what you think about this???

Nurses General Nursing

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I was wondering if I was the only person who feels this way. I have a huge problem with docs who have no problem with pushing as many pain meds on patients as they can. We tend to get the same pts. back frequently and they request pain meds on the min. they are due. Some even set their cell phones to go off and wake them so they can call for pain meds. I don't mind treating someones pain, but I do have a problem making these pts "legal junkies" and in my hospital we do. We just had a frequent flyer come in and for 3 days took demerol 75mg IVP every 4 hours around the clock.(not to mention 50mg of Vistaril IM every 6 hours) And guess what, all tests were negative. And all the MD could say was "Well she has a history of kidney stones". Well Doc, she didnt have them this time. Then he just ups and sends her home. This was a female who was 4'11" and weighed 80lbs. This happens way too much here. Anyone else with this problem???:angryfire

Specializes in acute, med/surg/ER/geri/CPR instructor.

Unfortunately, we do not have a pain management nurse. And we do assess pain every 2 hours . I am very compassionate when it comes to someone in pain, but I guess my point was these pts. are not being taken care of. They come in frequently and request the meds they want, the route they want them and the frequency. Then when nothing is found wrong, (and this is after severval days of routine pain meds) they simply walk out of the hospital. What are we doing to these ppl. when we don't taper down the dose of meds. before they leave or when we allow them to leave with no dx. This is the problem I encounter. And it is only 2 docs that allow it. Believe me, I do know pain is different for all pts. and we use a pain scale of 1-10. This particular pt. was told for proper care she needed to be transferred to her urologist at another hospital, she refused and for 4 days she took pain meds and went home on po pain meds. and no dx. She has been instructed to follow-up with her urologist for further testing but doesn't.

Anyway, I appreciate all the comments and hope i wasn't perceived wrong. I want my pts to be pain free and I have no problem administering pain meds. But I would also like to know what dx. I am treating. Then good education can be taught and maybe help.

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I hear you about overmedicating, I know exactly what you're saying. These docs could treat the pain with other meds or combos of meds rather than giving what is demanded. There are some pts who NEED to be demanding because they have legit problems and know what works for them, but many who act like this are indeed addicts. BUT....we (nurses) rarely create "legal addicts" by giving meds while they're in house. These people were addicted long before you saw them.

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Specializes in acute, med/surg/ER/geri/CPR instructor.

Thanks Tazzi,

I just want to help. I feel like I haven't done everything for this pt. when they leave and nothing has been accomplished. I feel like the middle man with no real say so. Docs and pts have the final word.

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with the threat of lawsuits and jcaho's push about pain control, i can understand why the docs just give them what they want. i agree with you that the pts you described may very well be there for the drugs, but until it can be proven the docs are kind of stuck too.

if i were you i would suggest to the mucky-mucks about getting a pain control specialist on staff or at least available for consults.

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lilcajun, I understand exactly what you are saying, we have one in particular that comes in every month, third week of the month. The day the checks are to be in the mail,pt. checks out ama, regular as clock work. I won't go into any details, but, I feel YOUR PAIN.

I do get that pain is what a pt perceives it to be, but, it that is also abused terribly. There are people out there that have learned how to work the system and are experts at it.

Please don't flame me for these statements, I'm just relating what I have seen in my own facility time after time after time.

I know exactly what you mean. We have some frequent flyers like that. They are drug users and when their welfare money runs out, they come to the hospital to get the drugs legally. Some times they even refuse to leave when they are discharged, they claim they are still not well enough when multiple tests shows nothing. One of them even fake having seizures so would not be d/c. Most of them always rate their pain at 10/10 and always get the max dose plus breakthrough and methadone. And they leave the hospital without being d/c when it is time to get their welfare check.

Hope nobody gets me wrong, I still give them the meds as prescribed.

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Y'know, my upper middle class white niece is off to prison today because she is a heroin user who was arrested for shoplifting and found with drugs in her possession. She went into "drug court" and tested positive for benzos so turned herself in at 9 today.

I am sick of the contempt in which I see users held, and astonished at the implications from some that the only abusers are on "the system."

K was sobbing last night like an infant left in the gutter. Yes, she created her own situation; yes, she's a criminal; yes, she is my flesh and blood and I adore her. And why she can't just get clean needles - she is Hep C + - and drugs I will never understand. I would give my right arm to ease her pain and wouldn't even wire her cigarette money last night because I knew she'd use and miss turning herself in this morning.

Who gives a rat's rear if these people can't cope with life as it is?

I'm sorry. But my heart is breaking today and I really, sincerely have never, ever understood why it mattered if adults got high or not, as long as they didn't endanger other people with it. And our current climate and repressive and regressive drug laws hurt people more and hurt more people than the drugs themselves. They turn people into criminals to feed their habits, we have the highest number of people in prison for non-violent crimes than any nation in the western world, and given the class and racial inequities in sentencing and arrests have an entire class of African Americans disenfranchised.

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Y'know, my upper middle class white niece is off to prison today because she is a heroin user who was arrested for shoplifting and found with drugs in her possession. She went into "drug court" and tested positive for benzos so turned herself in at 9 today.

I am sick of the contempt in which I see users held, and astonished at the implications from some that the only abusers are on "the system."

K was sobbing last night like an infant left in the gutter. Yes, she created her own situation; yes, she's a criminal; yes, she is my flesh and blood and I adore her. And why she can't just get clean needles - she is Hep C + - and drugs I will never understand. I would give my right arm to ease her pain and wouldn't even wire her cigarette money last night because I knew she'd use and miss turning herself in this morning.

Who gives a rat's rear if these people can't cope with life as it is?

I'm sorry. But my heart is breaking today and I really, sincerely have never, ever understood why it mattered if adults got high or not, as long as they didn't endanger other people with it. And our current climate and repressive and regressive drug laws hurt people more and hurt more people than the drugs themselves. They turn people into criminals to feed their habits, we have the highest number of people in prison for non-violent crimes than any nation in the western world, and given the class and racial inequities in sentencing and arrests have an entire class of African Americans disenfranchised.

I'm sorry you and your family are going through this. ((((hugs))))

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