Senate Investigates JACHO Big Pharma Pain Link - page 4

by Bklyn_RN 5,009 Views | 50 Comments

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 pain. It asks whether the pt... Read More


  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 5
    needless to say, regarding this issue i would say that, damn if you do, and damn if you don't.
    nuangel1, Not_A_Hat_Person, wooh, and 2 others like this.


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