Nurse accuses patient of drug addiction!

[Penelope_Pitstop]

A fellow RN on my floor did something last week that continues to amaze and shock me.

There was a patient admitted with pancreatitis, receiving the usual for that diagnosis: NPO, IVF, Dilaudid and Phenergen. Apparently she was asking for her meds as soon as they were due, if not sooner. Nothing new under the sun for pancreatitis.

Was she drug seeking? I don't know, but I don't think it matters. I know I've never had pancreatitis so I don't suppose to know the agony involved. I imagine it's a painful experience. With those cases, I give the meds if they're ordered, due and there are no contraindications. No problem, right?

Well...

My coworker had the bright idea of printing out information on drug addiction, highlighting parts of it and placing it on the patient's bedside table as she slept.

I most likely don't have to share that the patient was very upset. Oh yeah, did I mention that the patient is a hospice nurse? The patient stated after the incident that if she wanted to abuse drugs, she didn't have to come to the hospital. She had easier access to much better stuff.

I cannot understand how or why anyone could think that this is acceptable!

But ya know what? Nurse Nancy doesn't think she did anything wrong.

I'm going to add that this is the same nurse who told me in report that a patient suffering from a stress-induced flair-up of oral herpes virus "need[ed] an HIV test." Hmm, okay. The patient was septic with S. pneumoniae and intubated for a while. Yeah, I think my body would be stressed too...especially since I have HSV! Does that mean I need an HIV test?

Just so y'all know, management is aware and has spoken to her. Patient relations is also involved.

I just had to see if other nurses were as horrified as I am concerning her behavior.

[talaxandra]

Even if the patient is a drug addict it is non of the nurses bizness, the nurses job is to follow orders and not make judgements on people they don't know. If they want to talk about it they will The best and only way to approach a using drug addict is just as easy. You say "If you think there might be a problem Check out AA or NA." thats it, nothing more and walk away. It is like planting a seed. If they aren't an addict they will not think twice about it If they are they know where to go.

I disagree - I think drug dependency is absolutely our business, and I very much disagree that my job is to follow orders. I also think that 1) managing drug addiction is a little more complicated and 2) saying you think the patient has a problem and ought to consider a 12-step program is just a less significant a wrong as the one described by the OP, at least in this situation.

Regardless of any question of drug dependency, the time to tackle addition is not when a patient is acutely ill, particularly if they also have pain. If the OPs colleague had been genuinely concerned about substance abuse

and actually wanted to assist the patient with this (rather than alienate the patient while expressing her own bias/spleen/issues) she could have expressed her concern about the lack of efficacy of the prescribed analgesia or (my preferred option) see if the demand for pain killers diminished as the pancreatitis resolved.

She sounds like an idiot. Part of me is glad she did this to another nurse, who could defend herself and take action, rather than a defenseless layman who might have become worried about asking for enough medication to cover their pain. Did I say idiot already?

[truern]

She sounds like an idiot. Part of me is glad she did this to another nurse, who could defend herself and take action, rather than a defenseless layman who might have become worried about asking for enough

medication to cover their pain. Did I say idiot already?

:yeahthat:

And just in case you didn't mention it already, she's an IDIOT!!

[RN1982]

It was completely inappropriate for that nurse to have done that.

[Aneroo, LPN]

And this is a different issue about the same coworker - I hate tattling on people, but I guess I have to on her. This incident has made me get my nerve to tell management that she restrained a patient without a doctor's order in a non-emergency situation.

OMGGGGGGGG!!!!!!!!!!!! That should have been reported immediately after it happened. That would be grounds for dismissal. Can you imagine the field day JC would have if something happened to that patient while restrained?

[Happygolucky47]

Well I have to say That when a patient asks for a specific drug (ie dilaudid is the only thing that will work) it does send up a red flag for me, however I have never outwardly accused a patient of drug seeking, I think the worse are the chronic painers, I believe them that they hurt, but when the Docs think they are "drug seeking" and therefore will not give them narcotics, in essence they are making the day a living ---- for the nurse, I was working in the PACU, had a chronic painer who had a lap choley, he was yelling that he hurt like ------- ----!! and I had small children in the bays next to him, so I asked him to please watch is language d/t the kids, which only enraged him, and I also informed him that I was giving him as much as the Doc ordered, but he was gonna have to try and relax so the medicine would work, well he wasn't having any of that because the MORPHINE that I was giving him wasn't gonna work he needed DILUADID, so after 20mg of mso4, and nonstop -------- from him, I called the Anesth, and said this isn't working he wants dilaudid, well the Doc wasn't gonna give it to him "because he's just a drug addict" so I told the Doc that he was disrupting my PACU, and I asked for versed, which he finally ordered, so as I was drawing up the versed the patient asked what it was and I told him it was stronger than dilaudid, and he would feel better soon, to which he replied "THERE"S NOTHING STRONGER THAN DILAUDID

[morte, LPN, LVN]

Well I have to say That when a patient asks for a specific drug (ie dilaudid is the only thing that will work) it does send up a red flag for me, however I have never outwardly accused a patient of drug seeking, I think the worse are the chronic painers, I believe them that they hurt, but when the Docs think they are "drug seeking" and therefore will not give them narcotics, in essence they are making the day a living ---- for the nurse, I was working in the PACU, had a chronic painer who had a lap choley, he was yelling that he hurt like ----- ----!! and I had small children in the bays next to him, so I asked him to please watch is language d/t the kids, which only enraged him, and I also informed him that I was giving him as much as the Doc ordered, but he was gonna have to try and relax so the medicine would work, well he wasn't having any of that because the MORPHINE that I was giving him wasn't gonna work he needed DILUADID, so after 20mg of mso4, and nonstop -------- from him, I called the Anesth, and said this isn't working he wants dilaudid, well the Doc wasn't gonna give it to him "because he's just a drug addict" so I told the Doc that he was disrupting my PACU, and I asked for versed, which he finally ordered, so as I was drawing up the versed the patient asked what it was and I told him it was stronger than dilaudid, and he would feel better soon, to which he replied "THERE"S NOTHING STRONGER THAN DILAUDID

oh dear, a little illegal, much? you lied to your patient! if that were i, i would be raising a stink later......But the patient should have made arrangements with the medical staff to be properly medicated.....in the pacu is CERTAINLY not the time to send someone into withdrawl

[Smitty08]

If this happened in the doctors office/ hospital floor I worked at the nurse would have been fired on the spot. I am still in awe of the whole situation. I had an operation where I only wanted regular tylenol at first. 2 Aleeve get me looped up. After the second day of not being able to tollerate the pain I actually pulled the doctor to my face across the nurses station stating: give me drugs!! Does that make me a drug addict? This nurse broke a TON of the codes of ethics. She is a lawsuit waiting to happen. 10 bucks states she thinks she did nothing wrong or finds it funny in her own twisted way.

Maybe more than a TON of ethics broken! A very indirect and unprofessional way of broaching the subject of addiction, even IF it was the time or place to do so (not!)

[squeakykitty]

Maybe you can print this article out, and put a copy in her locker and one on the bulletin board. Here is the link. https://allnurses.com/nursing-articles/the-language-pain-265828.html

[Virgo_RN, BSN, RN]

Yes, I am horrified. My understanding is that pancreatitis can be excruciating, and I would never EVER question a patient with this diagnosis about their need for pain medication! Getting their pain under control would be one of my nursing priorities, and I'd be working very hard to do that. The gall of that nurse!

[pagandeva2000, LPN]

My nursing supervisor suffers from acute attacks of pancreatitis often enough for me to know if this nurse said something to her, we would be talking about attending a funeral. She used to have pain so bad that she would cry like a baby (normally, she was one tough cookie! No one messed with HER!) I'll bet if I showed her this thread, she would get the blood hounds out.

[Koyaanisqatsi-RN]

I asked for versed, which he finally ordered, so as I was drawing up the versed the patient asked what it was and I told him it was stronger than dilaudid, and he would feel better soon, to which he replied "THERE"S NOTHING STRONGER THAN DILAUDID

Whaaaat?

How often does this happen? This can't be legal, is it? I am really curious to know because I'm still learning, and if this is accepted practice, I think there's a huge problem with that!

[Vito Andolini]

There are so many people in this world that are misinformed and when they open their mouth you can usually figure out the depth of the ignorance they have. But info is needed for your know everythingg nurse. First off pancreatitis is very painful it hurts like the dickens, hence the dilaudid order. Second off when the patients starts puking and they will, the phenergan is really needed as well.

Now the part about the drug addiction B.S. Even if the patient is a drug addict it is non of the nurses bizness, the nurses job is to follow orders and not make judgements on people they don't know. If they want to talk about it they will. they make programs for folks like the nurse. It is called Al-Anon. they will tell you, anothers addiction is just that, their problem and not hers. and for the addict it is called Na OR aa. The best and only way to approach a using drug addict is just as easy. You say "If you think there might be a problem Check out AA or NA." thats it, nothing more and walk away. It is like planting a seed. If they aren't an addict they will not think twice about it If they are they know where to go.

Bottom line you can't drag a horse to water and make it drink.

If a patient is an addict, it would be the nurse's business in order to help the patient get through withdrawal. Just a thought. Don't mind me, I need to sleep. ZZZ