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:

LOL, right on Sahara. Tell it like it is! Legal fix, that's a great term. Sorry, but some of this PollyAnna talk on this thread is just too much. And also, it's not nice to bash people's nursing abilities just because they don't swallow hook, line and sinker the Sarah Bernhart performances that some pts put on to get their fix.

We're entitled, at least, to our opinions without getting scolded.

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Specializes in Cardiology, Oncology, Medsurge.

Recently I had a patient who was receiving 2mg of morphine q 2hrs...no biggy really; however, this lady was to receive 60 mg of MScontin... a scheduled med BID...so I go the extra mile and hunt for this med...hunt on my Tele floor and eventually trickle down to ICU where she originally transferred from to get the goods...So, I give her her precious pain numbing pill with the reply, "Is it not time for my 2mg morphine shot!!!???.....OK OK..;)

My response, let's wait a little while, say 30 minutes and see if this gives you your desired pain relief...she didn't counter with "Oh such pain" or anything like that just an understanding of my counter to her plea...

PS. Thanks with glee to all the wonderful contributers, once again to this forum post....from the OP originator.

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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.

Well, since you didn't have the humilty to apologize for bashing the OP, I did it for you. Now, will there be anything else? If not, have a good day.

Excuse me? Where exactly did I bash the poster that requires an apology?

I have to stop typing now because then I really WILL say something to apologize for.

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I read quite a few of there posts on this subject, but I didn't get to them all, so if what I say is just a repeat, bare with me.

I have a high tolerance for pain. I live with chronic pain and have indeed hit 9 on a scale 1-10 (I never rate a 10, it could get worse). I've had disks so severely herniated I couldn't walk for the pain. I've had 9 surgeries. Thank goodness for that recovery nurse that kept giving me pain medication when I said I hurt. And hurt it did. Now, my response to pain is to lie still and close my eyes. I'm not the recovery room patient screaming or trying to get up, yelling, carrying on. But I hurt.

I know there are patients that we question whether or not they are truly in pain or not. I'm not the one who gets to decide if they are in pain, they tell me. If your just drug seeking, fine, I'll give you whats ordered because who am I to judge someones reaction to pain and whether you are truley experiencing pain.

Oh, and for those nurses 2 years ago that kept changing my wound vac to a large abdominal wound and I kept telling you it hurt badly, but you just kept going and said hit your button, I hit the Darn button many times and it did not relieve the pain. When I begged you not to put a new dressing on because of the pain I would have changing it and you said well we'll try some (adaptic type stuff if I remember correctly) and it won't hurt as bad, YOU LIED. It hurt like he**. You never got an increase in my pain medication knowing I was having severe pain with the dressing changes. It took 4 dressing changes, but I finally refused to allow another wound vac dressing placed on my wound. It may have taken more time to heal with BID W/D dressing changes, but it didn't hurt near so bad as that evil wound wac.

jetscreamer101

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Pain is pain. What may seem to you as drug seeking may be true pain.

I have become so used to severe pain that I can act and seem perfectly normal to the most trained eye. Yet, I still am in agony.

If the patient is drug seeking, being enraged does nothing to help either of you.

LIGHTEN UP! YOU HAVE NEVER BEEN UPSET AND OR FRUSTRATED KNOWING THAT THE PT YOU ARE MEDICATING IS AN ADDICT SEEKING ONLY "THE ADDED BENEFITS" ( AS ONE RN PUT IT) OF NARCOTICS? I'VE BEEN UPSET A NUMBER OF TIMES AND UNFORTUNATELY, WORK IN HOSPITAL WHERE ADDICTS ARE REPEATEDLY ADMITTED ( CARDIAC UNIT.. DRUGS= ARRTHYMIAS ETC ) . EVEN CAUGHT A PT DOING BLOW IN HER ROOM WITH HER BOYFRIEND ... RAZOR BLADE IN HAND AND ALL. FEELING ENRAGED IS SOMETIMES SIMPLY A NATURAL REACTION TO THESE KINDS OF EVENTS TRANSPIRING WAY TOO OFTEN!! IM SURE THE PT STILL GOT HIS HIGH SO IT STILL HELPED HIM AND IN THE END, IS HELPING THE RN WHO BEGAN THIS THREAD BECAUSE VENTING IS CATHARTIC ..

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LIGHTEN UP! YOU HAVE NEVER BEEN UPSET AND OR FRUSTRATED KNOWING THAT THE PT YOU ARE MEDICATING IS AN ADDICT SEEKING ONLY "THE ADDED BENEFITS" ( AS ONE RN PUT IT) OF NARCOTICS? I'VE BEEN UPSET A NUMBER OF TIMES AND UNFORTUNATELY, WORK IN HOSPITAL WHERE ADDICTS ARE REPEATEDLY ADMITTED ( CARDIAC UNIT.. DRUGS= ARRTHYMIAS ETC ) . EVEN CAUGHT A PT DOING BLOW IN HER ROOM WITH HER BOYFRIEND ... RAZOR BLADE IN HAND AND ALL. FEELING ENRAGED IS SOMETIMES SIMPLY A NATURAL REACTION TO THESE KINDS OF EVENTS TRANSPIRING WAY TOO OFTEN!! IM SURE THE PT STILL GOT HIS HIGH SO IT STILL HELPED HIM AND IN THE END, IS HELPING THE RN WHO BEGAN THIS THREAD BECAUSE VENTING IS CATHARTIC ..

Uh. No.

Just curious. How did I become the target here?

I'll just go lighten up now.

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Specializes in Neuro ICU, Neuro/Trauma stepdown.

I still allow myself to get irritated at the patient that says with a smile "you're going too slow, push it faster......."

this is the type of patient i educate immediatley and continue to push at my own pace...maybe a tad slower....they can take it or leave it, we have our reasons why we push it slow.

but that's just it skm1, pain shouldn't really be the 5th vital sign as it is not an accurate indicator.

when they say pain is the 5th vital sign, it's refering to the fact that it should not be ignored, or forgotten about and needs to be assessed and treated as often as you would any other vital sign

Yeh, it can be time consuming to get that pain med to the patient every 2 hours, but:

1) it helps keep your time paced for the day (wow, 2 hours have gone by ALREADY?!!!)

2)If that's the least you can do for that person that day, hey, piece of CAKE!

hey, that's a good point!

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I think I know what is really bothering the author of this thread. I have similar problem. I usually medicate between 8 and 16 times per shift. Each medication involves assessing the patient, all the paper work involved in taking the medication out of narcotic cupboard(no we don't have accudose), the time involved in giving the medication and then reassessing within an hour. I then have to do 5-10minutes of documentation involving the original assessment and the hourly assessment. Many times I have to contact physician when there are problems with the medication and everything involved with that. Frequently I have 8 patients and they each need to be medicated 2 times a shift and so by the end of the shift I am enraged also. However, my rage is aimed at the system not at my patients. Thank God for those nights when I have people who are not heavy hitters when it comes to the narcs, I usually medicate about 8 or 10 times on those shifts and it is much easier.

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LIGHTEN UP! YOU HAVE NEVER BEEN UPSET AND OR FRUSTRATED KNOWING THAT THE PT YOU ARE MEDICATING IS AN ADDICT SEEKING ONLY "THE ADDED BENEFITS" ( AS ONE RN PUT IT) OF NARCOTICS? I'VE BEEN UPSET A NUMBER OF TIMES AND UNFORTUNATELY, WORK IN HOSPITAL WHERE ADDICTS ARE REPEATEDLY ADMITTED ( CARDIAC UNIT.. DRUGS= ARRTHYMIAS ETC ) . EVEN CAUGHT A PT DOING BLOW IN HER ROOM WITH HER BOYFRIEND ... RAZOR BLADE IN HAND AND ALL. FEELING ENRAGED IS SOMETIMES SIMPLY A NATURAL REACTION TO THESE KINDS OF EVENTS TRANSPIRING WAY TOO OFTEN!! IM SURE THE PT STILL GOT HIS HIGH SO IT STILL HELPED HIM AND IN THE END, IS HELPING THE RN WHO BEGAN THIS THREAD BECAUSE VENTING IS CATHARTIC ..

i agree venting is cathartic.

yelling is not.

for yrs i worked in an in-pt hospice facility.

the pts with AIDS were tucked away in a corner unit.

no one wanted to care for them because a couple of them were addicts.

i recall one whose room i walked into, his huge glass bottle of iv acyclovir had smashed to the floor, his nose was profusely bleeding and had blood all over his hands.

he had been snorting coke and ended up making a huger mess than expected.

i gowned up and swept the glass to one side (the maintenance guy had given the broom to me :rolleyes: ).

i rushed to get all my supplies right in his room and cleaned him from head to toe.

i had him pinch his nose closed while i cleaned.

no one wanted to help me.

i do recall the nm suggesting i wear 3 prs of gloves, as she stood out in the hallway.

after i got him in bed, all he did was cry.

he just wanted to have a few more good times before he died.

how does one get angry at that?

i spoke with the doctor and suggested a strong anxiolytic.

the pt loved its' effects.

i don't know why, but i just can't get angry when i deal w/an addict.

i do get upset with overly demanding pts but that's why i try to anticipate their needs.

it saves the both of us a lot of heartache.

i remember wanting to cry, just for the fact that these AIDS pts were dying alone in a hospice unit.

staff remained fearful and ignorant.

and this pt cried for many different reasons.

and although it wasn't cocaine, i did make sure to get him something that would make him feel he didn't have a care in the world.

so by all means, vent away.

but keep in mind, everyone has a story to tell.

leslie

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Specializes in Med/Surg, Home Health.

To all who have posted in this thread, we are supposed to be here to support each other, to allow each other to vent. This somewhat prevents us from venting toward our patients. We should NOT be venting AT EACH OTHER. I love this site. We all have hangups at work with which we need to deal with and this should be the perfect place to allow that. Some of our statements in this thread have been taken too literally. Some have focused on one word in an entire post rather than trying to view the person's point of view. We all have something to contribute and we all have alot to learn. Let's keep that in mind.

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he just wanted to have a few more good times before he died.

how does one get angry at that?

i spoke with the doctor and suggested a strong anxiolytic.

the pt loved its' effects.

i don't know why, but i just can't get angry when i deal w/an addict.

i do get upset with overly demanding pts but that's why i try to anticipate their needs.

it saves the both of us a lot of heartache.

i remember wanting to cry, just for the fact that these AIDS pts were dying alone in a hospice unit.

staff remained fearful and ignorant.

and this pt cried for many different reasons.

and although it wasn't cocaine, i did make sure to get him something that would make him feel he didn't have a care in the world.

so by all means, vent away.

but keep in mind, everyone has a story to tell.

leslie

You have a big, loving heart, Leslie.

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Specializes in Cardiology, Oncology, Medsurge.

Kudos ChenoaSpirit!

We are taught in nursing school not to have a bias regarding a patient's subjective pain, however not taught to look at the surrounding circumstances...ie. multiple tattoos, no significant signs of pain on a scale of 10/10 and confusion as to where the pain may be coming from!

Sometimes the reality is heart breaking! But do give the med is correct action...it is ordered, you have no say, really!

A healthcare system on the brink of collapse...it's expensive to harbor an individual just to satisfy his/her addiction.

Again...this old OP is grateful for all the diverse opinions and thanks for supporting my cathartic venting!

:typing

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