iv dilaudid

Nurses General Nursing

Published

:sniff:I work in a community hospital where it seems like every patient has an order for iv dilaudid for pain. I am an iv therapy nurse and it seems like I get alot of calls needing me right away to start an iv because the patient needs their iv dilaudid right away. It just seems like this is the drug of choice now for any type of pain. It just seems to be given out like candy. Is is like this in other institutions?

A couple of comments:

* Please use paragraph breaks. It's very difficult to read posts that are so long with no paragraph breaks.

* Since we're talking dilaudid: anyone notice pts complaining about headaches with dilaudid? I'm unsure if they have a headache that is not being helped by dilaudid, or if the dilaudid is causing headaches. It seems to me a disproportionate number of patients have headaches while on dilaudid, and I don't know what the correlation (if any) is.

* While there are, of course, judgmental nurses (just as there are judgmental people), I think you will find that most of us will vent about the difficulty of caring for pain patients mostly because it is so frustrating to be unable to provide sufficient relief. We want to help. Unfortunately for some chronic pain patients, there simply isn't a combination found (yet) that provides them with relief. Most of us have a lot of sympathy for such patients, and frustration that we can't help.

In the ERs I've worked in, the patients ask for Dilaudid by name. We give it for just about everything it seems.

The patients won't settle for anything less!

They'll also demand a 'script for percocet because their UTI pain is just awful.

If we could set up a machine that would print out prescriptions for hydrocodone and oxycodone, and set up a dilauded/ativan salt lick in the lobby, we'd probably whittle down the number of ER visits and end up taking care of people who actually need emergent care!

This is a message from a patient to whatever nurse would care to hear my story: I came across this site trying to find out more about the pain management the hospital I was in put me on, and how my doctor will taper me off when its time. As a patient prescribed an apparently notorious medication (dilaudid and MS Contin) while in the hospital, I had no control over being admitted for a month with a severe flare of Ulcerative Colitis and also and pancreatitis, also later was being monitored for toxic megacolon since I was swelling badly inside. I'd endured pain for months with no relief before being admitted, and did not expect to be helped with pain or my disease at all so when I went to the ER. I didn't know how bad it was, and wasn't going to a GI. I just thought I was really dehydrated from the bathroom trips and bleeding, would be given some fluids and released. No, I was kept, and for the first time in a long time felt what it was like to not be in pain. I cried from the relief.

Some of the nurses were great, it wasn't as scary with them being kind. Yet as you all know, nurses come and go, not all of them apparently looked at my chart or knew my story. I was dismissed & scorned by some newcomers the doctors orders ignored, while I'm crying in my room from pain and likely withdrawals that I never asked for or sought because some knew nurse presumed I'm a druggy. The doctor prescribes this, not the patient.

Please remember this next time you feel like venting your frustration on last weeks junkie on a patient...ignoring your patient and forcing them to hurt because you're feeling passive aggressive is poor nursing. When you are dependant on your nurse, and can't leave the hospital, its scary. Not all of us choose this, and I am not ashamed of wanting to live without feeling as much pain. You try feeling your guts rip themselves up on a daily basis, then ask me if you want relief. Please, be kind to your patients. Sick people are vulnerable. Some of your posts make me sad, and those attitudes are why I went so long without medical care even though I had insurance. Medical professionals can be so jaded.

I wish Allnurses would make the majority of the boards private. It would be nice to commiserate with fellow nurses without getting lectured.

Yes we know there are people who are actually in pain. We try our best to medicate and advocate. Sometimes the system and people in it fail. Nothing's perfect.

There are also people who use and abuse us and the system and they wear us down. Venting eases burnout.

Specializes in ICU, medsurg/tele.

I would just like to clear something up. I do not automatically label patients who ask for pain meds as addicts. In fact I do the opposite. I have taken care of patients who have been admitted with a diagnosis related to drug use (ie. cellulitis secondary to injecting cocaine and missing the vein). These patients do have real pain. I understand this and I do everything I can to control their pain. I do not put them on the back burner, I do not treat them any different than my other patients in pain, I do not label them as drug seeking. What I was discussing in my previous post was the frustration with those patients (drug seeking or not) that are rude, demanding and have unrealistic expectations of pain management and me as a nurse. When I try to educate them on pain management and the role of the nurse along with our responsibilities outside of them and they do not want to hear it thats when I get frustrated. I am sorry if anyone understood my post as automatically labeling patients because this is not what I do and I do not want anyone to be under that impression.

Specializes in pulm/cardiology pcu, surgical onc.
A couple of comments:

* Please use paragraph breaks. It's very difficult to read posts that are so long with no paragraph breaks.

* Since we're talking dilaudid: anyone notice pts complaining about headaches with dilaudid? I'm unsure if they have a headache that is not being helped by dilaudid, or if the dilaudid is causing headaches. It seems to me a disproportionate number of patients have headaches while on dilaudid, and I don't know what the correlation (if any) is.

* While there are, of course, judgmental nurses (just as there are judgmental people), I think you will find that most of us will vent about the difficulty of caring for pain patients mostly because it is so frustrating to be unable to provide sufficient relief. We want to help. Unfortunately for some chronic pain patients, there simply isn't a combination found (yet) that provides them with relief. Most of us have a lot of sympathy for such patients, and frustration that we can't help.

I have had numerous patients on dilaudid c/o hedaches.

While I do find it unnerving when patients set alarms to be awake and ask for pain meds, those who can't stay awake but requests for pain meds etc, I remember that one of the main side effects of narcotics is drowsiness. One can still be in excruciating pain yet can't keep their eyes open and fall asleep. I guess there haven't been too many nurses here that have been in serious pain for whatever reason. I myself have never used dilaudid but know how other meds affect me and know I can be drowsy but still painful.

What upsets me the most is when a patient tells the nurse they are allergic to synthetic and natural morphine. They ask for Tyenol and are snuck dilaudid and told oh it isn't any of that stuff. And you the patient gets very ill.

NO excuse. Patient asks for Tyenol then don't push the big drugs on them

Just got out of the hospital. I have chronic RA that has finally been somewhat controlled with an IL drug called Actemra. Point here, I KNOW pain. I know excruciating, mind blowing pain. But the chest pain I had this weekend was by far much worse.

I have an open script for tid Norco 10's, and really, never really took that many, thinking that it could get worse, I'll wait. (Not good for controlling the pain cycle, but not really into pain killers if I can get by.)

In the ER, the pain was causing vomiting, I was passing out from it, nurse gave me IV Dilaudid. Wow. Took a bit, but it worked. When it began to wear off, pain was coming back and I had another dose. Didn't need a third, pain had gone away.

However, headache was horrible, too. I'm 1 day out and still have a horrible headache. Can't take ibuprofen, tylenol doesn't work. Might just open that norco bottle after all, but seriously, the headache is nasty, but better than the original pain I was in.

Specializes in MPCU.
What upsets me the most is when a patient tells the nurse they are allergic to synthetic and natural morphine. They ask for Tyenol and are snuck dilaudid and told oh it isn't any of that stuff. And you the patient gets very ill.

NO excuse. Patient asks for Tyenol then don't push the big drugs on them

"Snucking" a drug to a patient is reprehensible and I'm pretty sure something that would require mandatory reporting. That would include giving NS when the patient requests dilaudid. (even if no doses are available.) just me a nurse.

Specializes in PCU, Critical Care, Observation.

It used to be the drug of choice until one of our hospital administrator's relatives died after being given 2 mg. For awhile we rarely saw it ordered, but it's starting to be ordered more and more...at smaller doses though.

Specializes in ICU.

I've seen too many patients get addicted that stuff. They know Q4! And one I know specifically likes it pushed fast and insists on a 10cc flush.

I had it once after my C-section. I did not like it. We can start a little more conservative thenw ork up to the dilaudid but it seems as if we just skip to it.

+ Add a Comment