Pain Medication addicts - page 2

by rgvnurse85 3,985 Views | 21 Comments

As a new nurse I have already encountered many patients who ask for pain medication non stop. I have even seen them place timers on their phones to remind them when the dose is due. Does anyone have similar experiences when it... Read More


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    Pain is easier to control if you're on top of it before it gets extreme. When I have patients who are in a lot of pain, I will ask them if they'd like me to wake them up and give them a dose of medication as soon as allowable, or in some cases, before I leave for the day. Then I set my timer. The patient has to be stable and rousable, of course.

    It irritates me that so many nurses do not want to give pain medication for various reasons. They think the patient is lying, watching the clock, drug-seeking, not acting like they're in pain, etc. It seems to be a control issue for at least some nurses.
    poppycat, leslie :-D, sharpeimom, and 1 other like this.
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    Something to consider is that the time frequency that pain meds are ordered are partly based on the time in which the medication will likely become ineffective, which would also be the time we should be planning to assess pain. If patients are constantly having to initiate this assessment then there's a problem.
    poppycat likes this.
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    Quote from Orange Tree
    Pain is easier to control if you're on top of it before it gets extreme. When I have patients who are in a lot of pain, I will ask them if they'd like me to wake them up and give them a dose of medication as soon as allowable, or in some cases, before I leave for the day. Then I set my timer. The patient has to be stable and rousable, of course. It irritates me that so many nurses do not want to give pain medication for various reasons. They think the patient is lying, watching the clock, drug-seeking, not acting like they're in pain, etc. It seems to be a control issue for at least some nurses.
    I had surgery recently, and the pain was something awful. At one point, when I asked for something, the nurse said that it was well within the time limits. She said that she had come in earlier but I was "asleep" so she just left the room. That really irritated me. I had just had general anesthesia, I was drowsy. This has nothing to do with my pain. You can sleep even when you have pain. Also, a lot of the time, I had my eyes shut in attempt to get control of myself. The more I hurt, the quieter I get. It doesn't hurt nurses to give meds. They don't deduct that morphine from our pay, so why do so many nurses act like it's personally costing them something?
    tsalagicara, poppycat, and sharpeimom like this.
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    I have a couple of thoughts.

    First and foremost- pain is what the patient says it is. It is completely a subjective symptom. That does not mean, however, nurses should administer medication without caution. If you feel the regimen is insufficient, talk with the prescribing provider. Also, watch for dependency s/s as well as cardiac/respiratory issues.
    Secondly- I am recovering from ankle reconstruction as we speak. It is not fun being on this end. I was timing a triad of meds post op. If the schedule was deviated, bringing the pain to even painfully tolerable was almost impossible. When I had my baby, a nurse kept me waiting for 1.25 hours for Vicodin, a very long time after a C-section. Hence, personal experience gives a new perception and appreciation for pain.
    Lastly-my dog, Colby, also takes Ultram for his ACL pain. Another participant mentioned their dog did the same. Needless to say warm milk and analgesics are a way of life around here for owner and dog lately. 😊
    poppycat likes this.
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    Quote from monkeybug
    She said that she had come in earlier but I was "asleep" so she just left the room. That really irritated me. I had just had general anesthesia, I was drowsy. This has nothing to do with my pain. You can sleep even when you have pain. Also, a lot of the time, I had my eyes shut in attempt to get control of myself. The more I hurt, the quieter I get. It doesn't hurt nurses to give meds. They don't deduct that morphine from our pay, so why do so many nurses act like it's personally costing them something?
    We aren't mind readers, though. If you want to shut your eyes to help that's fine, but there's a call button there for a reason, and if you need pain meds, ask for them. You should know it's easier to control the pain before it gets bad, so ask. Don't blame the nurses if you didn't tell them you had that much pain.
    AngelicDarkness likes this.
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    Quote from Orange Tree
    It irritates me that so many nurses do not want to give pain medication for various reasons. They think the patient is lying, watching the clock, drug-seeking, not acting like they're in pain, etc. It seems to be a control issue for at least some nurses.
    Quote from MunoRN
    If patients are constantly having to initiate this assessment then there's a problem.
    the most evident, glaring problem i see, is evidenced by the title where the op outright calls the clock-watchers "addicts".
    even more unfortunate is i know she is not alone in her thoughts.
    it's too, too bad this is such a problem amongst nurses...it really is.
    pain advocates should be requesting to drs, that all pain meds should be scheduled and atc for the first 24 hours.
    otherwise, this "prn" stuff is for the birds.
    gawd help those who are in pain.

    leslie
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    yup, in nursing school, many moons ago, we were taught that post up meds should at least be offered atc for the 1' 24'......of course that was before PCAs...
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    I am an advocate for treating pain. I give medicine for "breakthrough" pain as well. I find that pain control is essential to being able to recover.

    In my experience as a post-OP pt, I had to enlighten my assigned PACU nurse who thought that my pain was sufficient for my pain, however I had a headache, and the morphine was not touching it. When I ran down a couple if meds, she still looked unsure, she got the anesthesiologist, who stated "all you have to do is push the button." My reply was "DUH!! I am a NURSE employed at ----- and graduated from ---(the school was affiliated with the hospital and I used name clout, lol...) I am VERY aware of how to use if. My post-OP pain is controlled. I have a headache, I suffer from migraines. I still need a break through medicine to treat THIS new pain." VERY Grateful for a nursing who had NO PROBLEM administering Toradol IV ( and was an alumni from the school )...headache was gone in 5 mins!!!!

    I'm still and advocate on treating break through pain...if the person has a high tolerance level, we still have to tailor to their needs, and start having a plan on tweaking their pain plan, and for the pt to be actively involved. I'be had pts who had in the past taken illicit drugs, and their pain could never be satisfied because their pain receptors were covered in the drugs they frequently took. I tried alternative methods along with the pharmacological methods. I had to explain to them the WHY...some were able to eventually get their pain resolved, some still had trouble, but found a way to tolerate their pain-but used heat/ice, were willing to try deep breathing and guided imagery, and they felt it helped them cope. Some didn't feel it was enough, and U made sure they had resources to go into a pain management program.

    I think it takes a balance assessment wise and patient reporting to come to a decision on pain. If there are concerns about done of the physiological effects, there are too many alternatives that can be arranged to allow a pt to sit there in pain, IMHO.
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    Quote from SaoirseRN
    We aren't mind readers, though. If you want to shut your eyes to help that's fine, but there's a call button there for a reason, and if you need pain meds, ask for them. You should know it's easier to control the pain before it gets bad, so ask. Don't blame the nurses if you didn't tell them you had that much pain.
    I wasn't given a call bell. I was in a recovery situation. I don't know if they didn't have them or I just wasn't given mine. My point was that sleep is not the opposite of pain, and that nurses never should, but often do, assume that just because a patient is asleep, they are pain free. And I've spent a lot of my career recovering surgery patients (usually c-sections and tubals) and assessment is key. I have no qualms about waking up a patient to assess for bleeding, vital signs, OR pain. It's not the same thing as waking up someone at 3 am to ask them if they'd like a sleeping pill.
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    The patient gets pain meds when they ask for them. Period. I would rather overmedicate a junkie than undermedicate someone in legitimate pain. Most patients that are believed to be junkies are in fact not. Sometimes its an issue of poor pain management, other times its because the person is very sensitive to pain or has high expectations from the hospital (such as first surgery or childbirth). It is incredibly subjective to assign this title and dictate plan of care accordingly without all the facts present, and I've found calling people 'med-seekers' will only be a detriment to their care. Once the health care team's mind is made up, they stop investigating route causes, they stop treating, and they blame the patient for the problem. Don't get me wrong, they are out there. They are very cumbersome and annoying, I will give you that. But research suggests that number of legitimate med seekers is much lower than what health care professionals estimate it to be.

    Besides, even junkies have pain. Treat it.


    Edit: I guess I should have read through the thread first, I suppose a lot of people agree with me. Great to see, thank you all
    tsalagicara and monkeybug like this.


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