I am just curious how you deal with drug seeking behavior as a nurse. I have a hard time with these people, because while I know they need help (like a rehab or psych hospital), their orders for meds sometimes contradict what I assess, and I feel like the MD's are not always helpful in these situations with setting limits.
For example I had a pt last night who was on a med surg unit at my hospital and was discharged, only to be found lying next to the elevators. So, she was readmitted to our unit. I had her last night, and she was constantly on the call bell asking when shecould have pain meds, and also asked at the start of shift to have her morphine changed to Demerol, and could I page the MD and ask. Well, the first red flag was that when asked her pain scale it was always 10/10 but she could get up and walk to the cafeteria or outside to smoke, despite my asking her to stay on the unit and ask for help when ambulating, then when informed the MD would not change her pain meds asked for morphine and ativan (by name) as I was giving her scheduled methadone. She was A&O, but stoned out of her gourd already, and I told her I can't give those meds at the same tme, and would come back and reevaluate her in an hour. She started in about how noone understands her pain and that she was fine, but yet she was constantly up and restless even after meds that would have put me in a coma. I realize everyones tolerance and pain is different, but her behavior was very manipulative and led me to believe she was drug seeking. She got very upset with me and asked to talk to the Charge Nurse who backed me on this (we suspected she was using illicit drugs in the hospital but could not prove it).
How do you all deal with these patients when you also have 4-5 other SICK patients who require your care and attention? They do not listen to reason, just watch the clock to get their next dose, and God forbid you are late giving their meds!