Decision Report 201203744

Summary

Mr C was admitted to hospital for a hip replacement. Shortly after his operation, he said that he was in severe pain. Mr C said that he reported this to a nurse who told him that she could not divert from the anaesthetist's pain management plan until she discussed this with him when he was available later that day. The anaesthetist reviewed Mr C several hours later and prescribed a fast-acting morphine tablet. He also prescribed other pain relief, including a slow acting morphine tablet. However, Mr C complained that over the next few days, nursing staff refused a number of requests for pain relief. When his pain levels subsided several days later he decided to make no further requests for this. Mr C also complained that nursing staff failed to accurately record his reported levels of pain and the drugs administered.

We sought independent advice from our nursing adviser. The adviser said that the board's account of the drugs administered after surgery was evidenced by the medical records, although she recognised that pain was subjective and that it can be difficult in some instances to eliminate all pain. The board had also acknowledged this in their replies. We noted that the level of pain Mr C said he experienced was not reflected in the medical records. Having considered the matter carefully, we were unable to reconcile the different accounts of the level of pain experienced, and we did not uphold his complaint. We found that appropriate pain relief was administered in accordance with board policy and the level of pain recorded in Mr C's notes at the time. In addition, we noted our adviser's comments that a balance had to be struck between relieving pain and ensuring a patient was not over-sedated.