Inappropriate or a over reaction?

[mustanglover]

I recently had an exploratory surgery preformed. Prior to the surgery I informed the doctor that I was on pain mediation and in pain management, I am on 15mg of oxycodone 4 times a day for severe pain. The doctor said she would prescribe a pain killer for break thru pain.

After the surgery I was brought to ICU, my ICU nurse was extremely nice to me and did leave my side the entire time I was in the ICU. I was then brought to the post operative room, there were no clocks in the room. I found it quite disorienting not being able to tell the time. I asked the nurse who was assigned to me what time it was and she out right refused to tell me what time it was.

Prior to being discharged the nurse brought the prescription that the doctor had prescribed for break thru pain and hands it to my mother. My mother who was going to drive me home because I was given anesthesia says " aren't you already on pain medication?". The nurse then snatches the prescription from my mothers hands, and say "I guess you don't need this, so I will just shred this for you". I tell the nurse that the doctor was fully aware that I am already on a pain medication, and that the prescription was for break thru pain. As I say break thru pain the nurse laughs as if there is no such thing as break thru pain. The nurse then try's to tell me that I could over dose taking this medication while already on a pain medication and that I really should not have been given a prescription for pain. I then ask the nurse if she shreds the prescription, are you going to pay for my return visit to the ED if I have beak thru pain that I can not deal with later that night or the next day. The nurse then angrily hands the prescription to my mother and storms off in a pissed off mood.

The prescription was for 20 percoset 5mg/325mg. Also I did have break thru pain later that night and several days afterwards.

I later received a survey in the mail for that surgery, in the comment section I wrote how there was no clocks in the room and the nurses refusal to tell me the time and how I found that quite disorienting. I also wrote in the comment section about how the nurse tried to shred my pain prescription and when I told her it was for break thru pain she laughed at me. I asked that she be trained in pain management so that other patients did not have to go thru what I had to.

Was the nurses behavior inappropriate or did I over react?

[amoLucia]

Reading your other past posts, you've had concerns with staff provision for your personal care. Based on information that you've provided, it seems there prob were lapses in good care practice. I'm getting the impression that you are NOT a nurse but are you in nsg school? I'm only seeing/hearing your side of the story. I could see some rationale in their actions thatyou describe.

But know that this is a site where nurses will be hesitant to criticize another professional without hearing all 3 sides of the story.

[mustanglover]

I'm not asking any one you criticize any one, just wondering if it is appropriate for a nurse to question a doctors orders. I can see at first maybe she may of assumed that the doctor was not aware that I was on a opiate pain killer, but once I told the nurse that I had informed the doctor that should of been the end off it. If the nurse felt I lied to her about speaking to the doctor she should of called the doctor or the doctors office. I personally felt the doctor should of informed the nurse that I was already on opiates and the pain medication was for break thru pain.

I kinda felt like the nurse either did no believe that I had informed the doctor of the opiates that I was already on, or the nurse lost a loved one to opiate addiction. I personally felt that it was, she lost a loved one from opiate addiction. The nurse was pushing the "you may over dose" a little to hard. What I saw in the nurse is what I have seen in other people recently, they lost a loved one to opiate addiction so they lash out at any one on opiates whether they are on opiates for a medical need or not. These people who lose loved ones to opiates, do not think rationally they want the use of opiates banned for every one.

A month prior to the surgery there was this big news story that was released in my state about opiate abuse, the media is calling it the "heroin epidemic". Even our governor has jumped on the "heroin epidemic" band wagon because she has her eye on a seat for congress. The governor's first statements on the "heroin epidemic" was about how prescription fentanyl should out right be banned in the state because it is being mixed with heroin. What the governor failed to tell the public is that the fentanyl being mixed with heroin is synthetic fentanyl mostly made in Mexico. I absolutely believe there is a direct correlation between prescription opiates and the "heroin epidemic". I don't believe this "heroin epidemic" began from legit opiate prescriptions, I believe it arose from the "pill mills" and there closures. The Feds came in and closed all these "pill mills", you have all these people addicted to opiate pain killers who no longer have access to them so they turn to heroin. The heroin suppliers can't meet supply and demand so they start mixing fentanyl into the heroin, some where down the supply line they forget to mention or willfully neglect to mention fentanyl is mixed with the product. The users get heroin not knowing it is mixed with fentanyl and 100 time more stronger than the last batch and people start over dosing.

[Spidey's mom, ADN, BSN, RN]

Absolutely nurses are supposed to use their judgment and can question physician orders.

But saying she would shred the prescription without discussing with the physician who wrote the order is definitely wrong.

As to NO clocks in post-op and the nurse not telling you what time it is, that is certainly something that is concerning.

But yes, nurses are not a physician's handmaiden. We are our own professional entity. And we can question physicians.

[BuckyBadgerRN, ASN, RN]

If you have questions about the care you've received as a patient, I encourage you to speak with the facility that provided the care. Trying to get into the minds of nurses on a forum that you have no business posting on is getting old, OP

[luvsltcrn]

It is absolutely the nurses job to question doctors orders if it is for a patients safety. And unfortunately with the drug epidemic going on there are many patients that will lie to get pain medications and it is a nurses job to clarify any questions with the ordering MD.

I'm not sure why you would assume that the nurse lost someone to an overdose unless she gave you more information than you have given us. I would assume she is trying to keep you from harming yourself by taking too much medicine.

She could have handled the situation better as far as not telling you the time and threatening to shred your prescription but I totally agree with her questioning the order for more pain medication before sending you home with it.

[amoLucia]

Another thought about that Rx - I probably would have opted to shred it also as that would be the accepted way to dispose of 'sensitive' printed information and to prevent a 'dumpster dive' retrieval for the purpose of illegal filling.