Duragesic patch + recovering nurse with chronic pain = ???

NurseKimberley · Jun 4, 2004

I wouldn't call it a 'relapse' because it's a prescribed drug. If it were me, I think I'd have a talk with your director, just to be sure everything's out in the open and on the up-and-up. That's a hard one. Congrats on the being sober part, and sorry for the pain. :)

leslie :-D · Jun 4, 2004

i would opt for #2. i would hate to see you relapse which is always a possibility. good luck.

Quailfeather · Jun 4, 2004

Have you checked your hospital policy regarding working while taking a narcotic? In our hospital, nurses involved in direct patient care may not work if they are taking a narcotic pain medication. The administration makes it very clear that if you are in such pain that you need narcotics, then you shouldn't be working. I don't know what our policy is for clerical/supervisory positions, though. Also, have you tried Vioxx? When I put my back out last year, my pain resolved w/in 24hrs of starting Vioxx. I have a sensitive stomach so I can't take ibuprofen and most narcotics, but the Vioxx did not cause any GI upset. I wish you the best in resolving your dilemma. Also congrats on your recovery from addiction. I strongly agree that recovered addicts deserve the same level of pain relief as everyone else.

loerith · Jun 6, 2004

Have you checked your hospital policy regarding working while taking a narcotic? In our hospital, nurses involved in direct patient care may not work if they are taking a narcotic pain medication. The administration makes it very clear that if you are in such pain that you need narcotics, then you shouldn't be working. I don't know what our policy is for clerical/supervisory positions, though. Also, have you tried Vioxx? When I put my back out last year, my pain resolved w/in 24hrs of starting Vioxx. I have a sensitive stomach so I can't take ibuprofen and most narcotics, but the Vioxx did not cause any GI upset. I wish you the best in resolving your dilemma. Also congrats on your recovery from addiction. I strongly agree that recovered addicts deserve the same level of pain relief as everyone else.

1) I do not do direct patient care {clerical/bed control/paperwork}

2) I am very close for opting for #3

As you said I need to find out what my hospital policy is. But surely they make a distinction between a patch and just popping pain pills....but then again....who knows. I think I need to be relatively sure on this and I need more advice and time to mull it over.

I have quite a few sick hours acccumulated and I think I need to look out for myself here.

/sigh

Thanks,

loerith

Trauma Columnist · Jun 6, 2004

Well first congrats on being clean anId sober! As I'm sure you are aware - you must care for yourself first before you can care for others. I think a short leave would be appropriate. Good luck and hope you feel better soon.

Vanfnp · Jun 6, 2004

Please be careful, as you well know. Personally, I would find it easier to keep my mind and body busy at work than at home with the narcs, especially with your history. A red flag to me about this situation is why you consider an injury of two weeks "chronic pain". Be honest with yourself and your employers and you can't go wrong.

moia · Jun 7, 2004

She suffers chronic pain from repeated neck surgeries I would think.

Fentanyl patch/popping pills..no difference you are on narcs and therefore considered impaired.

I am a little surprised the doc chose fentanyl as it is one of the last drugs in the line but it may be because you can't alter the dose.

I think you need to take sick leave immediantly and keep your mouth shut.

If you tell your facility you are on narcotics at work they will freak....nurses who test positive on a surprise urine test on the job can be fired or referred to rehab...the fact that you got your drugs legally isn't going to save your licence.

Your job may help in moderating any punishment but no one believes you are not affecting patient care...just because you are not directly caring for them doesn't mean your actions don't effect them directly.

The college will consider you working while impaired...with your history it spells disaster.

Book off sick..get a doctors note...then approach the facility about returning to work while on pain medication...let them make the decisions not you.

Hellllllo Nurse, BSN, RN · Jun 7, 2004

Unless you have a VERY understanding NM, I would opt for option #1.

DG5 · Jun 7, 2004

You can never go wrong with prayer.

tommyperkins · Jun 7, 2004

You can never go wrong with prayer.

As long as it is your choice how and where to pray.

"There goes many a ship to sea, with many hundred souls in one ship, whose weal and woe is common, and is a true picture of a commonwealth, or a human combination or society. It hath fallen out sometimes, that both papists and protestants, Jews and Turks, may be embarked in one ship; upon which supposal I affirm, that all the liberty of conscience, that ever I pleaded for, turns upon these two hinges--that none of the papists, protestants, Jews, or Turks be forced to come to the ship's prayers or worship, if they practice any. I further add, that I never denied, that not- withstanding this liberty, the commander of this ship ought to command the ship's course, yea, and also command that justice, peace and sobriety, be kept and practiced, both among the seamen and all the passengers."

Roger Williams

Letter to the Town of Providence

1654

loerith · Jun 7, 2004

Thanks everyone sooooooooo much for your time and help. I am leaning more and more towards Moia's slant on things here. To be blunt, I dont trust the reaction I am going to get if I even mention the word "narcotics" ; even with my super-supportive director. :uhoh21:

I think the safest thing I can do is take off work immediately. {I am off work right now - just 3 paid time off days}. I will go see my family doctor ASAP and get some type of documentation from him saying that due to the herniated disc I need 3-4 weeks of medical leave of absence. I like the idea of THEM making the decision Moia but I am still hesistant to even mention the narcotic to them as I write this.

Then again if I am off work, with physician's letter in-hand it might be beter to be open and forthright about it.

As far as the "red flag" and "short time" chronic pain thing, let me elaborate just a bit. First I see red flags and feel them everywhere, but not because of the reasons you stated. Have had multiple spinal surgeries and have had chronic pain for a few years now.

Please feel free to post any other thoughts/sugestions.

And again.....

Thank you.

Love and Peace,

loerith