Pain shots are us, not this nurse!

Nurses General Nursing

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Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).

:icon_evil: :icon_evil: :icon_evil:

People get pretty judgemental about people they think are judgemental. Old story, I think Jesus addressed this more than once. I find it annoying, personally.

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I hate it when anyone does anything in front of the pt. Big beef of mine. I was at the supermarket the other day and the clerk was giving the bagger a hard time and embarrassed him in front of me. Really distastful.

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Specializes in Day Surgery/Infusion/ED.
I try not to judge. I know it's really hard sometimes though ! I think our er adds to the problem though. Now we are giving IV dilaudid (I was informed by a pt the other day that is the liqued form of dilada - HA !) and percocet in triage. The liability for that worries me. I do find myself getting frustrated with people who are allergic to Toradol, ultram, nsaids, thorazine. But that drug that starts wit D...something , always works . Imagine that. Heck , I remember the days when we could give NACAL injections. (saline). It was amazing the people that thought it was demerol because it stung so badly. And , they felt better !!!!!! Then the dr was able to say to them they think their pain may have a psyc aspect , and have the proof for the pt. If they had NACAL every 4 hours and felt better then obviously they don't need narcs to feel better. Too bad we can't do that now days. Not to be mean but to make it easier to evaluate the root of the pt's pain.:rolleyes:

What the heck is NACAL??? Do you mean NaCl?

You can be thankful someone didn't sue the pants off you for that. Quite unethical, possibly illegal. That violates the standard of care for numerous nursing organizations.

It's inappropriate to try to suss out whether a pt's pain is "real" or "psychogenic" by deliberately misleading him. Just what did you do after you got to the "root" of the pt pain, other than putting his name on a 3x5 card and adding it to the "turkey file?" Did you make appropriate referrals, e.g. psych? Consult an appropriate specialist?

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Anybody who says that they can't relate to what you are saying is lying. They, too, have seen what you're talking about and they are not perfect. They have hang-ups, too.

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No, I'm not lying when I say I can't relate to someone else who becomes "enraged" at their patient.

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No, I'm not lying when I say I can't relate to someone else who becomes "enraged" at their patient.

I think the use of the word 'enraged' was an exaggeration in order to express frustration. Just like pts have different pain thresholds for pain, nurses have different thresholds for pains in the tushes.

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Specializes in Cardiology, Oncology, Medsurge.

Thanks for acknowledging that the use of the word "enraged" was for the purpose of making this controversial subject more controversial...most of the time I am even tempered at work!!!

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Never been enraged by a patient expecting to be medicated as prescribed by the physician... it's their pain, not mine... and I have no right to judge. Give them their medication and go read up on pain management.

Amen to that. Thank you for saying so....

To the OP: When reviewing pain management, don't forget about your patients who are sedated. They have pain management issues as well. Though they can't express it, it often exists. Sorry, this is an issue very close to me and my family right now. Thankfully, my brother's nurses and physicians are well-versed on pain management.

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If someone is really frustrated about something and brings it here I am guessing they are expecting a wide variety of responses and reading those opposing opinions may actually alleviate some of the op's frustration by hearing someone elses perspective...that being said here is my 2 cents. I was listening to NPR one day and heard them talking about a pain, saying that some people have more of a certain amino acid and those people experience pain more strongly, i.e. "lower pain threshold" so two people can suffer the exact same injury and one can deal with like it's nothing and to the other the pain will be unbearable. Totally agree with keeping pain under control for patients because I am the one who let's my own get out of control so it's hard to bring it back to a bearable level, and I suffer quietly, I do not express my pain other than maybe trying to sleep. Had an experience in the hospital the nurse asked my pain rating and I said maybe a 4 thank god my mom was in the room because she knows that I suffer silently and underestimate my pain and spoke up, they gave morphine several times and a sleep aid it did NOTHING!!! I had let it get out of control and looking back know I would probably say my pain was actually more like an 8-9. I was in induced labor, it was pretty painful. So I try to encourage my patients to try and keep their pain under control. As for "drug seekers" which I have encountered in an immediate care setting I just treat them as prescribed, it's not my call and I would hate to have judged someone and it turn out I was wrong........

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I don't need anyone to apologize for me. If I need to apologize, I can do it well on my own, thank you.

My post, and many others, were to point out that you CANNOT decide yourself if a patient is in pain because they don't act the way you think or feel that they should.

And, no, I'm not lying. I have never become enraged at a patient, nor would I use that term to emphasize a point. I have become annoyed and frustrated from time to time. But please, don't ever apologize for me.

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If you are enraged, I'm concerned about your mental health, and would not want you to be my nurse! Perhaps you need some time off. Also, after my C-sec (many years ago) you are damn right I was asking for my pain pills every 4 hours and was therefore active and home in short order!

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clemmm78, your post followed mine, wasn't sure who you were addressing in regards to apologizing for you?????

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Specializes in Neuro ICU and Med Surg.

I wouldn't go as far as to say that I was ever "Enraged" but maybe a little annoyed. I have been having chronic pain in my knee since I have avascular necrosis. I usually don't say anything. I was started on a nsaid but it ripped my stomach up and i was given tylenol 3, which helped. I can now deal with it just by taking motrin 800mg prn. I would have rated pain differently at different times. (I have a good tolerance for pain)

But I have been a patient complaining of chest pain with every breath and was NEVER EVER offered or given ANYTHING AT ALL, while rating pain 8/10 with VERY tachy hr. ER doc sent me home with script. If I had been any other person and NOT a nurse I would have been given Morphine or dilaudid. This particular day I had been just released from the hospital with asthmatic bronchitis, and had elevated HR before they let me go. I was seen by and cleared by cardio even though I had been having chest pain and elevated HR for days. I always had to be pratically in tears before anyone decided to give me anything for pain. At most during hospital stay of 4 days when I complained of pain I was only medicated 2 times. Usually I was given some toradol or vicodin. That was fine but only as one time orders. The night before I was sent home, I called for my nurse. The tech came in and took my VS, I told her to tell my nurse that I felt like my heart was racing. NOT ONE NURSE SAW ME FOR OVER 1 HOUR. I was told she was in a staff meeting when I called again. STILL NO ONE CAME IN TO CHECK ON ME. Again my heart racing was chocked up to anxiety and not pain. I was given xanax and nitro ( which did nothing) and 1 hr later some ambien and I don't remember the rest of the night. I was screamed at by the ER doc telling me that the clarinex was causing me to be tachy. I explained to him that I had been on this med for over 1 yr and this was not the cause. My mom begged them to give me something for pain and they came back and gave me cardizem after arguing about which bed to put me in and how much to give and turned off the O2 so they could put me on a monitor in another room. I was in the 130-140 range and very uncomfortable. The cardizem didn't work so they gave me Lopressor. Brought HR down to 100. Before they gave me cardizem they gave me IVP ativan because the doc thought i was "JUST ANXIOUS". DAMN RIGHT I WAS ANXIOUS MY HEART WAS POUNDING AND I COULDN'T BREATHE, WOULDN'T YOU BE ANXIOUS. So sometimes a person in a lot of pain won't say anything at all and others with a simple sprained ankle will need vicodin for pain instead of motrin.

I have had many issues with being in pain and just plugging along and no one really knows. I worked through a month long headache before being diagnosed with migraines. I have had to go to the ER for a few of those when abortive meds didn't do the trick.

I guess I know how it feels to be on both sides.

I had a great nursing instructor tell me and I totally believe this PAIN IS WHAT EVER THE PT SAYS IT IS. A pain that is no biggie to you and I is distressing to someone else. So don't be so quick to say, that you don't think some one is not in pain.

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