Pain shots are us, not this nurse!

  1. 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:
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  2. 120 Comments

  3. by   Fgr8Out
    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:
    Never been enraged by a patient expecting to be medicated as prescribed by the physician... it's their pain, not mine... and I have no right to judge. Give them their medication and go read up on pain management.
  4. by   atwtrn
    I'm not sure that every patient should be labeled as a drug seeker. There are diseases where the patient is in intense pain i.e. fibromyalgia. At one time FM wasn't considered a disease. Perhaps the patient is in real pain. I just read about a patient who was in pain all the time and the MD said it was all in her head...turns out..it was LYME DISEASE....
  5. by   chenoaspirit
    Yeah, I do know what you mean. BP and HR WNL with no facial grimacing. I have had patients fall asleep within the length of time it took me to go to the OMNI to get the meds and walk back to their room. I know that pain is subjective and we need to medicate accordingly and I do. I always medicate PRN and as doc orders, regardless of what I "think". But there are some patients who arent drug seekers 'per se' but enjoy the added benefits these drugs provide. I had one patient tell me he would give me half his dose if I would call and get him some percocet Another patient was getting a HUGE amount of morphine via PCA, was upset because doc wouldnt increase his dose AGAIN. He said he was leaving AMA because he could medicate himself better at home. 3 weeks later he was busted for selling drugs. Another patient wanted his pain meds, I asked him to rate his pain on pain scale, he said "0, but I still want my pain meds" and smiled. Just as we shouldnt judge the patients we treat, we also shouldnt judge the nurses who express their feelings. Granted, most patients are truely in pain, but there are some who abuse the priviledge of being treated. And I think those are the ones the OP is referring to.
    Last edit by chenoaspirit on Jan 2, '07 : Reason: edited
  6. by   SitcomNurse
    We had extensive pain managament seminars at our facility, and pain is pain is pain... the biggest moaners and goroaners for me, are those having pain Id call a 4, but they say is a 10. Ok, its their perception. I get that. And when I have a person who is showing no visible signs of pain, we start investigating, and finding alternate measures... Pinpoint the pain, describe it to me. If you could point to the center of it with the head of a pin, where would it be?

    how about some non narcotic measures? turning & positioning? excersizing? massage(out building has it) Lidocaine patches? or longer acting meds to decrease on the # of injections a day. Non narc. meds?

    Im in pain alot during the course of a month. I only work part time, as sometimes I cant walk, and sleeping too long in the same position is torturous for me with my spine problems, even on a sleep number bed. But I still do my stuff, take care of a 2 & 3 year old, and only my closest friends can see it in my eyes....today is a bad day. I dont wear pain on my sleeve, and really appreciate it when my husb. sees what im going through, and comes to me with meds I havent asked for, but he knows I need. Im the prime example of not showing pain. I see it as weakness in myself(yeah, i need help with that one). Thats just he way it is with me. And maybe with your patient. Maybe then you'll find that he/she had someone in their lives who lived in pain, and never complained, and learned from that example.
    I hot hit with the re-coil of a fully stretched bungee cord, and the metal hook grabbed my leg.. I only yelled 1 word, and said no more. It wasnt a pretty word, but it was only 1.

    Sorry if Im rambling, but pain is something I really understand from acute to chronic, and you just cant judge anothers pain.

    yes, I truly believe there are drug seekers out there, but you need to do the investigating and offering of alternatives before the lable is laid. someone who dosent wanna try new things to do a better job of alleviating pain, is prolly enhancing their number, someone who will try anything to get rid of pain..is another story.

    Dont get 'enraged' ......get activated.
  7. by   SitcomNurse
    Oh yeah, and great topic by the way.. this is a hot one.
  8. by   clemmm78
    Pain is pain. What may seem to you as drug seeking may be true pain.
    I have become so used to severe pain that I can act and seem perfectly normal to the most trained eye. Yet, I still am in agony.

    If the patient is drug seeking, being enraged does nothing to help either of you.
  9. by   bethin
    Quote from Fgr8Out
    Never been enraged by a patient expecting to be medicated as prescribed by the physician... it's their pain, not mine... and I have no right to judge. Give them their medication and go read up on pain management.
    :yeahthat: Took the words right out of my mouth.
  10. by   atwtrn
    I know this is a bit off topic of patients seeking pain meds..BUT I was wondering if anyone has an experience with alternative ways to manage it like accupuncture? I've tried different oils and they seem to help sometimes..but mostly my CP requires muscle relaxers..anyway sorry to ramble..just wondering about alternatives to medication..
  11. by   UM Review RN
    Enraged?

    Ummm, that's a little strong. I wouldn't say enraged. Annoyed, maybe, if they were showing a lot of sedation and signs of overmedication, yet continued to request pain meds.

    But if I let a patient like that get to me to the point where I was enraged, I'd probably have to take a look at what was going on in my home life or something.
    Last edit by UM Review RN on Jan 2, '07
  12. by   GatorRN
    no, i have never been enraged by a pt asking for their pain meds that have been prescribed by a qualified physician. a pts pain is what they say it is, plain and simple. i am a huge advocate for adequate pain management. i would never withhold or judge a pt for requesting a pain med. i suffer with chronic pain myself, and can be experiencing mind numbing pain and most ppl wouldn't even know it. over time you adjust to it being a normal part of your every day life, and show no outward obvious signs.

    if my pts ask for their pain meds, i give it to them promptly without judgement. it's our job as nurses to care for and comfort our pts with whatever means available to us. if they need a bedpan, they get it. if they need a blanket to warm them, they get it, same difference in my eyes. not everyone is "drug seeking." who are we as nurses to make such a declaration?

    i have taken many pain mgmt classes. i think every nurse should be required to take a class in pain mgmt. many of us suffer from a lack of knowledge and training in this very important area of our job. in addition, i have a very clear understanding, from personal experience, what suffering needlessly can do to a person. if the pts physician has given you an order to medicate his pt for pain, why let a pt suffer needlessly if we have the means to give them relief? it's no skin off my nose to give a prescribed pain med to assist the pt to be more comfortable.

    ok, i'll step down off my soap box now.

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  13. by   bill4745
    I get as frustrated as anyone with drug seekers, however, I learned a lesson when I had a kidney stone - one of the worst pains I've ever had, but vital signs 110/68, HR 76. Obviously, vital signs not always a good indicator.
  14. by   Fairlythere
    Had two of them tonight, Q2h and one wanting more within15 mins, yet she was not grimacing, writhing, she even fell asleep between asking and getting it, yet would wake right up and say she was so glad to see me. The other guy was chronic pain plus a huge infection, and Im sure he hurt. They both stated 10/10 each time with the best relief being an 8. Now annoyed, yes, very. But as others have said, who am I to judge. For one, I dont think people understand the pain scale even though it is explained again and again. Also, I think docs sometimes undermedicate in small amounts that don't last long and if they are NPO and only can have IV meds, its hard.

    I think we have come a long way in saying pain is what the pt. says, but we still have a long way to go. Its hard to run to the Pxyis all the time for narcs and get witnessess to waste and all. I try to do what I can to reposition, encourage po meds and discuss pain control and pain meds with patients, and I chart every med and pain number and reaction and let the MD know. Its all we can do, right??

    I don't blame the OP for venting, but I do agree enraged is a little harsh to describe these pts.

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