Senate Investigates JACHO Big Pharma Pain Link - page 3

Read article below first. I always thought something was fishy the way hospitals were mandated by JACHO to make pain a priority. My Admission assessment have an entire tedious section devoted to... Read More

  1. Visit  GrnTea profile page
    1
    i didn't take away the impression that taking them off the market was the focus of this investigation.
    usalsfyre likes this.
  2. Visit  wooh profile page
    7
    I'd rather give someone without pain a narcotic than withhold it from someone that is in pain.

    But I think it's super amazing that JC is getting "investigated." Perhaps they should start having to fill out a bunch of forms to comply with a bunch of policies to assure the public they aren't corrupt.
  3. Visit  SHGR profile page
    1
    Quote from CapeCodMermaid
    If I am ever hospitalized again with cellulitis from have no lymph nodes, I certainly hope my nurse takes my complaints and rating of pain seriously. People who are in pain shouldn't be judged and denied pain meds because there are people who abuse medication.
    That's why this is such a conundrum. Nobody wants people to hurt. Yet, because of these legal medications, there are people who are so addicted out there that they would kill to get high.

    I had a significant surgery in 2005 and was prescribed oxycontin and percocets. Then it was vicodin. I needed these for some time. Then the pain was less, but I was physically dependent on them. It took immense will power to stop using them.

    Now I work in a clinic with patients who are manipulative, who expend vast energy and brain power trying to get narcotic prescriptions. I have worked in med-surg, oncology and hospice. I feel like I have the ability to see the issue broadly, but have no solution. In this day and age, why are we still using so many of these opioid meds that have been used since at least a thousand years BC? Seems like we should have something with less addictive potential by now.
    gonzo1 likes this.
  4. Visit  apocatastasis profile page
    7
    Pain is not pain is not pain - there are different kinds of pain that need to be approached differently depending on the situation. The current research, which is what we should all be looking at, is that chronic, daily use of opioids for non-terminal chronic pain is not only inappropriate but INEFFECTIVE for the majority of patients and creates significant detriment to daily functioning. These patients are more appropriately served with drugs such as NSAIDs, tricyclics, GABA analogues, physical therapy, and psychotherapy (particularly cognitive-behavioral therapy).

    HOWEVER, under-treatment of ACUTE pain (e.g. by someone who isn't even a nurse yet but who has ALREADY(?!) decided that she has a vendetta against opioids across the board for the "benefit" of her patients) leads to establishment of pain pathways in the nervous system within the first several weeks after the initial injury. If unchecked, the establishment of these pathways leads to a patient who now has CHRONIC pain rather than ACUTE pain.

    Acute pain should ALWAYS be treated swiftly and appropriately, and this includes use of narcotics if necessary and appropriate to the patient (e.g. no history of addiction), so that pain does not become a chronic issue, with attendant psychiatric comorbidities.
  5. Visit  dirtyhippiegirl profile page
    2
    Quote from nerdtonurse?
    We're talking apples and oranges, I think. Nobody's going to hold a pain med on a burn victim, major surgery patient, ortho repair or someone with trauma.
    But it's only wishful thinking to assume that these issues are black-or-white, major burn vs. chronic migraineur.

    As a burn nurse, I routinely deal with people who come in with pretty nasty burns who are already addicted to opiates, often on top of meth and alcohol. How do you deal with these patients? I'm pushing massive amounts of pain and sedation meds to get these guys through a dressing change. We discharge them home on orals, but you're still talking fairly large amounts of oxy -- of which they get a script for (90 a pop) and can easily abuse or sell. But they're a 70% mostly second and third degree burn victim. What is the right thing to do?
    Not_A_Hat_Person and Sisyphus like this.
  6. Visit  SuesquatchRN profile page
    6
    Instead of gumming up our EDs and hospitals with seekers, why not just make it legal to get high? Humans have been figuring out ways to do just that since someone noticed that the cactus juice that sat in the sun for a week gave 'em a buzz. And if someone overdoses he overdoses.
  7. Visit  Bklyn_RN profile page
    0
    Grntea. You said it best. And yes, I am as shocked as you are. That the American Pain Federation voted to dissolve "effective immediately" when they got wind of this investigation, says volumes. 90% of their funding was from Big Pharma! I wonder how much they give to Joint Commission?
    Who is really looking out for the the pt's interests when Joint Commission has been co-opted by drug companies (just like the senate that will be conducting the investigation). It will affect us as nurses as well as consumers of health care. Because JACHO makes policies that hospitals and nurses must follow.
  8. Visit  kcmylorn profile page
    1
    I'm so glad to know that some of our nursing practice has it's roots in true "evidence based practice" aka "Follow the money"

    When is the Senate going to investigate these Patient Satisfaction Survey's? God only knows how much of the diving force behind them is contributing to patient mortality and morbidity-

    So here lies the practice of medicine and nursing these days- "give the patient what they want for a good rating not because it's what they need or in their best medical or ethical interest."

    I must applaude the poster who honestly stated- to summarize: many times we give these patients pain medication just because they asked for it knowing quite well they were not in pain that warranted the drug they were ordered and just because administration will pound their heavy fist on our back if we don't, after all it's really about the money(satisfaction survery) not about the best interest of the patient. Maybe if doctors and nurses were allowed to practice based on their clinical judgments and not on a survey that ultimately lines the pockets of CEO's and Drug Companies, the prescription drug problem in this country would not be the Public Health Issue it is. Another damn good reason to get the MBA's out of healthcare.

    "Pain is the 5th Vital Sign" There's a statement for pondering in light of this investigation.

    Hospital's pay money to JACHO for them to come into the hospital and perform their inspection. I had heard it was approx. $60,000 but that was many years ago.
    Last edit by kcmylorn on May 13, '12
    Bklyn_RN likes this.
  9. Visit  That Guy profile page
    0
    Quote from SuesquatchRN
    Instead of gumming up our EDs and hospitals with seekers, why not just make it legal to get high? Humans have been figuring out ways to do just that since someone noticed that the cactus juice that sat in the sun for a week gave 'em a buzz. And if someone overdoses he overdoses.
    Because those idiots STILL end up in the ED just in worse shape from doing stupid things.
  10. Visit  SuesquatchRN profile page
    2
    Quote from That Guy
    Because those idiots STILL end up in the ED just in worse shape from doing stupid things.
    And prison? The war on drugs costs us a lot of money.
    apocatastasis and tewdles like this.
  11. Visit  TopazLover profile page
    3
    Quote from dirtyhippiegirl
    But it's only wishful thinking to assume that these issues are black-or-white, major burn vs. chronic migraineur.

    As a burn nurse, I routinely deal with people who come in with pretty nasty burns who are already addicted to opiates, often on top of meth and alcohol. How do you deal with these patients? I'm pushing massive amounts of pain and sedation meds to get these guys through a dressing change. We discharge them home on orals, but you're still talking fairly large amounts of oxy -- of which they get a script for (90 a pop) and can easily abuse or sell. But they're a 70% mostly second and third degree burn victim. What is the right thing to do?
    I know there are few easy answers for your questions. I wish some of the current nurses had made an attempt to give some concrete answers for you.

    1. Recognition of those who have been fighting the battle of addiction by attendance in NA/AA. Support this by encouraging visits by 12th steppers.
    2. identify those who you can already see will have difficulty going home with bottles filled with narcs. Get honest with them. Why can we be honest about the effects of the burns but hesitate to say "dependent, developed tolerance".
    3. Advocate for use of a detox prior to leaving. I once had a pt. who had done well post addiction treatment until he was badly burned. He was receiving narcs via needle up until day of discharge. What did anyone expect to happen? He relapsed into heroin quickly. Fortunately he got himself back into treatment. I don't recall if he contracted hep or HIV before coming back. That would have been common in that area at that time. This relapse would have been prevented with appropriate detox following burn treatment.
    4. Use the time of dressing changes to establish a positive relationship with your patients. Encourage them to use this experience as an added push for them to get help.
    5. Get yourself educated about local help for addicts. Keep a list of NA meetings at your finger tips. Connect with some local NA members and ask their help with this problem.

    Thank you for your recognition that there has to be a better way. Accept my pat on your back for a difficult job you are doing.
    tewdles, Bklyn_RN, and SHGR like this.
  12. Visit  SHGR profile page
    1
    Pain is whatever the patient says it is, occurring whenever and wherever the patient says it does. Never undertreat a patient's pain.

    A mantra, repeated over and over again, in the name of caring, of good nursing, good ethical patient care. Treat pain. End suffering.

    Then we began to suspect, this was not so good after all.

    Does Big Pharma have an answer for us now?
    Bklyn_RN likes this.
  13. Visit  kcmylorn profile page
    2
    To do the logical nursing interventions that aknottedyarn proposed would go against the derranged mentality of the hospital administration. Hospital administration really cares nothing about the patient's projected outcomes( back in my day it was called"Long Range Goal setting) post hospitaliztion- all administration cares about is "making this the best experience possible for the patient" likening it to a trip to Disney or an orgasmic experience. I think it is coming to light- how much hospital adminstration really care less about the patient and their quality of life. How many addicts really fight back or advocate for themselves??? Administration knows this.
    gonzo1 and wooh like this.


Nursing Jobs in every specialty and state. Visit today and find your dream job.

Top
close
close