pain in the ed

Hmmm...whatever that is supposed to mean.

Yes, I WAS paying attention during pain management.
I guess this sets me apart from the others who tuned out the lecture with rap music.

Dave, who agree's that statement was just a little.... trite?

My last thought on this subject. Pain is what the patient states it is, medications will be given as ordered and are first priority unless something really big is going on. Value judgements are left at home.

But sometimes people need to vent and IMHO it should not be taken personally.


Beth

I have frequent visitors to my "fast-track" who are simply there to obtain narcotics; they know I'm a softy. But I gained this attitude in part from doing numerous diaper changes and avoiding airborne vomit while caring for someone in narcotic withdrawal (let's not even dwell upon the times I have had to put central lines in seizing IV drug users-no veins, you know). I have also come to believe that pain is vastly magnified in the opiate-addicted (how they keen like banshees just over being stuck for blood!) because their bodies want the stuff. Nonetheless, all of my chronic pain folk have to endure my speech on the high cost to the user of drug dependence. I ask if the 12 hour wait to see me really makes it worthwhile. I talk up the great times to be had with the local Narcotics Anonymous group (this is very effective when injecting lidocaine into a shooter's abscess that needs lancing). I mention how The Man is sending his kids to college while profiting from their addiction (works with tobacco, too). I also say that I have confidence that they can quit once they make up their minds to do so. So far, 6 of my patients have gone to NA and 4 are sticking it out. One is now in ...drumroll, please...nursing school.

i always wonder about those who speak of themselves in third person......

i agree that people can function in pain - however until i walk a day in your shoes or you in mine this debate is going nowhere
you all continue to assume that i am speaking of a patient who has a back inj and ........ IF you bothered to ready any of my posts in their entirety you would see that i actually know these people as well as the doc's know these people and we have evidence that they are selling rx on the street - they are not in pain they are ACTUALLY there for the narc's either for themselves or to sell...... believe it or not it actually does happen.... and believe it or not they actually threaten our lives when we don't give them that 8th dilaudid shot.......
i have all the empathy in the world for those in pain - you all have no clue what my life consists of - perhaps i myself have been a cancer patient..... i just post here at times to vent - to allow a small window into my world - i guess that is too much to ask of some.....

-the real slim shady....

oh - by the way - a little culture never hurts.....

This is to athomas91 and avigail

I completely respect what you've had to say here. I am very disappointed when advanced practice nurses and similarly experienced nurses trash the views of other nurses. We each have a unique experience that should be considered and respected. Though we all appear to be coming from a patient advocate type of perspective, we indeed do have a lot of variance in them. This is good!

YES! We DO need to be nonjudgemental in our assessments of patients, including pain. But, this needs to be tempered with our EXPERIENCE. I am personally aware of a "sickler" whose a regular in our ED that has a script for (are you ready???) 3200mg of oxycontin q 8 hours!!! I am serious! She then expects this from us in ED for exacerbations. We were all stunned when the doc looked up records on said pt during a recent visit and found this rx! I fail to see how a human being could tolerate that much. This aside, the patient DID get enough IV pain meds to releave her symptoms, though no where NEAR what she was asking for. We all assume, this is a second income for her - keeping the local junkies fixed... Of course, Medicaid (WE) pays for this.

A person's perceptions and personal habits (drug use) do indeed have a drastic affect on their pain perception and how much it takes to get relief. I have no problems with ensuring a pt gets relief. In fact, my biggest problem is getting a reasonable order from a doc for pain control. How many times have you had a huge person with obviously severe pain get a rediculous med order, such as MS 2 mg IVP?

There's a happy medium here, some where. Trashing other nurses opins do not help.

athomas91 and avigail, read this as I am in agreement with you. And, to my learned colleagues that laud themselves over our "ignorant" views: get a life! You should learn to respect your colleagues as much as you respect your drug abusers.

'nuff said!

------------------------------------------------------------
"Discretion in speech is more than eloquence."
Sir Francis Bacon