RN's w/chronic pain, using narcotics

medsurv · May 11, 2006

I ended up on this site today looking for information regarding RN's using narcotics. This morning, I had a follow up appointment with my physician. I have been seen at the same military clinic for almost six years now, just two different doctors. I'm also seen annualy by my neurosurgeon. I take Oxycontin, with Norco for break thru pain. This morning, my MD was on leave, and another doctor saw me. He has decided that since I am an RN, he feels he must report me to the BRN, California.

I am so angry I can't see straight. I am the sole provider in my home for my children. I too, as some of you, have 8 herniated disks, but cannot afford to not work. I have been cleared by my neurosurgeon and FP to work, but now I see the new doctor ONE TIME, and my whole life may be about to fall apart.

I have never worked as a nurse NOT TAKING narcotics. I graduated from nursing school while taking them, I took my boards while taking them, and I started work on a VERY busy floor while taking them (no drug test). Knock on wood, I have not had any medication errors so far, and have made good decisions in the care of my patients. If you question the medication error thing, I focus only on meds when I give them, don't chat with others, and check my work twice, maybe 3 times, everytime. I hope neither you or I ever make medication errors.

It breaks my heart to see other RNs who have so little knowledge regarding pain. I really am NOT affected negatively by my meds anymore. But I am willing to admit that there may be people out there that would be no matter how much they take, no matter what their occupation. And, lets keep in mind, Benadryl, Sudafed, antidepressants . . . they all have side effects too!

The other thing I want to convey is that I have been able to work because of my meds, not unable because of them. And until today, there should never have been a concern at my work about taking narcs, (and I wouldn't do that anyway, no matter how desparate, I know my character) because I had my own medications to manage my unbearable pain.

I wish the best to all you nurses out there suffering from injuries and trying to work, and for those of you who haven't been there yet, I hope you don't ever have to go there. :saint:

LoriAlabamaRN · May 12, 2006

medsurv, I am sorry this is happening to you. It is such a shame.

I am also an RN with chronic pain. I broke my back six years ago, and I live with pain every day. I hardly ever take pain meds while at work, but I do take them off of work simply because otherwise it is impossible for me to sleep. I have a very high tolerance for pain, so the majority of the time I can handle it while awake (although there are times it gets unbearable even for me.) Not many people realize what a nightmare it is to constantly hurt. I truly feel for you. I have a wonderful DON who knows about my back problems, and who has told me that if I ened to take my oxycontin during my shift, it is fine with her as long as it does not impair me. Even so, I personally feel uncomfortable doing that. PM me if you ever need to talk to someone who understands what you are going through.

jerseyboy · May 19, 2006

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.

CaseManager1947 · Aug 20, 2006

I have struggled with chronic back pain (3 level disc degeneration) for over 6 years. After many bouts with PT, epidurals and trigger injections (which helped temporarily), I am now down to opioids. They are the only thing which work, but still give minimal relief. I am in so much pain, there are times, I just feel I can't go on. Now my docs are wanting me to come in to office for each refill (25 dollar copay for office visit) cha ching$$$$$. Help, this is so frustrating. I know this is a rant, sorry.

47Nana · Sep 6, 2006

Medsurv,

So sorry this has happened to you. I am in almost the same position. I am 47 yrs old and have been nursing for 20 yrs. At age 15 and 17 I had compund fx to ulna and radius resulting in nerve damage, shattered femur and fx tibia and fibula , along with pelvis, resulting in 4 surgeries, 2 months in traction, a year in a cast, bone grafts, etc. A car hit myself and someone else head on at 60 mph. We were on a motorcycle and he did not survive. When I was younger, I could tolerate the pain better, but injuries,noncompliance with wearing a lift and my age( growth plates not completed )caused my right leg to be 2" shorter than my left,resulting in scoliosis. I had intermittent acute pain, until 12 yrs ago when it became chronic. I have been on pain mgmt,Vicodin,Soma since then ,only taking as prescribed, but on one morning, 2 yrs ago, I went to work and felt strange. I was not doing pt care at the time, but my new boss unjustly turned me into the BNE. Ultimately, I sought an attorney. My doctor,whom I see every month for the last 12 yrs, performed numerous tests including a 5 hr gtt. I was found to be hypoglycemic. Now I am having to go to court because I will not accept the boards decision of intemperate use of meds. My doctor has performed at least 25 series of proliferative injections into my back, along with regular manipulative therapy in the last 12 yrs and is very angry with the board. He states that I could easily be on oxycontin or MS with the condition I have. I don't want that, I just want my name cleared. Since this occurrence 2 yrs ago, it is still not resolved and I have filed for disability. It seems ashame that we as nurse are suppose to be empathetic, yet when it comes to us having disabilities, it's not accepted. Also, I ,as you, functioned perfectly, always had good evaluations and took the medicine for so long that I didn't receive any type of high, just pain relief. Without the medication, I can not get out of the bed in the morning and have no life whatsoever. Previous to this boss, who was new, my immediate supervisors were aware of my physical disabilities and pain management. They did not agree with her judgement, but went along because of their own jobs. She just assumed because I told her I took medications that I was high. She never checked my BP,my blood sugar, nothing. She just had someone drive me home and left me there, all for having a hypoglycemic reaction. She also reported to the board that she was to check on me that evening and the next day and never did anything. So far it has cost me approximately $3,000 in atty fees and is going to cost me another $2,000 in court costs. I probably won't return to nursing, but I want my name cleared. It was unjust and unfair. There is a big difference between addiction and dependance.

I will pray for you and hope that your future gets better, I know the only thing I can do now is place it in gods hands.

JentheRN05, RN · Sep 7, 2006

Do you want someone under the use of narcotics driving a car.
Do you want a nurse using narcotics to control pain to take care of your family members
To be truthfull for myself I have to answer....No
I do feel sorry for your problems though. There are areas that you can go into not involving patient care though, that you can do. Insurance comapnies love haveing nurses for audits and such. So do Shysters.

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!

JentheRN05, RN · Sep 7, 2006

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.

47Nana · Sep 13, 2006

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

deehaverrn · Jan 19, 2007

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.

harley007 · Jan 19, 2007

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.

:nurse: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!

chase4myheart · Jan 19, 2007

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.

gr8rnpjt, RN · Jan 19, 2007

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!!!