Do you get "pain med seekers" in hospice?

[JacelRN]

Hello all,

I have finally worked it out to transfer to hospice. I'll be working part time hours there and still 12 hours at my current job on a heavy med-surg floor.

My question is regarding "pain med seeking" behavior in hospice. Do you get it often? I have the least amount of compassion for these types of patients. That is one of the main reasons I wanted to work at hospice-working with patients who have true need of pain relief, who need me to advocate for them in case they cannot, etc.

Please understand my term "pain med seeker" to be someone who is obviously timing their meds. I know we are to treat each patient as their pain is real to them, but in reality, much abuse is present in the current hospital setting.

Please tell me I won't encounter this as much in hospice. That is my true hope in transfering is that I can care for patients as I wish to-and their pain.

Thank you for any replies,

JacelRN

[mjamesRN]

Drug-seekers on a Med-Surg floor can be a difficult endeavor -- one you really shouldn't have to manage alone. Most hospitals have a Pain Management team that can help.

Hospice is an entirely different animal. I had a guy with endstage pancreatic cancer who had been on pain killers and was an alcoholic all his life and, by the time I received him, had a port and a Dilaudid pump that was delivering 180 mg/ hour PLUS q15 minute 30 mg boluses for breathrough. (These high doses apparently aren't uncommon with oncology patients), however, He was beginning to have myoclonic twitching -- was verging on fullblown seizures and possibly a stroke -- from the high doses of Dilaudid. If we even pulled back a little, his pain would skyrocket. In otherwords, there was really nothing more we could give him. He was already on Oxycontin as well and morphine or methadone wouldn't even touch his pain. He died in pain. One good thing was he kept a sense of humor right until the end and his wife was wonderfully supoortive and caring.

[aimeee, BSN, RN]

YES , I , AND OF COURSE OTHERS KNOW A "DRUG SEEKER" TYPE......in an acute care setting.....but, let me just say this: HOSPICE PATIENT= LICENSE TO BE A DRUG SEEKER. i AM SORRY TO BE HARSH, BUT I THINK YOU SHOULD KNOW THIS, AND NOT EVEN HAVE THIS ENTER YOUR MIND WITH A HOSPICE PATIENT.

Read the entire sequence of this thread and you will see the thread originator came to a new understanding through the dialogue here. The negative comments she received from some resulted in a defensive position. Gentle education works wonders in bringing others around to your point of view while sharp words just tend to make others turn away or entrench themselves more deeply.

[JacelRN, BSN, RN]

Thank you Aimee, :)

Please people, the horse is dead.

I've been at hospice now for almost 5 months and now I'm switching to full time, I love it that much.

As I posted earlier, I understand now where I couldn't before. My background was in medicating Med-Surg patients.

Thanks to all who posted, negative or positive, but I would truly like to let this issue drop now that its no longer relevant.

JacelRN

[prmenrs, RN]

It sounds like you would like a moderator to close the thread? I will close it, if you want it re-opened, pm me.

[aimeee, BSN, RN]

Thanks! I was planning to do just that when I got home. :) This seems like a good place to end things.