chronic pain and pain control

[mel1977]

I am very aware of how careful us nurses have to be when it comes to using narcotics. I know that as long as you don't abuse them and have a legal prescription then there is not a issue. But, a part of me just doesn't feel right using any narcotics at work. I have had two back surgeries and some small bulges in my neck. My main problems stem from muscle tightness and spasm. I have burning pain and general pain and these together wear me down. I have tried many things, right now I use Ultram, but I am nearing the full dose in 24 hours. But, I just can't imagine using percocet or anything. I tried Ultram ER but it hasn't helped, I can't use muscle relaxers cause I'll pass out on the med cart! The lidoderm patches only do so much. I have thought about MS CONTIN or OXYCONTIN, since they are CR, and thought maybe the effects wouldn't be as harsh compared to a fast acting percocet or something. I then could take the ultram or even ibuprofen in the mean time. I don't know if this is a bad thing, how it would be for work. I could use a little help here trying to figure this out. I am trying to figure out a plan to propose to my doc.

Heat is the best and so is lying down. But, can't do that all day!

(oh, for the most part I do okay, but I get so uncomfortable. I mean, my pain isn't horrible, but enough to interfere with daily life and make me miserable.)

thanks

[IntoTheUnit]

I have had chronic daily migraines for the past 4 years. In the last year, I've been trying to get pregnant, so I'm off all my preventative meds--and I was on 5 of them!

I tried my hardest to hold out with just taking meds when I had a headache, rather than doing any long acting narcs or preventative meds, but couldn't do it. I started on a fentanyl patch last friday, along with midrin and MSIR to take when the pain overwhelms me, and I can't tell you how much better I feel. I'm not sedated, I actually have more energy now that I'm not constantly fighting the pain.

The way I've interpreted the BON rules, if you aren't impaired, your liscense isn't at risk. I don't consider myself impaired, and my neurospecialist knows that I'm working and driving and doesn't consider me to be a danger to myself or my patients.

I hope you find a good pain relief regimen soon.

[saillady]

Hello: I'm on this site looking for information about this very topic. I graduated from nursing school many years ago and my sister is also a nurse. My sister has had chronic pain for a number of years and underwent a 3-level cervical spine surgery. She has had every other treatment, including steroid injections, physical therapy and a trial with a deep nerve stimulator. Eventually, she started using opioids - only after educating herself and under close medical supervision. While taking the medications she worked, obtained her RN to BSN degree, and received an award for nursing excellence. Because she was familiar with the medications, my sister acted as a resource for other nurses when they cared for patients with those special needs on her unit.

This is a long story made short...

A coworker complained to her supervisor that she did not feel comfortable working with my sister knowing that she was using the medications. She was terminated and the hospital reported her to the state Board of Nursing. My sister refused to admit that she was an addict and go into a "program" - initial charges of drug diversion and impairment were dropped at the beginning of her trial. During the trial, her supervisor testified that she had no concerns about impairment, drug diversion, or patient safety. Nothing conclusive came from the trial. The Board has suspended her license (several months now) - even though she has been off all meds since June 2008. She is now in an addiction recovery program (weekly urine tests, bi-monthly counseling, etc.) She has never smoked and never consumed alcohol while taking the meds - nor has she ever craved the meds. Her life is a nightmare.

The moral of this story is to be very careful. Some states (FL for example) have clear guidelines in their Nurse Practice Act. Many do not. Do not expect a Board to be informed or respond to your information. Make sure that you belong to your State Nurses Association and possibly the ANA (maybe you would then have a little support if you find yourself needing it?) . Finding appropriate legal counsel is an entirely separate matter.

Supposedly your medical information is your personal business; it is very hard to keep it that way once something like this starts. When dealing with the Board, you will have not rights and they can do pretty much what they want.

I once worked with an impaired nurse in a unionized facility. I know how destructive such a situation can be to a nursing unit. In that instance, it was very difficult to do anything because of the union. That said, based on what I have observed with my sister - I fail to see any other way to protect the rights of a nurse.