Pain shots are us, not this nurse! - page 4

Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it... Read More

  1. by   SuesquatchRN
    Quote from TeleRNer
    Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).
    :icon_evil: :icon_evil: :icon_evil:
    No. Part of the point of main management is to alleviate pain. If I know that it'll hurt if I don't get my PRN med you can bet your sweet bippy I'll be asking for it. You're not supposed to demand that the patient disintegrate with a pain level that you deem okay for meds before administering something.
  2. by   kstec
    Whether it be a pain shot or pill, patients can and will take advantage of them. And yes, pain is subjective, but common sense goes a long way. If it walks like a duck, talks like a duck, you know the rest. My mother died of an overdose of Norco. Why because she was in pain. I do not work in a hospital, but I do get patients discharged after surgery who just can't seem to heal. The pain is a 10/10 everyday. Well next thing you know they are going to more than one doctor, rewriting prescriptions and ending up in ER with an overdose. Yes, I probably should take a pain mgmt. class, but in my nursing experience and life experience, your gut feeling tells you a lot. I don't want to see anyone in pain, but I will not contribute to their abuse or addiction. I value my patients that much.
  3. by   SaharaOnyxRN
    Quote from TeleRNer
    Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).
    :icon_evil: :icon_evil: :icon_evil:

    Hello, TeleRner. Hello, there, sweetheart. First, on behalf of all the naysayers, i want to apologize. Because so many are talking about who shouldn't judge and all that, but yet, they are judging you based on one comment.

    Yes, i do feel where you are coming from. I don't get angry, but I do get frustrated when dealing with these types of people. These people know good and well what you mean. They know that they, too, have been frustrated at times. Because I tell you, it really takes away from dealing with your critically ill patients when you are in a patient's room every hour pushing drugs to people that have no other problem except unresolved pain. The hospital is not where these people need to resided. There are pain management clinics out there for that. If they have chronic pain, then the doctor needs to handle it to the point where they don't always have to come to the ER for drugs.

    Anybody who says that they can't relate to what you are saying is lying. They, too, have seen what you're talking about and they are not perfect. They have hang-ups, too.

    Anyway, I support you and feel where you are coming from. Keep coming to allnurses.com. This is a good place to vent, as opposed to doing it in front of the patients.
  4. by   miko014
    Quote from Works2xs
    Perhaps having chronic pain all her life, she's learned coping mechanisms that allow her to function at something near normal levels. Maybe, even though she masks the outward signs, she's still continually suffering on the inside. It might even be possible that the only thing that empowers her to continue on in that manner is that she knows that in "x" number of hours, she'll be granted some respite from her pain so that she can build up enough stamina to bully herself through for the next little while. Wouldn't it be a shame if some outside observer misinterpreted her ability to endure as an absence of discomfort? Perhaps because this has happened enough in the past, she's learned that if she doesn't behave in some "socially acceptable" way of demonstrating "real pain" then she'll be damned to having to endure even more. It's almost too much to contemplate that a person who has the guts and determination to actually live a life in that sort of condition would still have to "prove" her pain on a regular basis.
    I was saying, isn't it sad that she thinks she needs to do that in order to get her pain meds? I don't even know if she realizes that she does that, because if she did, she would act like that more often. I mean, she's a big girl, if she was consciously doing that, she would know to do it for more than just 30 seconds while she asks for pain meds. It's something about the pt-nurse-pain meds part of it, because she acts normally the rest of the time and with other people. I was just pointing out what I have observed, not saying that she isn't in pain, or that she's exaggerating to get her meds. Pain is pain, I don't want you to be in pain, if you say you're in pain, I'll give you your meds and be glad that I'm not the one hurting (so long as your pulse ox/resps are okay and you are low enough on the sedation scale that I don't have to worry about you crashing on me).
  5. by   GardenDove
    I like PCAs for this type of pt. Big time savers.
  6. by   Kait
    Quote from SaharaOnyxRN
    Hello, TeleRner. Hello, there, sweetheart. First, on behalf of all the naysayers, i want to apologize. Because so many are talking about who shouldn't judge and all that, but yet, they are judging you based on one comment.
    I think this response was needed here. Thank you.
  7. by   PANurseRN1
    Quote from TeleRNer
    Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).
    :icon_evil: :icon_evil: :icon_evil:
    No, but I do get enraged by nurses who have judgemental attitudes about pts. who ask for pain medication.

    Maybe I'm just stupid. Here all this time I thought the point to pain management was to keep the pt. from having so much discomfort that he/she is moaning/grimacing/crying/having altered VS. Silly me.
  8. by   chenoaspirit
    deleted. Posted twice. "sorry"
    Last edit by chenoaspirit on Jan 2, '07
  9. by   chenoaspirit
    [QUOTE=chenoaspirit;1998712]
    Quote from SaharaOnyxRN
    Hello, TeleRner. Hello, there, sweetheart. First, on behalf of all the naysayers, i want to apologize. Because so many are talking about who shouldn't judge and all that, but yet, they are judging you based on one comment.

    I agree. This is basically what I was trying to say
  10. by   GardenDove
    People get pretty judgemental about people they think are judgemental. Old story, I think Jesus addressed this more than once. I find it annoying, personally.
  11. by   GardenDove
    I hate it when anyone does anything in front of the pt. Big beef of mine. I was at the supermarket the other day and the clerk was giving the bagger a hard time and embarrassed him in front of me. Really distastful.
  12. by   PANurseRN1
    Quote from lauralassie
    I try not to judge. I know it's really hard sometimes though ! I think our er adds to the problem though. Now we are giving IV dilaudid (I was informed by a pt the other day that is the liqued form of dilada - HA !) and percocet in triage. The liability for that worries me. I do find myself getting frustrated with people who are allergic to Toradol, ultram, nsaids, thorazine. But that drug that starts wit D...something , always works . Imagine that. Heck , I remember the days when we could give NACAL injections. (saline). It was amazing the people that thought it was demerol because it stung so badly. And , they felt better !!!!!! Then the dr was able to say to them they think their pain may have a psyc aspect , and have the proof for the pt. If they had NACAL every 4 hours and felt better then obviously they don't need narcs to feel better. Too bad we can't do that now days. Not to be mean but to make it easier to evaluate the root of the pt's pain.
    What the heck is NACAL??? Do you mean NaCl?

    You can be thankful someone didn't sue the pants off you for that. Quite unethical, possibly illegal. That violates the standard of care for numerous nursing organizations.

    It's inappropriate to try to suss out whether a pt's pain is "real" or "psychogenic" by deliberately misleading him. Just what did you do after you got to the "root" of the pt pain, other than putting his name on a 3x5 card and adding it to the "turkey file?" Did you make appropriate referrals, e.g. psych? Consult an appropriate specialist?
  13. by   JPine
    Quote from SaharaOnyxRN
    ...

    Anybody who says that they can't relate to what you are saying is lying. They, too, have seen what you're talking about and they are not perfect. They have hang-ups, too.

    ...
    No, I'm not lying when I say I can't relate to someone else who becomes "enraged" at their patient.

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