One of the things I've learnt after many admissions to hospital is that your little one shouldn't be in pain post surgery - its just not good for them. I have also learnt that despite doctors and anaesthetists signing off on decent amounts of pain relief, nurses can often have a strong aversion to giving the full dose. This is not okay.
Just now, in the last 30 mins I put my foot down and demanded they increase the morphine for Matilda and we're still not close to the full dose that she can have if the pain is really bad. I've spent nights in hospital with babies in other rooms screaming all night and thought to myself "why won't they address that child's pain?"
We have teams of pain specialists and nurse clinicians who are pain specialists, and yet when these people leave the ward, sometimes some nurses like to err on the side of less rather than enough. This is not good enough. It traumatises the child, affects their recovery, in our case their willingness to wee and stresses the mother out. Comfort post surgery is paramount.
I have found that post surgery, the major milestone for Matilda is getting her to wee - this only happens when she has sufficient pain coverage - today she needed morphine, paracetamol and ibuprofen to feel relaxed enough to wee. And this is totally okay with me…. there's no damage in taking these medicines in safe doses and there is psychological damage in getting kids to "tough it out" by not giving them enough particularly if you have more hospital trips and surgery likely. At the Royal Children's Hospital in Melbourne I used to help kids who'd become so traumatised by their procedures feel able to face "yet another one." We have to make each procedure as comfortable as possible or we risk traumatising and retraumatising which leads to greater fear and resistance in the future (This is my perspective as a Clinical Child Psychologist).
Matilda's last major surgery was when she was 12mths old. I was so frustrated at a particular nurse who withheld giving Matilda pain meds that she was signed off to have. I rang the surgeon and luckily his wonderful receptionist put me straight through to him, I told him what was going on and he told the nurses to give the pain meds. I was so upset at the unnecessary pain they put her through that once I got Matilda to to sleep I went to the nurses station and said "I don't understand your conspiracy against giving pain relief, if you had a headache you'd take something!!!" and then unfortunately I cried. Bloody tears…. when you're a woman and you're assertive people listen, but when you're assertive and then you cry "your being irrational and emotional."
I'm lucky, I'm white, middle classed, well educated, very medically literate from spending 15 years working in the hospital system and still these things occur frequently when I'm on watch. I hope this post helps another mum to stand up strong and make sure her child gets the pain relief they need.
A mother's blessings and support to us all.
What great advice Sophie, I had no idea that it was up to the nurses to determine the amount of pain relief given, I had thought that they would have given amounts as determined by the doctor. This reflects how often your mummy instinct should be followed, something that often comes unfortunately after an incident such as this.
ReplyDeleteThank you! It's something dear to my heart as both a mum and a child psychologist.
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