new nurse needs advise to deal with difficul pts

[topacio]

I am a new graduate. I have being working for a community clinic for the last 3 months.

We get a lot of patients that are in pain meds for example I had one today that needed refills on

Ultram (tramadol)

flexeril

vicoprofen

He broke his back 7ys ago and has being taking those meds since them. The MD (new MD for the patient) decided to refill only Ultram and flexeril and sent him to a pain management doctor.

The pt was very upset because he also wanted his vicoprofen. The worse part is this MD always send me as messenger to tell this pts that certain pain killers Rx won't be refill by the MD, so I am the one that has to deal with their fit.

Since I don't have experience dealing with long time user pain killers pt's. I am not sure if it was a good idea to get this pt out of vicoprofen. What I understand ultram and vicoprofen taken at the same time seems to be kind of a lot!

I will appreciate your advise

[beckster_01, BSN, RN]

Did you try asking the MD for a specific answer on why he stopped the medication? Something a little more detailed than "I am uncomfortable with that drug." Make the doctor tell you what makes him uncomfortable with it, if the patient has been using it for long term therapy and hasn't had adverse effects yet. Does s/he think that the pain service can find a more effective therapy? How long will it be before the patient has access to the pain service? Ask the doctor if there is a way he can prescribe enough of the drug to last the patient until they can get to their appointment so the patient isn't left out to dry...

[Elvish, BSN, DNP, RN, NP]

Moved out of Nursing Humor into Nurse Colleague/Patient Relations forum :)