Deehaven, we have talked privately, but I have been in your position.
I had many mental tests to prove I was not "impaired" and that reflex time, etc were actually BETTER with my pain controlled, than not. If all I can do is think of my 10/10 pain, how can I care for my patients??? If I am medicated, and not going through a dose change or dose increase, I think you are okay, as long as you have doctor's approval. But, I know in some states, BON's need to come up with the times.
Chronic pain is increasing in this country, as the detrimental effects of pain on a person's body and mind is being discovered. As our country ages, we will see more and more people on long-term opiates for pain control. I know this scares the begeezus out of a lot of people, but those people probably have never felt our pain. My pain is not a simple "I did too much moving furniture this weekend". No, my pain at a 7 level makes me diaphoretic, shaky, unable to think about anything but my back feeling like a dagger is on fire, twisting along my spine and down my legs. It has gotten so bad in the past few months that I can't go to a store without a scooter. I am only 30. It is humiliating. I am scared to think about what will happen to me if I ever end up in a nursing home. I am on a lot of narcotics now, and in 30 years, it will be more. Will I get a nurse or doctor who thinks "Oh, she's on WAY TOO MUCH of this morphine!!! OMG!!! Take her off ALL OF IT and give her Vicodin!!!" or "She's an addict, take her off everything"!!! I would rather die than have that happen.
BON's around this country need to understand CHRONIC pain is different than ACUTE pain. Yes, during an acute injury, when a opiate-naive patient is given morphine, most likely they will be "out of it". If a person has been on morphine for a while, at a stable dose, they are not "out of it". But, many many health care workers and laymen alike don't understand. I wish, more than anything, that all the nay-sayers I am confronted by could feel my pain just by my touching them. Maybe that would change some minds.
I don't know what the answer is. My nurse practice act does not state that you can't work on narcotics. I have seen NPA's that DO state that, however. I know my opinion will be an unpopular one, but I think that nurses who are seen on a monthly basis by a pain management specialist, and who follow their contract with said physician, and are not just starting opiate therapy, or trying a dose change or increase, or a med change, should be able to work with physician clearance. Do the tests or whatever they need to do to see you are not impaired by having your pain controlled, you are impaired by having your pain OUT OF CONTROL. And that's all I have to say about that.