How do you deal with suspected addicts?

[OhioCCRN]

I had a Resident that threatened to sue/ call the state on the facility because she did not get her PRN dose of Oxy IR/ Vicodin RIGHT on schedule.

1. Resident says she is in 8/10 pain, and has been 'falling asleep but had to stay awake to get the next dose of pain meds' I re-educated about the pain scale and how w/ 8/10 pain you cant possibly be asleep and if you are asleep that's a good thingetc...

2. Resident pulls call bell right on schedule for PRN meds (all of them) and says she needs then NOW. When i am even 3 minutes late, she starts cursing and rolling around the bed.

3. Resident writes down all the doses and sets an alarm clock to wake her up during the night to get her PRN meds and then complains that she has had no sleep.

- How do you handle such a pt. One who has admitted to popping oxy before going to work. i'm documenting EVERYTHING that i do.

i understand that i am biased about this... its really frustrating and i need some advice on how to deal with this.

[xtxrn, ASN, RN]

Just for a chuckle I have to throw in that I floated the other day and had a young uncomplicated lap chole approaching her 2nd night of hospital stay. She kept asking for a fentanyl patch for pain control. For real?!? No, no, and no I'm not going to interrupt your surgeon in the OR to ask for the umpteenth time. Just take your 2 mg of IV dilaudid Q 2 hrs and hush up, you won't die tonight. In fact you look more put together than me!

Sorry, just a little vent.

ETA: The above was def a PITA and it was a very very long 4 hrs with this pt. When she wanted to know what pain meds she could take that wasn't oral I told her-to start with your surgeon will always order phenergan suppositories for the nausea (which is why she wanted a patch). Probably will D/C all opiates as your BT are absent and have nurses administer APAP supp PRN. Possibly you will need an NGT if you don't start passing flatus soon. Didn't hear another peep the last hour of my shift.

HaHa I am evil

I'm sure she loved the idea of actually walking the CO2 bubbles out of her system

[DookieMeisterRN]

I'm sure she loved the idea of actually walking the CO2 bubbles out of her system

She was practically running down the hallways

[xtxrn, ASN, RN]

She was practically running down the hallways

My poor dad had a lap choley a few years ago. This is a guy who has had a blown appendix ( that he doesn't remember much of- I DO, since I was the one hollering at him with the Better Homes and Gardens Home Medical Guide turned to the risks of appendix rupture page-- before nursing school, so early 80s). No medical issues to speak of. No concept of 'big' surgery, or post-op pain. None.

He calls me over one night to bring Gatorade, ginger ale, chicken soup, jello, etc- thinking he'd probably poisoned himself again with expired food in the frig (thinks the exp date is still good AFTER the mayo is opened...). I get there, and he looks puny, and was rolling around on the bed. Didn't want to go to the ER, so I set him up with a cooler with ginger ale and Gatorade, and puke pails by the bed (bathroom was about 10 feet from the bed), and head out (I was trying to go back to work after first round on disability and didn't want to risk catching something if he had a bug). Told him to call if he wanted to go to the ER, and I'd be right back. I'd call him in the a.m. otherwise.

He was at an auction the next morning by 8 am:devil:

A couple of months later- another attack of "food poisoning"....finally saw the doc, and an US showed gallstones, and he was scheduled for a lap choley. I'd told him about the faster recoup time, and fewer side effects/risks than an open choley. Three bandaids. WELL.... 1) he's a guy (sorry, guys- it's true ...at least with acute pain; chronic pain guys seem to be tough as nails :)) and 2) the idea of MOVING to relieve pain must be something cruel I'd dreamed up to drive him nuts (I was on home health and not even supposed to be away from home- but had to check on the guy- I'd already refused to pick him up from the hospital when they were going to discharge him before he'd a) peed and b)kept fluids down....so I didn't go get him; his lady friend did. He has horrible reactions- major vomiting- to Versed and wouldn't tell anyone before surgery- SO they could deal with him (he should have stayed the night- this wasn't some 30y/o, he was in his mid-70s).

Anyway, I went over the next day, and he's still using the URINAL he dragged home from the hospital (yuck). The bathroom was about 5 "puny" steps away- not even 'good' steps.... I told him if I got there the next day and he was still peeing in the jug, it was going in the trash. I went to get his pain meds (which was a good thing since the drive-by pharmacy window guy gave me someone else's asthma meds WHILE looking at the address (that was wrong) while I told him the correct one ).

He survived :) He thought I was 'mean' to tell him to get up, but I got over it

He still needs to keep the frig hazard free...but, at least he will ditch things now and then. Progress is slow :)

Sorry about the derailment :)