Need Advice...new LPN grad w/chronic pain

iwanna · Jul 17, 2009

Have you ever tried tramadol? I have chronic pain and have taken it for about 10 years. I take it on routine, bid.

Honestly, I don't think that you are impaired if you have been on Vicodin, long-term. If taken, as prescribed and not abused, I don't think that Vicodin impairs the pt. with chronic pain. But, these are just my feelings. I do not believe that you are obligated to tell them that you take narcotics. Unless, it is written somewhere that you are not allowed to work while taking narcotics. Perhaps, some placers do have such written policies.

You mentioned that you have verbal clearance from your doctor. I would get a written clearance. If there is nothing stated anywhere in employment policy about narcotics, I would not offer any info. "Don't ask, don't tell" would apply here. When you take a drug test, as long as you have a prescription from your doctor, you are cleared for employment. The only thing your employer will be alerted about, is if you tested for a controlled substance and did not have prescription for it. I would get the written statement from your doctor, just in case, anything would happen, and you can cover yourself. Just in case, you would get injured on the job, they always make you get drug tested. If you have the written staement from your dr. about not impairing you, then you will be covered.

And, another option is that you can try the tramadol.

Heogog53 · Jul 18, 2009

as an rn suffering from chronic pain, i've learned to read all the policies and procedures about the taking of prescription medication.

most hospitals have a policy which states that prescription medication can be taken within the parameters of the doctor's order, as long as it doesn't interfere with your behavior, your ability to perform your normal duties, that you are not taking illicit meds(including obtaining prescription meds on the street).

the last drug test i took around 6 years ago tested for everything under the sun. i also wrote on the test slips the names of all my possibly "suspicious" prescription medications. oddly enough, i was contacted by the nurse recruiter and hr only because i tested positive for stimulants, but not a word was said about any of the pain meds i took. if there are any questions about the medications you are taking, what is required is a note(best written by the doc on a prescription pad- has the doc's license number, etc on it) from your doc which states that she/he has prescribed the following medications for you- with the whole "percocet tablets 1-2 q 4-6 hours, sig 240", or in my case "dexadrine 15 mg qam, 10 mg @ 1200 and 5 mg @ 1500."

however, do not volunteer any information. unless hr or nurse recruiting requests further information, do not give them any private and personnal information. according to law, no-one is privy to your health conditions/treatments and the like unless you open the door, legally.

so, you must ask yourself the following questions-

when i take my pain meds, do i act any differently than before or do i act the same way?

when i take my pain meds, is it to follow a round the clock prescription or a prn one?

do i crave my pain medication even when i don't need it, or always crave it too early for the next dose?

if i'm not having pain that day, do i take any pain medication at all?

if the answer to the first one is no- then don't reveal anything.

if you take pain medication intermittantly and only when you have pain- shouldn't be a problem. neither is round the clock prescribed pain medication if y9ur answer to the first question is the same.

if your answers to numbers three and four are yes- then you have a pain medication issue, especially number three. that's the indicator that you are taking the medication for the "feel good" aspect more than the "feel normal" aspect. see your doc immediately.

you can try tramadol or ultram.

has anyone ever suggested a tens unit, acupuncture, biofeedback, acupressure, or massage as other pain management options? also yoga, aquatherapy or t'ai chi?

if you would like to contact me privately, please feel free. i've been dealing with this for what seems forever.

i'm sorry that you have to use pain meds, but i also understand that just being able to act like a normal person is invaluable when struggling with chronic pain; to have as much of a life as you can, on as many levels as possible.

best regards.

a "verbal order" from anyone just won't cut it; would you give a patient on the floor a pain med because the patient said the doc had given the patient a verbal order? nope. it needs to be written on your chart and on your prescription bottle.

CharleeJo.RN · Jul 23, 2009

Thanks to both of you...the advice definitely helped! Heogog, I am going to PM you when I figure out how I can do it!