You make the decisions on YOUR shift and I'll make the decisions on MINE

[CrazierThanYou]

Here lately, I've had a couple of situations where the oncoming nurse didn't agree with choices I made on my shift regarding patient care. Usually, it is regarding pain medication.

In nursing school, I was taught that it isn't my place to judge someone's pain. It is what they say it is. Therefore, if the medication is ordered and its safe to give it, I will. I do begin with less potent drugs and I try to stay with them but that isn't always possible.

I had a cancer patient who was having some pretty bad pain, if one judged by his behavior. He only had one percocet ordered to control this pain, besides IV morphine. He had been complaining to the nurses and doctors that his pain wasn't being controlled with the perc. He couldn't sleep, etc. So, finally, I decided to bump him up to 1 mg of morphine. Afterward, he was able to rest and that was that.

Well, the oncoming nurse, who is known for her snippiness, didn't like it. She asked me if I REALLY thought it was a GOOD idea to be giving this patient MORPHINE.

Yes, I do think it was a good idea. He was having a miserable time beforehand and had relief afterward. Perhaps she would have liked for me to call her at home in the middle of the night to get her take on the situation?

This is just one example but the rest are pretty similar.

I don't understand some nurses' attitudes regarding pain control. Some act as if it the drug will come from their personal stash or something.

[LynnLRN]

If a patient wants pain medication I give it to them. If a pt is painful they deserve pain control. If they are a "drug seeker" it is not my job to "change" them and in the amount of time they spend in acute care it isn't possible anyway. The only thing I consider is if the person is to be discharged the following day I try very hard to use every other intervention I can besides giving IV pain medication as they need oral pain control to discharge.

[noyesno, MSN, APRN, NP]

The biggest complaint that I have is when a pt is on chronic pain management. Then we admit them to the hospital or they have surgery, then give the pt less or the same as their maintenance dosage

My other one is they suddenly cancel antidepressant or anxiolytics. Withdrawal cold turkey from those meds is BRUTAL!

YES! They always do this. At home they were taking two percocet 10's for fifty years. Now you've ripped apart their body and ordered two norco 5's. Not going to cut it. I'll be paging your rumpus all night.

Loved the patient who would take two norco 10's every hour at home. He would fall asleep with a heating pad on his back and was too sedated to feel his skin being burned by the pad, leaving burn scars all over his back.

When he came in for his lumbar fusion, it was pretty much impossible to get his pain under control and he didn't understand why he couldn't have norco every hour. When I paged the doctor for additional IV pain medication, the physician said, "he's a drug addict, I'm not ordering anything else." Made for a great shift. NOT.