This is a tough issue. I agree that drug-seeking patients are in the minority and that we don't have a right to decide another person is not in pain. In nursing school
, they teach you that "pain is whatever the patient says it is". Unfortunately, it's not that simple.
There IS such a thing as a drug-seeking patient and as nurses we need to use our assessment skills as well as our instincts and common sense or we risk doing a great disservice to those entrusted in our care.
I remember one patient who complained of horrible, agonizing pain for seven or eight months after his hip fracture had healed. He was on Vicodin and a morphine patch and still he reported pain. No one could find any physiological reason for his pain and he reported that all non-drug methods of pain relief (and believe me, we tried them all) were ineffective.
I reported and documented my findings and I spoke to his doctor no less than six times about what I felt was a drug problem. So did the other nurses, and we all continued to medicate him as ordered.
Finally, the doctor stopped ordering the pain medicine and put him on Methadone. Shortly thereafter, he overdosed on cocaine.
Maybe nothing could have helped this patient but I wish we had all been more aggressive about what we damn well knew was a drug problem and less concerned about appearing "judgemental".
If I've offended anyone with this post I am sorry, but I had to say what I feel.