Almost all of my long term residents are on crazy routine pain medications.

[Mely_bee]

I have been an LVN for 12 years now, and before Dallas, TX hospitals went magnet status I was employed in that system. I have now been working LTC for 3 years, and the trend is disturbing. Not only are my patients on frequently scheduled narcotics, they "jones" for them. I have residents taking 2-3 narcotics q4hr scheduled, but asked for them constantly. No one bats and eye when I question it. It is seeking behavior. I have now been to 3 LTC, because of the crazy stress I have moved on to find something more normal, and less stressful. Is this the norm in LTC, or is this a mismanaged issue? I do not want to discount a pain issue, but the diagnosis of chronic pain seems really far spread.

[vintagemother, BSN, CNA, LVN, RN]

You just described my current residents!!

I'm trying hard not to judge them. After all, pain is what the patient says it is, the residents are elderly and don't have any s/s of over dose--like low BP, low RR, or altered LOC.

I do feel a bit claustrophobic when multiple residents surround me and park their WCs next to my cart every 2 hrs to get their next dose--which isn't scheduled yet, BTW!

I also have residents with routine Q4-6 hr. Norco/Perc

Plus routine MS Contin

And Another PRN narcotic analgesic

It is weird!!!!! I assume chronic pain.... Possibly their bodies have developed tolerance.....

They also tend to have gabapentin routine...

But it is kind of interesting/sad that a person is in that much pain and can tolerate those (to me) large doses regularly as a routine part of life.

[RNrhythm, BSN, RN]

Sounds like my unit. Patients set the phones to stay on top of their Q4 IVP Dilaudid, around the clock.