders. Was so disgusted when I got there and started questioning the nurses because she continued to have severe pain. Only then, when I asked how I could get in touch with the MD and get her a PCA, did they say "oh, he said she could have one if this didn't work". I asked them if they didn't have the assessment skills to realize when something was NOT working well enough, and told them to get her pump. Just be advised, if you go into the hosp. don't expect anyone to act as an advocate for you (nurses are suppose to be but seems now if it takes a little time and effort, they'll just 'forget' it), you must speak out or have someone with you who will. Make yourself heard and understood. If your stay is going to involve painful procedures, such as surgery, ask ahead of time about pain mgmt options and make sure it is understood between you and your doctor. If there is a failure to adhere later on, tell the nurses. If that doesn't work, you have every right to call the hosp. nurse supervisor, and if nec. YOU call the Dr at his office # or you can call the hosp. operator or his office # and ask to have him paged to your hosp. room phone. In these cases, the wheel that sqeaks the loudest....... It is really sad when someone goes into the hosp. and is alone. If you know someone is preparing for a hosp. admission, be a true friend and if you can't go, help that person find someone else. Patients desperately need an advocate with them. It hasn't always been this way but now computers have pulled nurses away from the rooms, meds have to be taken out of computerized carts that require much more time. All orders have to be faxed to the pharmacy, retrieved there and processed, then sent up usually by a tech that has several other stops to make. All of this makes getting your meds. much slower, don't be surprised if you end up waiting a miserable amt of time. Cutting back on the work force is part of the reason, but not all. Also, and I speak from experience, techs fill the med carts, not pharmacist and usually not under supervision. I noticed my daughter's IV antibiotic was outdated while it was infusing; after telling the nurse and walking to the med cart with her, saw several others still in the cart that were out-dated.. Often meds are spelled almost alike and if a tech is unfamiliar or doesn't pay close attention, the wrong med can be brought up or put in the wrong cubical. Techs re-fill the routine order meds that are kept in the carts. Drugs such as hydroxyzine (atarax,a sedative-antiemetic-antihistamine & not to be given IV) and hydralazine (Apresoline for high blood pressure) look very similar to an untrained eye and have been confused by techs (don't believe it when you're told techs don't pull meds without supervision). This switch took place on my own unit (Labor and Delivery) where pts with toxemia require BP-lowering IV drugs freq. The Pharmacist just blew it off when I complained that techs were doing these jobs without supervision. It is very important for your own health and well-being, take notice and speak out. Your life could depend on it.