[font="comic sans ms"]i acknowledge that the situation is completly out of my hands.
i didn't tell them to come to the er. they decided that themself.
i don't order the pain meds -- i only administer them.
since i only work pt in the er, i realize that the er docs know the ffs better than i do. if they order lortab, rather than dilaudid, for a patient c/o severe abd pain that has had 30 visits in the past 3 months, there must be a reason.
if the patient tells me that "i don't want pills," i let them know that the doctor has order pills, and that is what i have to give them. i tell them that i will relay their thoughts/concerns to the doctor, but i warn them that i seriously doubt the doctor will give them anything parenteral unless they give the pills a chance.
if the doc wants to give them something iv/im, fine. i'll give it. if not, i let the patient know and give them the option of taking the pills. the way i look at it, it serioulsy decreases their credibility to refuse to take pain pills when coming in c/o pain. if you are truly hurting, you'll give the pills a shot. they may not work, but you will be willing to try them.
we have a few new docs in the er where i work, and between us, we've probably been "taken" a few times lately with regards to pain meds. too busy to look up the old chart, there too infrequently (me) or not enough yet (them) to know better. however, i have to agree that it is better to give pain meds to those "seeking" than to let someone who is truly hurting lie there in pain.