Just came here to blow some steam off. I just put in a three day stretch with a chronic pain patient assigned to me that was a royal pain in the behind to take care of. This patient was on our floor for a ORIF of her knee. She also had a hx of fibermyalgia and was on all kinds of pain meds and narcs and junk to keep her zoned out most of the time. I tried my best for the three days I had her as my patient to take very good care of her and meet her needs, but for the most time she was very rude and nasty to me. It did not matter what I did, I could never do enough nor could I do it right.
Here is the question I would like to put out there: Why do these docs keep ordering all of these highly addictive substances for these folks? I know that when I go see my doc he is very conservative about pain killers and does not want folks to become addicted to them. He will give you something for pain, but he won't keep ordering it over and over again for you. He also looks for alternative medicines to give to you that will do the same thing but are not addictive.
Another question to throw out there: Why are most chronic pain patients "nasty" to deal with? They always have "attitudes" with the nursing staff. Most are downright rude to everyone who takes care of them. Many do not know the words "thank you" and are very demanding and critical of your care to them.
Sorry if I sound like I am not compassionate. I really am. I just came here because this is a safe place to sound off about these issues. If anyone out there has some answers, please, please post them.
I just want to understand better why these people act the way they do. Thanks.
Tadpole: I am so sorry that you feel that way about all of your chronic pain patients. I am one of those people that is in intense, never stopping burning pain. I also have been in the ER where the doc does not believe in giving the meds that have been prescribed by my pain mgmt docs and so leaves me to SUFFER for days until I have to check myself out of the hospital or have my meds brought in by family just to take the slightest edge off the pain. You of all people should know that if one is in high pain, the meds do not make you addicted or high, and go directly to the pain receptors. God forbid...I hope you never have to experience chronic pain...because once you walk in those shoes, you never have to ask those questions again...you will understand fully that those patients are just trying to hang on for one more second in pain and not wanting to disappear from the face of the earth just to not be in that pain anymore. We don't need to be bullied or made to feel like we are junkies or not worthy of equal care. If you aren't interested in helping patients and haven't any compassion...why are you in this profession? I do agree, however, that if these people are being treated fairly and with love and compassion, they have no right to be ugly and hateful just because they are in pain. I never mistreat medical staff (to the point of not speaking up for myself) nor do I mistreat anyone just because I am suffering. I also agree, that there are some people out there just looking for drugs, but if you hear from their PCP that it is legit, then please don't try to reinvent the wheel. Give the meds like they are prescribed. Thanks so much for letting me share my personal pain story.
Hello,
Just came here to blow some steam off. I just put in a three day stretch with a chronic pain patient assigned to me that was a royal pain in the behind to take care of. This patient was on our floor for a ORIF of her knee. She also had a hx of fibermyalgia and was on all kinds of pain meds and narcs and junk to keep her zoned out most of the time. I tried my best for the three days I had her as my patient to take very good care of her and meet her needs, but for the most time she was very rude and nasty to me. It did not matter what I did, I could never do enough nor could I do it right.
Here is the question I would like to put out there: Why do these docs keep ordering all of these highly addictive substances for these folks? I know that when I go see my doc he is very conservative about pain killers and does not want folks to become addicted to them. He will give you something for pain, but he won't keep ordering it over and over again for you. He also looks for alternative medicines to give to you that will do the same thing but are not addictive.
Another question to throw out there: Why are most chronic pain patients "nasty" to deal with? They always have "attitudes" with the nursing staff. Most are downright rude to everyone who takes care of them. Many do not know the words "thank you" and are very demanding and critical of your care to them.
Sorry if I sound like I am not compassionate. I really am. I just came here because this is a safe place to sound off about these issues. If anyone out there has some answers, please, please post them.
I just want to understand better why these people act the way they do. Thanks.
GOD BLESS YOU!!! We need more professionals like yourself. Sincerely, Thank you for what you do.
I always give pain meds when asked to, as long as I have an order, if the pt isn't in distress. I encourage my pts to ask for their meds before the pain get bad because it is harder to control if we don't stay on top of it. even if my pt is in deep sleep when I walk back in with the med, i will still give it (as long as they wake up easily) If I have someone with chronic pain, I give what is ordered, I advocate what is needed to control the pain. an acute care facility is not a rehab, it is not the place to get drug addicts off of drugs, that can wait til after they are no longer acute. pain is whatever they say it is. It is not my place to try to get someone off of drugs they may have been taking a lifetime. I could care less if they are a drug seeker or not. if its ordered I'll give it so long as it won't kill em!
Specializes in rehab; med/surg; l&d; peds/home care.
I got me a nice new video cam a year ago, reallly sweet. I finally learned how to work it, That only took 6 months. Anyway this past summer. I took it out to play with, and I saw this guy parking in a handicapped spot, with no sticker. So I caught him on cam and got nice pic of him, his license plate, and asked him why he was parking there. Of course he got angry, and denied everything. I dont know how he could deny it. But I posted that video on you tube. Yes I decided to join the you tube craze. But since then Ive videoed almost a dozen others and put them on the tube also. Thats people without stickers or license plates, and those without who also arent disabled. They are using a relatives or something.
I videoed one lady, who used her mothers sticker, to park in a handicapped space. She said she only did that because she didnt want her kids to walk that far into the store. All 5 of them. She got put on you tube also.
Those videocams are fun.
Peace, Love, Golf
I have a permanent (blue) disabled parking sticker. Some days I need a cane, some days I go inside to use the stores motorized cart. As long as my sticker is up, how do you know I am not disabled just because I am perhaps walking without an cane/walker, etc? My father also has a permanent sticker, for respiratory issues. Not all who qualify for their disabled sticker actually appear disabled. My chronic pain and my cancer are not visible either.
I am with you that I dislike people who are not disabled using up disabled parking spots, but how can you prove that a person is *NOT* disabled as you video tape them???
Specializes in icu, er, transplant, case management, ps.
I have a permanent (blue) disabled parking sticker. Some days I need a cane, some days I go inside to use the stores motorized cart. As long as my sticker is up, how do you know I am not disabled just because I am perhaps walking without an cane/walker, etc? My father also has a permanent sticker, for respiratory issues. Not all who qualify for their disabled sticker actually appear disabled. My chronic pain and my cancer are not visible either.
I am with you that I dislike people who are not disabled using up disabled parking spots, but how can you prove that a person is *NOT* disabled as you video tape them???
He doesn't but he will never admit that what he is doing is equally wrong. He likes to believe he is doing a public service. I have asked him if he is so correct, why not just turn in the tape to his local police department. I am still waiting for an answer that I can believe. I too am disabled. I also have the hanging tag. But it is not possible to see my disabilities unless one is up close to me and can see the pain in my face. One day, he will tape the wrong person and post his tape on the net. And then be sued. I hope he has a lot of assests to be seized.
I don't like people who park in handicapped spots either. But I am equally against self appointed individuals who believe they have the right to invade someone elses space. Most states now have parking enforcement officers. One of their jobs is the patrol parking lots and parking spaces to ensure that the people parking have the right to park there. People need to leave law enforcement up to law enforcement.
Please...stop playing judge and jury where it comes to deciding who's disabled and who is not. Yes, there are too many people who abuse the sticker/parking space. BUT... there are a lot of people with "invisible" disabilities. It does not make them any less disabled just because they aren't using a walker or two crutches or a wheelchair. My back is crumbling away from the unrelenting arthritis, but, to look at me, I'm the picture of health. I'm slim (I HAVE to be so as not to put any undue weight on the spine), and I smile whenever possible. I will NOT become a whiny complainer that everyone avoids just because I'm always in pain. I've found the joy in just being able to walk in reasonable discomfort rather than being in terrible pain. Oh, how I love those times.... and I smile because of it. When I can do my shopping without having to stop and medicate myself because the pain is becoming intolerable.... I'm happy and I smile and enjoy that which most take for granted.
I do NOT have to explain to anyone why I have a permanent disability sticker "at my age" (mid 50's). And when I get "the look" questioning why I am using a handicapped space when it's obvious that I'm perfectly find and healthy... I hold my head high and ignore that person. Am I supposed to wear a back brace at all times or a sign explaining my disability? Just remember the old episode of "The Odd Couple"..... "when you assume... you make an ass out of u and me". You don't know the whole story. Until you do.... don't don the mantle of supreme judge.... please??
I read the first few posts, but not all. I just have to say, that now, after breaking my neck, many other problems related to the injury, that I now have a greater respect to patients who are truely in pain- and yes, you can tell the drug seekers. I have to bite my tongue with the dramatic queens, but I never knew that a person can have so much pain at a constant. It is sort of like morning sickness for pregnancies- I thought morning sick was such a drama thing.... well to my horror, when I was pregos, I had nausea so bad I weighed 109# at 5 months (5'6"). Doc said one more pound lost and into the hospital you go! Guess that taught me a lesson!
Specializes in icu, er, transplant, case management, ps.
Woody... you expressed it beautifully. Thank you.
You are welcome. And in case you haven't notice, he still hasn't responded to any of our comments. I would like to think it is because he is too embarrassed but I doubt it.
I'm an RN. I also have Atypical Facial Pain, Allodynia, Occipital Neuralgia, Chronic Migraine, Photosensitivity and Phonosensitivity. I have had to stop working and am currently on disability because the level of pain medications required to keep my pain at a tolerable level is too high for me to feel I can safely provide patient care.
I have gone to the ER several times for breakthrough pain because until we got my pain under control, I would have times where the pain was at a 9 for hours. I couldn't sit, stand, lie down, walk, or do anything to ease the pain. In fact, the pain from the AFP got so bad at times that even with my extreme sensitivity to sound, I actually had to scream to make the pain not feel so intense.
I have been called a drug seeker. I was refused the meds my neurologist approved for my pain. How much, you may ask? 2 mg of Dilaudid and 50 of Phenergan, both IM, not IV. The Phenergan wasn't to potentiate the Dilaudid. It was to keep me from throwing up all over the ER. The staff was very kind the first few times, taking me immediately to a darkened room and talking quietly. The fourth time or so, I was made to wait in the waiting room with a blaring TV and poorly supervised kids. I was put in a curtain next to a screaming toddler getting stitches. I was informed that there were no rooms with doors, despite me being able to see them from where I was sitting - not to mention the fact that I had been in those rooms before. I heard the staff, both nurses and doctors, talking about me where they thought I couldn't hear...apparently they forgot about the phonosensitivity thing. I was a drug seeker. I was nuts. I was a junkie looking for a fix. It didn't matter that my neurologist approved the small dose of Dilaudid and Phenergan. I had one doc offer me Toradol despite the fact that I have a documented sensitivity and intolerance to NSAIDs. He said that even if he called my neurologist and got approval for the drugs, he wasn't going to give them to me because I was already taking narcotics. I left rather than be treated like that, and he promptly billed me for "services rendered," though it was more of a services denied situation.
I have worked with chronic pain patients who are addicted. I've had them scream at me because I wouldn't push the Dilaudid, Benadryl and Phenergan through their central lines rapidly so they could feel the buzz. I've watched them get up after 3 minutes and head off downstairs for a smoke and goodies from the cafeteria or gift shop, and known they would be back up to their rooms 15 minutes before the med was next due, acting for all the world as if they were in excruciating pain. I've seen them get their IVP drugs, pick up their IV poles and jog down the steps for a cigarette. I know the games they play.
However, I have also been on the side of the fence where I was in pain that had me begging God to let me die, and I have been treated like I was stupid and unaware of the patient bill of rights and my right to be treated with dignity and to be treated for my pain in a humane manner.
I've been dumped by doctors for being in too much pain to ride for an hour to an appointment. I've had docs write me off because I have a diagnosis of anxiety secondary to my chronic pain. I've been denied proper treatment because my disability doesn't show up on any CT, MRI, or MRA scan, and because, "You don't look sick."
When I was able to work, I saw my responsibility as a nurse as following the orders of the prescribing physician. If the doc wrote the orders for the pain meds, regardless of how I felt personally about the patient and their pain or lack of it, I treated them as prescribed. It is not our job to decide who is in pain and who isn't, or who is addicted and who isn't. I can usually tell the difference, but that isn't my place. My position is advocate, caregiver, helper.
For statistical purposes, only 3% of chronic pain patients on narcotics become addicted to those drugs. 3%. That's not a lot of people. Unfortunately, we let those people, who are usually the ones we remember the best, affect our attitudes and perspectives on most, if not all, chronic pain patients, and we don't realize that our attitude shows and that the patient sees it and feels it.
As one who has been on both sides of the fence, I am ashamed of many of my peers and the way they treat people in pain. I was taught that if a patient says they're hurting, they're hurting - no matter if we agree with their complaint or not. Pain is a subjective thing, not objective. There are no hard and fast ways to determine if John or Jane is really hurting or if they're lying in order to get drugs. It is our obligation as caregivers to provide compassionate, competent care for them and not let our personal feelings get in the way.
I just pray to God that the people who think that all chronic pain patients are a bunch of cranky, demanding junkies are never on this side of the equation. Being denied adequate care, including meds, because of prejudice, presupposition, and archaic attitudes is not something I'd wish on anyone. We all deserve to be treated with respect and to have our dignity maintained.
I don't know the answers. I'm a relatively new nurse, but have had a few chronic pain pts already on a stroke floor. It is a difficult situation indeed for many of them. I understand why they are in pain -- many of them. And for some of them, it seems that the only reason they're in such terrible pain is due to being morbidly obese and the stress that condition is putting on their joints and muscles.
I have to wonder if there are Pain Centers or special places for pts like this to go, or if there ever will be? Seem many of their needs are too high level to be taken care of in a hospital for a few days and they need more.
I also wonder if there are extensive and powerful non-pharmaceutical treatments available that people can take advantage of. It's just go to be terrible, and expensive to be on so many opioids all of the time.
When I see CP on my sheets, I will admit, I wince. I know it's going to be a rough time and a time consuming one as some of these pts are receiving pain killers by the hour, or sometimes every other hour. I just can't believe some of the doses and drug combinations. I just would hate to live that way -- understand they have to -- but there's got to be a better way out there someday to treat these problems these patients have -- some way to get at the root of the problem.
I understand why they are in pain -- many of them. And for some of them, it seems that the only reason they're in such terrible pain is due to being morbidly obese and the stress that condition is putting on their joints and muscles.
Ahhhh, but which came first--the pain or the obesity? For a lot of patients, pain decreased their activity level, and then the weight was gained. From there, the vicious circle was in effect.
And lest we forget, antidepressants and muscle relaxers do tend to pile on the pounds as well.
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deweytl
2 Posts
Tadpole: I am so sorry that you feel that way about all of your chronic pain patients. I am one of those people that is in intense, never stopping burning pain. I also have been in the ER where the doc does not believe in giving the meds that have been prescribed by my pain mgmt docs and so leaves me to SUFFER for days until I have to check myself out of the hospital or have my meds brought in by family just to take the slightest edge off the pain. You of all people should know that if one is in high pain, the meds do not make you addicted or high, and go directly to the pain receptors. God forbid...I hope you never have to experience chronic pain...because once you walk in those shoes, you never have to ask those questions again...you will understand fully that those patients are just trying to hang on for one more second in pain and not wanting to disappear from the face of the earth just to not be in that pain anymore. We don't need to be bullied or made to feel like we are junkies or not worthy of equal care. If you aren't interested in helping patients and haven't any compassion...why are you in this profession? I do agree, however, that if these people are being treated fairly and with love and compassion, they have no right to be ugly and hateful just because they are in pain. I never mistreat medical staff (to the point of not speaking up for myself) nor do I mistreat anyone just because I am suffering. I also agree, that there are some people out there just looking for drugs, but if you hear from their PCP that it is legit, then please don't try to reinvent the wheel. Give the meds like they are prescribed. Thanks so much for letting me share my personal pain story.