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.
Wow, as an addiction recovery nurse, I am very appalled at that nurses' actions. It is not her job to discuss whether or not that patient is an addict. As an addiction recovery nurse, I cannot even discuss to the patient whether or not that patient is drug seeking. I can only assess the patient and then give that information to the dr. Boy she did have alot of nerve!!!!!!!
I am a caregiver for my husband who, due to an car accident 21 yrs ago, is both a T-3 complete paraplegic (with all the wires and plates and bolts that go with that) and a double amputee with chronic wounds that make most seasoned medical professionals blink.
It would be fair to say that he relies heavily on pain medication when he can get it (during and after hospital stays) and only refuses a pain management program due to his past experiences with psychologists. Your nurse there would be printing fact sheets left and right.
However, he would say, and I would agree, that while he IS addicted - it is the addiction of pain reduction (taking it from a 10 to a 5) and living life rather than for any "high" he might be perceived as chasing.
Compassion for the suffering comes in many forms. Criticism is not often one of them.
Specializes in Wilderness Medicine, ICU, Adult Ed..
It is very disturbing how many nurses (and doctors, by the way) carry biases into their care of patients who require narcotics for moderate to severe pain. It causes a lot of unnecessary suffering. As for drug seeking; of course she was drug seeking! She was in pain (pancreatitis is often agonizingly painfull) so she sought the medicine that would relieve her pain. SEEKING A DRUG THAT IS APPROPRIATE FOR YOUR CONDITION IS HEALTHY BEHAVIOR, it is not a sign of addiction! If a patient came in with a grossly infected wound, and asked for antibiotics, or a diabetic presented asking for a prescription for insulin, they would also be drug seeking AS THEY SHOULD! It is our job to be the source of the medicine they need. However, when opiods are involved, some professionals get really wierd. Opiods are not evil. For the patient in severe pain, they are a blessing from God, and we who nurse them should take great satisfaction in having been entrusted with the privilege of ministering this blessing to those suffering pain. Why else are we there?
it is very disturbing how many nurses (and doctors, by the way) carry biases into their care of patients who require narcotics for moderate to severe pain. it causes a lot of unnecessary suffering. as for drug seeking; of course she was drug seeking! she was in pain (pancreatitis is often agonizingly painfull) so she sought the medicine that would relieve her pain. seeking a drug that is appropriate for your condition is healthy behavior, it is not a sign of addiction! if a patient came in with a grossly infected wound, and asked for antibiotics, or a diabetic presented asking for a prescription for insulin, they would also be drug seeking as they should! it is our job to be the source of the medicine they need. however, when opiods are involved, some professionals get really wierd. opiods are not evil. for the patient in severe pain, they are a blessing from god, and we who nurse them should take great satisfaction in having been entrusted with the privilege of ministering this blessing to those suffering pain. why else are we there?
you said this better than i ever could. i've said before that we are all drug-seekers and clock watchers. why? because we all use otc med for the colds and flu, and we follow dosing instructions which involves checking the time to see when the next dose is due. when i had my impacted wisdom teeth pulled, i got a prescription for tylenol with codeine to be taken every 4 hours. i didn't need to watch the clock to determine when i could take the next dose. the pain in my jaw did it for me.
Someone said, we are here just to follow orders and I completelly disagree with that. If we, as nurses, just follow orders we would make many mistakes. We have to think critically and do the best for our patients. That includes good pain control and the "do not harm" principle. I have been a patient myself and had my problems with other nurses because of poor pain control. One time a nurse answer was " that's all the doctor ordered". I had meningitis and severe headaches. Put yourselves on the patient's shoes and that might help you understand your patients' needs.
I am a first-semester nursing student, and I have been appalled at nurses labeling patients. I thought maybe I was being extra sensitive since I am still new and we are just learning about "pain being whatever the patient says it is." But, now seeing all these post I realize I wasn't the one in the wrong. Most recently, I had a patient with multiple diagnosis, and was on a ton of meds. Just two of her diagnosis were, multiple sclerosis & neuropathy, both which cause chronic pain. But, every time my patient stated she was in pain, my nurse would roll her eyes or sigh, right in front of the pt. Then, when we would leave the room, she would tell me "she is a drug-seeker, she is so addicted to narcotics that she doesn't know how to live if she's not high." I was shocked. Later, I asked my nurse if she knew why my patient was taking Aricept because it wasn't consistent with any of her diagnosis, I had reviewed the chart & asked the patient, and hadn't gotten an answer. When I asked that my nurse said "she is taking it because she is a drug addict." I was like what the heck does that have to do with anything?? She then told me "you are not going to figure this patient out, she is a drug addict & has fried her brain to the point that she is crazy." I just did not think either one of us knew enough about this pt to make such a bold statement. All these posts helped me appreciate how wrong she was in verbalizing such statements.
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
I'm Not sure HOW you think I lied to my patient, or what was illegal, I medicated him with as much as the physician ordered, it would have been ILLEGAL had I given him more than what was ordered, ANd since he had THREE fentanyl patches on I doubt that he was withdrawing
No one seems to be addressing any addiction issues here....like I said before I am an addiction recovery nurse. If there are nurses who for whatever reason might be saying their patient is drug seeking, it's quite possible they are!!!! I have seen enough addicts in my time, and they will plainly tell you that they will try and get whatever they can get their hands on. I have had many people tell me they are in such great pain, yet when I take their vitals, nothing is suggesting that they are in such great pain. I hope someone else can recognize this as well......
No one seems to be addressing any addiction issues here....like I said before I am an addiction recovery nurse. If there are nurses who for whatever reason might be saying their patient is drug seeking, it's quite possible they are!!!! I have seen enough addicts in my time, and they will plainly tell you that they will try and get whatever they can get their hands on. I have had many people tell me they are in such great pain, yet when I take their vitals, nothing is suggesting that they are in such great pain. I hope someone else can recognize this as well......
I agree that there are addicts out there, but generally we do not have the ability to differentiate between an addict & a person in genuine pain. As far as relying on vital signs to assess pain, I thought that was no longer an definitive way to determine pain. See this link: http://emergency-medicine.jwatch.org/cgi/content/full/2006/1006/4
ANd since he had THREE fentanyl patches on I doubt that he was withdrawing
CrunchRN, ADN, RN
4,558 Posts
I had pancreatitis 30 years ago at age 17 when I had a gall stone stuck in the duct. It is incredibly painful. Just unreal.
It doesn't matter if the person has a drug problem. If they have pancreatitis they need pain relief. It is excruciating!