RN's w/chronic pain, using narcotics - page 7

I am currently, and have been, for 3 years, taking oxycontin for chronic pain. My question is, Is is legal for a nurse to work while taking pain meds? I am unable to work, or hardly move unless I... Read More

  1. by   JentheRN05
    Quote from teeituptom
    When you out it that way, that really is a scary thought.
    I am also a chonic pain sufferer, and I also take narcs, AND I always disclose my use of them, and I have NEVER had a problem. In fact at my doctors office where i used to work, my doctor could tell when i hadn't taken my narc meds (stooping over, and holding my back) boy I tell you you'd never seen a doctor whip out his Rx pad or a 2cc syringe of toradol so fast. Normally I wouldn't need the toradol (unless it was during my cycle at which time the pain is 10x worse) and my pain was caused by a work related injury, in which at the time of injury when allowed to come back to work, I informed my supervisor and health nurse of my script and they had no problem with my taking it as long as I could function in my position without feeling any sense of being impaired. And at no time did I feel impaired, I ONLY felt some relief, not even total relief but better than immense pain that I suffer without it.
  2. by   47Nana
    Quote from JentheRN05
    As mentioned before, when the pain is controlled there is NO incompetence at all. It is NOT a high they are looking for and they do NOT get one. It is relief they are looking for and should have a right to have.
    I just don't understand!
    Thanks so much for the understanding. I have been dealing with this for a long time 30 yrs to be exact and it's nice to have educated nurses who realize the difference between addiction and dependance.
    Have a wonderful day, cause you made mine a better day. Thanks again
  3. by   deehaverrn
    Really interesting reading all this information even though much of it is years old.
    I injured my back at end of 2005 so it has been just over a year. Actually that was just the breaking point i guess, i've been injuring my back for over 20 years by lifting and turning pts. I have multiple bulging discs and degenerative changes, also an annular tear. The docs mostly dont seem to care much about my pain level, they do exams but since i don't have actual herniated discs, it doesn't seem to count. I work 6 hours daily in supposedly light duty modification. This only usually means that I don't lift patients. I have other specifications in my physician ordered limitations but my manager ignores these. She says that I should just call for help if i need it, and even though i am not supposed to stand for long periods she thinks i can just rest when i need to, like my coworkers will start doing my assignment or something.. I have always considered giving my patients their pain relief medications promptly to be a priority. But these days its hard when I have just sat down and my pain is an 8, and I am taking meds to someone who is requesting T3s with a pain of a 2!
    The only thing that has helped my pain is medication. I think I am getting more tolerant of Vicodin, and it does't help the pain much. However, I don't know if Im just sensitive or what, but any muscle relaxant (which only helped for the first 2 weeks of my injury anyway, but they kept prescribing and if I didn't take labeled me noncompliant) makes me drowsy. And meds that helped my pain like Percocet make me woozy too. I definitely feel impaired when I take meds. When I don't take them I feel like I am just not in the right frame of mind to care for others.
    I wish I could just be labeled disabled and be done with it. I am in constant pain and like some of you feel like the system is against me. Its not that I'm a baby, I would say that I'm good at taking pain, but when it is constant and for so long, it really floors you. My husband pretty much does everything at home. Once in a while I'll cook but thats about it. Socially I only do family stuff..like attend my kids functions (after taking Vicodin), I can't understand how my employer is so adamant about pts pain levels and treatments but cares so little about mine. My boss is constantly assigning me to areas that I consider beyond my capabilities since they present a danger of emergency that i can't handle on my own now. Also, it seems like our nursing associations have no help for injured nurses, its obvious that there are alot of us, so WHY NOT? I'm tired of struggling to do a good job while in pain and after 2-4 hours of sleep since I am basically up all night. I can't even find documentation of the physical requirements of certain nursing jobs, to prevent my employer from assigning me to pt care areas like PACU and OB triage--where my inability to lift or bend or move quickly--could cause harm. I don't know what it would be like to not be in pain, I think that once last spring after taking 2 Vicodin and just having a heat pack and electric treatment--I was pain free for about 5 minutes. Anyway, I can't imagine not being impaired from the meds. Of course even cold remedies always zonked me. And when I was on Lyrica I felt totally out of focus, and like I couldn't hold on to a thought process.
  4. by   harley007
    I go to a internationally known pain MD. He works closely with our state's Attorney General to make sure that situations, like those described above, are not happening due to antiquated data and misinformation. When I first went for a consult I was so embarrassed to be considering prescription pain treatment. He sat me down and said "The dirty little secret in this country is that 70% of adults past 35 are using some form of chronic pain control and in your case, nursing education on this subject is in the dark ages". At the time I was a non-working, pain limited and suffering individual, in a falling apart 26 year marriage. After obtaining pain relief and thus gaining back my life, I sadly realized my husband's problems were caused by his refusal to obtain help for a long term mental illness. His refusal to deal with this caused the end of our marriage. I gradually built my physical and mental strength back and returned to a entry level RN position. Today it has been 8 years of treatment, with some fine tuning of my prescriptions. I don't think people realize that medication can be compounded in doses for each particular patient. Vicodin have too much Tylenol long term? Compounding pharmacies make it without the Motrin or Tylenol. It is a whole new world where specialty MD's and pharmacies adapt the treatment to the patient.
    I now work in an high volume, acute care specialty area of a Medical Center and have never had a problem with impairment. I able to schedule my time with my boss so I am allowed proper time to rest and regroup after my shifts and on call time. (God bless that man.) Due to this I take my medications only during my off time and never ever just before or during my work time. One of the most talented, outstanding people, I have ever worked with, used a patch 24/7. Nobody would ever guess this person was on chronic pain medication and if I or anyone in my family was admitted I would have moved mountains to have her take care of us. Bottom line? I was urine tested before my acute care position and arrived with a notarized document from my MD explaining my treatment. The document had no limitations on taking medications at work and as a matter of fact, made it sound as if it was to be expected. I never shared this information with anyone except the MD that did my physical. I love my job and thank God everyday for my pain MD and the fact that my state allows me to work. I am lucky that there is active work between the pain MD's and the Judaical Offices to recognize that times have changed and it is possible to function as a nurse and at the same time be treated for pain. There are too many studies out there that disprove the old fashioned theory that impairment is always present if prescriptions strength analgesics are taken at work. Like anything, there are situations of poor ethics on the part of the patient and or the MD and these are the people that the BON should be pursuing. I consider myself so very, very lucky each day as I trot off ,a happy camper, to a challenging and taxing job. I know I am so lucky to work my shifts without medication. I hope everyone caught in this web of lack of current knowledge, is able to hang in there and perhaps not just take one person's opinion on this rapidly evolving subject ....... May the force of reasonable pain relief go with you!
    Last edit by harley007 on Mar 15, '07 : Reason: change in information
  5. by   chase4myheart
    I developed an absessed tooth during the time for my drug test for clinicals. My dentist gave me a prescription for oxycodone due to the severe pain that I was having. I was very honest and told the director of my program and showed her the prescription bottle. She told me to just declare the med when I went to do my drug test. Well, when I get to the hospital for the test, they won't let me declare it. They told me that it was illegal for them to put down any meds that I was taking. Something about it being a violation of privacy. I told my program director what they had said. She told me that we would just deal with it when the test came back. Apparently, nothing showed up because I never heard anything else. I think that it's a shame that nurses are left in the dark ages when we talk about pain management. I have had a herniated disc and have had to have back surgery. I stayed on narcotics for many months, and I was never impaired after the first couple of weeks of being on them. Chronic pain needs to be managed. The complete goal of pain management is so the pain sufferer can maintain normal functions and continue with the functions of everyday living. Well, where I'm from that includes working. You only get disability if you are half dead. My best friend was diagnosed with malignant melanoma and died 4 months later. She had applied for Disability Benefits but had never received the first check when she passed away. Nurses deserve the chance to continue to work as long as they are not impaired! Just my 2 cents worth.
  6. by   gr8rnpjt
    Quote from jerseyboy
    Dear Medsurv,
    Please check out www.painreliefnetwork.org
    Contact them, perhaps they may be able to help you if you are willing to fight this. Also, perhaps you can sue the Dr. for violating your medical privacy rights.
    BINGO! My thoughts exactly!!!!
    What about HIPPA? She was not caught doing anything wrong, she just happened to have a different doctor for her appointment. She did nothing to report!. He is violating her right to privacy and confidentiality under HIPPA!!!
  7. by   gr8rnpjt
    Deehaverrn, If you have not been to a pain clinic yet, I urge you to go. Long acting morphine is available and does not impair you at all. Read the post after yours, she is in a pain clinic and there are ways to compound meds so that it is tailored to you. You will get much more relief if you go to a pain clinic and they will work with you to make your ability to work without pain a priority.
    Last edit by gr8rnpjt on Jan 19, '07
  8. by   Comanche_1
    I am unsure what the nursing regulations are but I'm sure they are similar if not the same as the ones in EMS. You are not allowed to work while you are on narcotics. You will be considered to be under the influence and putting yourself as well as others at danger.

    Not that I agree with this as I have my own health issues that can be taken care of by narcs but I also see where they are coming from. Where can you draw the line??
  9. by   CLAIRE'S COWBOY
    I WAS A WORKING RN FOR OVER 20 YEARS. I HAD SEVERAQL BACK AND NECK SURGERIES. IN 2002 I ENDED UP HAVING MULTIPLE SURGERIES AND FUSIONS ON 10 DISCS. IT WAS LIKE ONE DAY WAKING UP AND YOUR WHOLE LIFE IS GONE. I LOVED NURSING, BUT BECAUSE OF SEVERAL REASONS MY ONLY OPTION WAS TO GO ON LONG TERM NARCOTICS.

    EVEN THOUGH I WAS SAD AND VERY DISAPPOINTED. I CANCELLED MY RN LISCENCES IN 5 STATES i DID SOME TRAVEL BURSING) AND THEN WENT TO THE DMV AND TURNED IN MY LISCENCE FOR A STATE ID.

    THIS WAS ESP. HARD BECAUSE MY ONLY DAUGHTER LIVES IN SWEDEN AND I HAVE ONLY MY BOYFRIEND TO GET ME AROUND. WE LIVE OUT IN THE DESERT 50 MILES TO TOWN.

    IT IS NOT THE STATE OR YOUR EMPLOYERS. DIDN'T ANY OF YOU READ YOUR NURSE PRACTICE ACT. FROM THE VERY BEGINNING I KNEW I COULD NOT TAKE NARCOTICS AND WORK AS AN RN IN THE ER OR FLIGHT.

    I KNEW TAKING THESE NARCOTICS MAKES IT AGAINST THE LAW TO DRIVE.

    REGARDLESS WHAT OTHERS ARE DOING THESE ARE THE FACTS.

    OUR NURSE PRACTICE ACTS WERE WRITTEN BY OTHER NURSES.

    YOU MAY THINK YOU ARE NORMAL - BUT REMEMBER YOU HAVE A BRAIN WITH NARCOTICS FLOATING AROUND TELLING YOU THAT.

    BELIEVE ME IN ER AS NURSES WE WERE ALWAYS THE FIRST TO ACCUSE PTS. OF DRUG ABUSE.

    YES, I HATE BEING SICK AND DISABLED. AND YES I THINK THE WORK WE DO OFTEN CONTRIBUTES TO THE PROBLEM AND THAT IS WHERE WE SHOULD PROBABLY FIGHT FOR RECOGNITION AND SOME TYPE OF COMPENSATION.

    BUT I HAVE TO SAY EVEN THOUGH I HAVE DAYS I SEEM NORMAL TO ME I WOULDN'T WANT A NURSE ON NARCOTICS TAKING CARE OF ME OR MY FAMILY, NOT ONLY BECAUSE OF THE NARCOTICS EFFECT, BUT BECAUSE THEY ARE WILLING TO KEEP QUIET ABOUT A MAJOR ISSUE THEY AGREED TO WHEN ACCEPTING THEIR LISCENCE TO WORK AS AN RN.

    SAD, WISH IT HAD TURNED OUT DIFFERENT, BUT NOT THE FIRST.
  10. by   morte
    Quote from CLAIRE'S COWBOY
    I WAS A WORKING RN FOR OVER 20 YEARS. I HAD SEVERAQL BACK AND NECK SURGERIES. IN 2002 I ENDED UP HAVING MULTIPLE SURGERIES AND FUSIONS ON 10 DISCS. IT WAS LIKE ONE DAY WAKING UP AND YOUR WHOLE LIFE IS GONE. I LOVED NURSING, BUT BECAUSE OF SEVERAL REASONS MY ONLY OPTION WAS TO GO ON LONG TERM NARCOTICS.

    EVEN THOUGH I WAS SAD AND VERY DISAPPOINTED. I CANCELLED MY RN LISCENCES IN 5 STATES i DID SOME TRAVEL BURSING) AND THEN WENT TO THE DMV AND TURNED IN MY LISCENCE FOR A STATE ID.

    THIS WAS ESP. HARD BECAUSE MY ONLY DAUGHTER LIVES IN SWEDEN AND I HAVE ONLY MY BOYFRIEND TO GET ME AROUND. WE LIVE OUT IN THE DESERT 50 MILES TO TOWN.

    IT IS NOT THE STATE OR YOUR EMPLOYERS. DIDN'T ANY OF YOU READ YOUR NURSE PRACTICE ACT. FROM THE VERY BEGINNING I KNEW I COULD NOT TAKE NARCOTICS AND WORK AS AN RN IN THE ER OR FLIGHT.

    I KNEW TAKING THESE NARCOTICS MAKES IT AGAINST THE LAW TO DRIVE.

    REGARDLESS WHAT OTHERS ARE DOING THESE ARE THE FACTS.

    OUR NURSE PRACTICE ACTS WERE WRITTEN BY OTHER NURSES.

    YOU MAY THINK YOU ARE NORMAL - BUT REMEMBER YOU HAVE A BRAIN WITH NARCOTICS FLOATING AROUND TELLING YOU THAT.

    BELIEVE ME IN ER AS NURSES WE WERE ALWAYS THE FIRST TO ACCUSE PTS. OF DRUG ABUSE.

    YES, I HATE BEING SICK AND DISABLED. AND YES I THINK THE WORK WE DO OFTEN CONTRIBUTES TO THE PROBLEM AND THAT IS WHERE WE SHOULD PROBABLY FIGHT FOR RECOGNITION AND SOME TYPE OF COMPENSATION.

    BUT I HAVE TO SAY EVEN THOUGH I HAVE DAYS I SEEM NORMAL TO ME I WOULDN'T WANT A NURSE ON NARCOTICS TAKING CARE OF ME OR MY FAMILY, NOT ONLY BECAUSE OF THE NARCOTICS EFFECT, BUT BECAUSE THEY ARE WILLING TO KEEP QUIET ABOUT A MAJOR ISSUE THEY AGREED TO WHEN ACCEPTING THEIR LISCENCE TO WORK AS AN RN.

    SAD, WISH IT HAD TURNED OUT DIFFERENT, BUT NOT THE FIRST.
    i think you may need to reread your nurse practice act, with a dictionary at hand...
  11. by   teeituptom
    Quote from CLAIRE'S COWBOY
    I WAS A WORKING RN FOR OVER 20 YEARS. I HAD SEVERAQL BACK AND NECK SURGERIES. IN 2002 I ENDED UP HAVING MULTIPLE SURGERIES AND FUSIONS ON 10 DISCS. IT WAS LIKE ONE DAY WAKING UP AND YOUR WHOLE LIFE IS GONE. I LOVED NURSING, BUT BECAUSE OF SEVERAL REASONS MY ONLY OPTION WAS TO GO ON LONG TERM NARCOTICS.

    EVEN THOUGH I WAS SAD AND VERY DISAPPOINTED. I CANCELLED MY RN LISCENCES IN 5 STATES i DID SOME TRAVEL BURSING) AND THEN WENT TO THE DMV AND TURNED IN MY LISCENCE FOR A STATE ID.

    THIS WAS ESP. HARD BECAUSE MY ONLY DAUGHTER LIVES IN SWEDEN AND I HAVE ONLY MY BOYFRIEND TO GET ME AROUND. WE LIVE OUT IN THE DESERT 50 MILES TO TOWN.

    IT IS NOT THE STATE OR YOUR EMPLOYERS. DIDN'T ANY OF YOU READ YOUR NURSE PRACTICE ACT. FROM THE VERY BEGINNING I KNEW I COULD NOT TAKE NARCOTICS AND WORK AS AN RN IN THE ER OR FLIGHT.

    I KNEW TAKING THESE NARCOTICS MAKES IT AGAINST THE LAW TO DRIVE.

    REGARDLESS WHAT OTHERS ARE DOING THESE ARE THE FACTS.

    OUR NURSE PRACTICE ACTS WERE WRITTEN BY OTHER NURSES.

    YOU MAY THINK YOU ARE NORMAL - BUT REMEMBER YOU HAVE A BRAIN WITH NARCOTICS FLOATING AROUND TELLING YOU THAT.

    BELIEVE ME IN ER AS NURSES WE WERE ALWAYS THE FIRST TO ACCUSE PTS. OF DRUG ABUSE.

    YES, I HATE BEING SICK AND DISABLED. AND YES I THINK THE WORK WE DO OFTEN CONTRIBUTES TO THE PROBLEM AND THAT IS WHERE WE SHOULD PROBABLY FIGHT FOR RECOGNITION AND SOME TYPE OF COMPENSATION.

    BUT I HAVE TO SAY EVEN THOUGH I HAVE DAYS I SEEM NORMAL TO ME I WOULDN'T WANT A NURSE ON NARCOTICS TAKING CARE OF ME OR MY FAMILY, NOT ONLY BECAUSE OF THE NARCOTICS EFFECT, BUT BECAUSE THEY ARE WILLING TO KEEP QUIET ABOUT A MAJOR ISSUE THEY AGREED TO WHEN ACCEPTING THEIR LISCENCE TO WORK AS AN RN.

    SAD, WISH IT HAD TURNED OUT DIFFERENT, BUT NOT THE FIRST.
    I feel sorry for you chronic condition But I applaud your brave decision in knowing what you can and cant do. My prayers are with you.
  12. by   abbaking
    Being a RN with severe chronic back pain myself, I can attest to the pains of the Nursing profession that being a nurse causes. Alas, working with under the influence of narcotic pain medication is unethical and places your patients and you at many risks. Sadly, many fellow RN's and myself with severe pain conditions have HAD to pop a Vicodin or Norco at work on breaks just to take the edge off from terrible pain. My advise would be to err on the side of caution, and refrain from using narcotic meds at work unless the pain is terribly severe. Do what you gots to do!
  13. by   SRbear
    Doesn't time go by in the blink of an eye........I have not nor do I plan to get back into nursing. But what is keeping me out is this dang fibromyalgia. I did hear back from the board of nursing, instructing me to go to an addictionologist at my expense to determine if I could handle taking the oxycontin and be competent at work. All I could think of was that song..."take this job and shove it....." so, I told them after 28 years of hospital nursing.. I am DONE.

    It is really a shame that as nurses we are expected to work in pain, work double shifts, work when sick, etc, with no regard to what it is doing to us.

    I have no great words of wisdom, or answers to any of life's mysteries, but I do know that if we do not take care of ourselves.......who will?

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