Do you know the Candyman? - page 2
Who here knows exactly who the candyman in their town is (the doc who supplies the addicts with prescription drugs, or, worse case scenario - creates NEW addicts by encouraging unsuspecting patients... Read More
Jun 26, '02Occupation: Quality Nurse & Home Health Nurse Joined: Dec '99; Posts: 3,786; Likes: 129Jeanie, I am sorry you are in such pain, both the emotional and the physical. If you were my pt, I would have no problem giving you all the meds you need. I have no problem with people who have a diagnosis that supports legitimate pain. Neuropathy, Trigeminal neuralgia, arthrtis, cancer, etc, even if the person was laughing w his grandkids, that's the idea, to keep them comfortable. I am pretty sure that those who are causing the problems for people like you getting your Rx filled, are people who do NOT have pain, but are buying this stuff off the street for a thrill.
Do you know why it is so difficult to get a Rx for oxycontin now? B/c some idiot on the street chewed a tablet for the extra rush, 12 hours worth of MS04 dissolved rapidly...well, he died. Not an isolated incident. If there was no abuse of the medication, there would be no restrictions placed on it like there is now. My patients can't even get percocet called in by the doc on a weekend, in NJ, you must have a Rx in your hand to present to the pharm. People who abuse the system have made it extremely tough for elderly and homebound people to get the relief they need and THAT pi$$es me off!!!!!!!
Jun 26, '02Occupation: Hospice clinical director Joined: May '02; Posts: 2,873; Likes: 26Vital signs, interaction with others, watching TV, sleep, laughing, etc are NOT indicators that someone has less pain than he/she is reporting. This is not my opinion, it is in the literature.
To paraphrase Margo McCaffery, MSN, RN, one of our leaders in pain mgmt:"Pain is hatever the pt says it is, and occurs whenever the pt says it does."
Pain is subjective, and we cannot, and should not disagree with the pt's rating. It would be nice if you could meaure pain like a blood glucose, but you can't. Therefore, we must err on the side of the pt. It is not our place to do otherwise.
Again, think about yourselves. Many of us, when in pain, will try to sleep. Why? Because sleep is an escape mechanism, as is watching TV, talking on the phone, etc. Really, do you want to see your pt writhing, diaphoretic, crying out in pain? I doubt it.
Pts. with chronic pain get very good at masking how severe their pain is. They have to, because the medical community, and the community at large, tells them to, directly or indirectly.
Do we ever question a pt that states he has chest pain? Why should any other pain be different.
Patients have a LEGAL right to have their pain controlled. For heaven's sake, we treat our pets better when it comes to pain. Why should our fellow man be any different. Pts. are getting very savvy these days about pain mgmt., and you are putting yourself on the line to be sued for witholding pain relief.
Personally, I would rather give a junkie a fix than deny somone who has pain medication that can make him more comfortable.
Jun 26, '02Occupation: RN Joined: Feb '01; Posts: 1,840; Likes: 218This subject is an important as well as emotional one. I work in post-anesthesia care (recovery room) and had an experience with an doc just last week.
It went like this:
Me: "Doctor of anesthesiology, our patient is in severe pain. He rates it an 8 or more out of 10."
Doctor of anesthesia: "What is his pulse?"
Doc: "He's not in pain with a pulse rate like that"
Me: "Oh yes he is!!!(loudly but not screaming). Now, what can we give him? Demerol? Toradol? Both? (Tapping foot wildly)
Dodtor: "O.k, give Demerol IM, 50mg. Then Give IV toradol 30mg"
Me: "Great idea doctor!"
Pain is SO difficult for us as professionals as well as people to deal with. On one hand, we HATE to see pain in our patients, on the other we are so fearful of overmedicating or being accused of it. We all know what "snowing" a difficult patient is. I myself live with pain, usually the level is 3/10 on good days. My 3/10 used to be a 7/10. The longer we are forced to endure it (or force ourselves to endure it) the more "used to " pain we become. The problem is that when we have a different, new pain, our tolerance for THAT new pain is ZERO. This of course is my opinion.
I am with fab4fan 1000%! I say better to medicate the wrong pt, than NOT to medicate a suffering patient.
Jun 27, '02Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70And again I say the disease/illness I am treating is addiction, not chronic pain. On a normal med surg floor, you might be giving someone a high 5% of the time and medicating genuine pain 95% of the time. It would be the opposite with my patient base. I'm not talking Tylenol here.
It's my job to safely detox patients, get them clean of whatever they were using and not give them what they came in to get off of. I don't expect people to understand the differences between addictions nursing and "normal" nursing if you haven't experienced it. I can assure you that I would not be doing my patients any favors by advocating for orders for Lortab, Oxy, etc. We minimize use of narcs of any sort, but that does not mean we don't treat pain.
And yes, hoolahan, it does make me angry that some medications have been abused to the point that they are difficult to get for people who have legitimate pain issues (and that Ensure thing just was over the top!.) That was part of what motivated my original post. Thank you for understanding that there are implications beyond the individual patient.
Jun 27, '02Joined: Apr '02; Posts: 4,738; Likes: 104We know what you're talking about. We just all like getting off on a tangent. But I digress..............
Jun 27, '02Joined: ; Posts: n/aNurse Ratched, I do apologize for flying off on a tangent. I truly admire nurses like you who work with the addicted, and I thank Hoolahan so much for the kind words. I wish that we could take anyone's claim of pain at face value. Those who are addicted have their own special pain, which is far more severe physically and emotionally than the pain that persons like me face. If there are physicians who are lining their pockets at the expense of these people, they deserve to be denounced and lose their licenses. Take care of yourselves, and keep up the great work that you do. JeannieM