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Nurse Jane and the Surgeon Ms. Bell, aged 65 years, is under the care of Registered Nurse Jane. Ms. Bell had a total hip replacement yesterday. She told Jane that her pain was intolerable, and then she groaned loudly and said, "Oh, I hurt worse than I have ever hurt before in my life. Please help me, please, please, I can't stand it anymore! Please give me something for pain now." When Jane assessed her level of pain, Ms. Bell described her pain as the highest level, 10 on a 10-point pain scale. Her blood pressure and pulse were slightly elevated as compared to her last documented vital signs. Jane proceeded to check Ms. Bell's orders but discovered something very unusual. The surgeon had ordered her IV pain medication for only every 6 hours instead of the typical 3-hour frequency for patients with 1-day postoperative hip replacements. Ms. Bell would have to wait 3 more hours for her next IV pain medication. Jane returned to Ms. Bell's room to explain her current pain order and inform her that she would call the surgeon now. By that time, Ms. Bell was crying out with pain and moving her head from.
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