You are currently in a patient's room during hourly rounds and although she is not due for another dose of pain medication for two more hours, she is complaining of increased pain. Tell me how you proceed.
The interviewer is asking this question for two reasons - first, to ensure the candidate will not give the patient a dose of pain medication before it is due; and second, to see if the candidate will attempt to lower the patient's pain using other comfort measures. While the administration of pain medication will relieve a patient's pain, it is important that pain medication is administered as directed by the physician, in order to avoid patient overdose or other negative side effects. Although patients may ask for pain medication in advance of their scheduled dose, nurses can help reduce their pain using other comfort measures, such as repositioning, offering heated blankets or warm compresses, helping them stretch, or getting them up for a walk. To effectively answer this question, the candidate should indicate that they would avoid giving the patient their pain medication early and instead use alternative comfort measures to help reduce the patient's pain. A more successful answer to this question would include an example from the candidate's nursing career where they helped a patient manage their pain using comfort measures rather than pain medication.
"Unfortunately, since the patient is not due for their medication for a couple of more hours, I would not be able to administer it to them. But, I would be able to help reduce their pain using other comfort measures. So, instead of simply telling the patient that they could not have any medication, I would work with them to see what I could do to make them comfortable in the meantime. Having many years of experience as a nurse in the emergency department, I have a lot of experience helping patients manage their pain when they do not get the desired relief from pain medications that were administered, and I would be able to draw from this experience to help this patient get relief until their next dose of medication."
"If a patient is not due for their pain medication for two more hours, I would explain to the patient when they can next have their pain medication. I would explore non-medication measures, such as heat, cold, repositioning, massage, or other options. Many patients that I've worked with over the years have found relief with non-medication interventions. During this time, I would also be reassessing the patient to see if any changes have occurred in the patient's condition--for example, if a surgical site looks reddened when it hadn't before, or if a patient was complaining of increased pain in their foot and their pedal pulse was weakened or absent when it had previously been palpable or audible by doppler. If any changes have occurred in the patient's condition, I would contact their doctor and report these changes."
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Anonymous Answer
I would not give additional pain medication if it was not due yet, don't want to overdose the patient. I would provide other comfort measures, pillows for support, warm or cool compresses, distraction, let the patient know when the next dose can be given and that they can use their call bell if I'm not back by that time. If they're constantly requesting pain meds prior to the next dose I would call the doctor and see if pain management could be adjusted as the patient may require additional doses or higher strength. Perhaps changing the route from IV or PO to SQ butterfly for longer-lasting effects. Also, advise the patient to let me know when pain increases, don't want to play catch up harder to control pain that way.
Cindy's Feedback
Great. I like that you assume facts and then answer the hypothetical. It shows that you're able to think ahead and have a plan if the original one doesn't work.
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