Battle the jaded?

Specialties Pain

Published

Specializes in ASC, Infection Control.

I've worked in a pain clinic for a few years. We mostly do interventional treatment, but of course we prescribe as well. However, with the increase of abuse and diversion, we have all become so jaded, almost automatically assuming people are just drug seeking. I feel like we treat patients like criminals sometimes...random drug screens, pill counts, pharmacy check ups, huge contracts to sign, etc. etc... Obviously we have patients with legitimate pain who really do need opioids. But my question to you guys is, what do you suggest in terms of trying to "re-wire" the way we first perceive our patients? Any articles or anything like that you know of, that I can distribute to our doctors and nurses to help bring some of that negativity down? I just feel like we're doing a disservice to the field; but it's very difficult to work in pain management!

Up Vote Up Vote ×
Specializes in critical care.

As a legitimate pain management patient, no one feels that stigma more than your patients. I feel awkward and uncomfortable discussing my pain management needs because I am so afraid of getting that seeker label. What if I really do need a higher dosage right now? What are they going to think about that? What if they tell me no? But I really need help to get through this. So if they happens, and I go somewhere else, will the new place be told I'm a seeker by the old place? Then what?

Trust me when I say it - the fear of being perceived as a seeker probably rivals the feelings you have that we are viewed as seekers. And it doesn't help when prescribers are being put through the ringer for writing too many scripts for narcotics. I've heard recently of a pharmacy being shut down because they filled too many narcotic prescriptions. A pharmacy! I don't think there are any easy answers to your question.

I had a professor tell me last semester when talking about prescription med abuse: "maybe they are addicted and using more than they should, but if it is in response to their pain, you should work through that in a supportive way and address the addiction when the pain is under control." Heck, if the pain is that bad, when their doctors abandon them, they'll find other sources of pills. That's a whole new can of worms.

Up Vote Up Vote ×

I am also a pain patient and a full time nurse who works 40-50 hours a week. I have been taking pain meds for over 20 yrs. I have developed a significant tolerance to the short acting opiates and the only thing I ever got true relief from was Suboxone. It was a great 2 years for me when I was taking it. Then, I lost my job and insurance!!!! My job after that didn't offer insurance and I couldn't afford the $700/mo medication. It is very hard to do my job as well when I am treated like a drug seeker by my family physician who will not prescribe enough to take care of my pain. I was offered the implant, as long as I could pay the $5000 up front! The DEA and other agencies are making life so unbearable for the innocent ones, like us, that I am actually looking at applying for full SSI and SSD benefits. I lost a significant portion of my body with my first of four surgeries all from being a good person and taking care of my fellow man. I was only 21 when I ruptured 2 discs, L4-5 and L5-S1. I went through a fusion surgery and spent 2 yrs getting back on my feet. It has been a living nightmare ever since. I have an 8 inch scar to prove it. Boy, they sure do a lot better now. For anyone who reads this, please don't think that I am whining. I have no regrets where my healthcare career is concerned. It's just a travesty that those of us who do get hurt, and I have a minimum 20% PPI just from the first surgery, we get pigeonholed into this group of drug seekers and I am not. I want to be free of these harmful meds. But until they drop the prices and/or give us better insurance, we will never receive the full treatments that each of us deserves! I hope you have better care and luck than I did.

Up Vote Up Vote ×
Specializes in critical care.
I am also a pain patient and a full time nurse who works 40-50 hours a week. I have been taking pain meds for over 20 yrs. I have developed a significant tolerance to the short acting opiates and the only thing I ever got true relief from was Suboxone. It was a great 2 years for me when I was taking it. Then I lost my job and insurance!!!! My job after that didn't offer insurance and I couldn't afford the $700/mo medication. It is very hard to do my job as well when I am treated like a drug seeker by my family physician who will not prescribe enough to take care of my pain. I was offered the implant, as long as I could pay the $5000 up front! The DEA and other agencies are making life so unbearable for the innocent ones, like us, that I am actually looking at applying for full SSI and SSD benefits. I lost a significant portion of my body with my first of four surgeries all from being a good person and taking care of my fellow man. I was only 21 when I ruptured 2 discs, L4-5 and L5-S1. I went through a fusion surgery and spent 2 yrs getting back on my feet. It has been a living nightmare ever since. I have an 8 inch scar to prove it. Boy, they sure do a lot better now. For anyone who reads this, please don't think that I am whining. I have no regrets where my healthcare career is concerned. It's just a travesty that those of us who do get hurt, and I have a minimum 20% PPI just from the first surgery, we get pigeonholed into this group of drug seekers and I am not. I want to be free of these harmful meds. But until they drop the prices and/or give us better insurance, we will never receive the full treatments that each of us deserves! I hope you have better care and luck than I did.[/quote']

Thank you so much for your kind words, and I am deeply saddened by your story. I know that sympathy isn't what you shared your story for, but I feel your pain quite literally.

Up Vote Up Vote ×
Specializes in Vents, Telemetry, Home Care, Home infusion.

Check out our FAQ section for pain mgmt resources

avoiding misconceptions in pain management

one main reason for this undertreated pain is the existence of several myths and misconceptions regarding pain management. goal of this summary to dispel these myths and misconceptions.

free registration required.

http://www.medscape.com/viewarticle/418521

Up Vote Up Vote ×
Specializes in Flight, ER, Transport, ICU/Critical Care.

I realize that the OP posted this months ago - but, let me help you get your "empathy" back.

If you think it's "hard" to work in pain management among the seekers and those that make you so jaded - just stop. That's right --- stop. Pick another line of practice. I get the "we have all become so jaded ...." Well, that's your sign to do anything else. And it doesn't have to be in nursing.

You have a choice -- I venture to think that some, just maybe some, of your patients may not have a choice. Something to think about. So, unless you are working in a "pill mill" --- I will take you at face value that you are practice in an interventional pain practice. RX opioids are a component of that. If it bothers you and everyone you practice with that much --- please, for your sanity and for the sake of your patients emotional well-being, just move on.

The very best thing about nursing (and medical) practice is options.

Oh yeah, just thank GOD that you are not a patient dependent on (maybe even desperate for) the services that you and your ilk provide. Makes me a little sad, that you have that much doubt in your patients. Maybe even a bit of contempt? Do epidurals and facet injections sound fun? Spinal pumps? Selective nerve root blocks? And if sending a patient out with a prescription is eating away at you all - really? At an interventional pain practice? At first I thought this was a troll, till I saw the exclamation points!!!!

But, karma is what karma is. Would you want a nurse treating your mom or hubby the way you or your practice treats (or even talk, vent, etc) your routine patient. Just something to think about. The thing is that patient you are so "jaded" over is someone's mom, sister or hubby, dad. You get the idea. Life goes along and a car slams into you at 60mph or a workplace accident hurts you --- who knows where you or someone you LOVE may find yourselves seeking care? Heck, the shingles virus that lives in all of us can cause a nasty outbreak of shingles and post-shingle neuralgia can occur regardless of vaccination status. Desperate for help? Could happen to anyone, anytime.

Really a reset of attitudes via an article? If it bothers you or those you work with that much - the door should swing both ways. Find the exit. I don't have any articles, but this post might inspire you.

On the upside. You have semi-regular hours, decent pay, no exceptional patient loads (not like 50 patients can show at once), rare pedi patients, mostly ambulatory care (meaning patients largely self care & not a lot of poop to clean), and I'd bet few patients die during interventional procedures.

The only thing that has broken my green color in the past has been a change of scenery. Good luck.

Up Vote Up Vote ×
Specializes in NICU, PICU, Transport, L&D, Hospice.

I agree with the above post.

You need to change jobs. Trust me, your patients are well aware of the feelings that you and your co-workers share about them.

I have a 1st degree relative with significan chronic and acute pain issues. He simply experiences long periods of time with intractable pain because his medical and nursing "professionals" put their personal bias and discomforts with the medications before his need for care and relief.

Recently he happened to be on the phone with me during one of his visits with his provider. I was shocked by the way the NP treated him during that encounter as I could hear her ignorant and biased comments and "interview" style. Ultimately, he left that visit with NOTHING added or changed to improve on his pain...he just left in pain with no resolution. Can you even imagine?

Yeah, if you can't have empathy and unconditional regard for your patients please consider doing something else.

Up Vote Up Vote ×
Specializes in Vents, Telemetry, Home Care, Home infusion.

Closing thread as OP not onsite in over a year.

Up Vote Up Vote ×
+ Add a Comment