Getting thru clinical with disability and pain meds!

anangelsmommy, ADN, BSN, RN · Feb 1, 2008

ooh, guess i should have added, i am starting my LPN clinical in september! and then hoping to do my LPN to RN online!

JP

4XNURSE · Feb 12, 2008

If you are taking narcotic pain relievers you are altered.

I went back to work on Tylenol # 3. I didn't feel altered, just didn't feel as much pain. I did not perform to "standard of care". I had to go off work again for two months, till I was OFF the narcotics.

In my opinion, you should be off the prescription pain killers, before you are doing patient care.

ken

woody62, RN · Feb 14, 2008

Most people who take pain medication are affected by it to a certain exent. State laws prohibit a person from driving a car while taking pain medication. Be stopped by a police officer and you can be arrested for driving under the influence. Most state boards have regulations regarding people working under the influence of narcotics. I suffered a herniated disc and received pain medication for it. I had to continue to work while I fought with the insurance company. My primary job required a great deal of driving. I never took any medication while I was working and driving. I advise people not to take pain medication and attempt to work.

Woody

allnurses Guide · Feb 14, 2008

I have sciatica. On top of this about 2 years ago i contracted an infection in my sacroiliac joint. This was the most painful experience of my life. after IV antibiotics and now oral for 9 months i have been taken off atb and the drs are waiting to see if my infection is cleared. I have been feeling pretty good but i have trouble standing for long periods. I have been able to reduce my pain meds and have been able to go way down and even without a few days. My question is first, is it a problem to do clinical with pain meds if you are a regular user and have a valid prescription? I do not feel anything but relief when i take my meds- i usually cut it down (sometimes only take a 1/4 tab) unless i have had a bad day. Was anyone even asked about medication while in clinical?
also, my biggest pain trigger is standing. I still have bone swelling and pain from the infection. Over the holidays prolonged standing to make bread or dinner - big family dinner put me in a LOT of pain for about 3 days each time. I can stand and move around it is just if i stand for prolonged periods. Has anyone here done clinical with issues that prevented long standing or needed meds to deal with it? I am also working with my dr to try to sub some of my medication with non opiate but i have gotten gastritis in the past from too much ibuprofen so she is hesitant to have me take much else.
JP

I would contact your state board of nursing yourself. There is a big difference between chronic pain medication use and acute pain med use. In general people that take chronic pain meds (more than a 2-3 months w/o changes in type or increased dose) can and do hold down regular jobs/teach/nurse/practice medicine etc.

You could also talk to your provider about pain injections/intra-articular injections/facet injection etc.

caroladybelle, BSN, RN · Feb 15, 2008

A bigger worry to think about.

If you are having trouble with pain, attending nursing school....what happens after you graduate and you try to work. If the pain is an issue now, it will probably be the same or worse as you work as a nurse.

Also, most hospitals and facilities will put you through a physical that involves extensive moving. The last one that I did, involved checking flexibility and exercises that I haven't done since grade school. You also sign off that you are capable of lifting 35 or more pounds (amount depends on the facility).

With the stats on nursing injuries, the high cost of workman's comp., you may have difficult getting that first job or two, s/p graduation.

As a general rule w/regard to long term pain meds, state boards vary in treatment of this issue. They and/or your employers may also refer to your MD, and may require written data that you are safe to practice both in regards to the meds and the injury

FranEMTnurse, CNA, LPN, EMT-I · Feb 18, 2008

I have sciatica. On top of this about 2 years ago i contracted an infection in my sacroiliac joint. This was the most painful experience of my life. after IV antibiotics and now oral for 9 months i have been taken off atb and the drs are waiting to see if my infection is cleared. I have been feeling pretty good but i have trouble standing for long periods. I have been able to reduce my pain meds and have been able to go way down and even without a few days. My question is first, is it a problem to do clinical with pain meds if you are a regular user and have a valid prescription? I do not feel anything but relief when i take my meds- i usually cut it down (sometimes only take a 1/4 tab) unless i have had a bad day. Was anyone even asked about medication while in clinical?
also, my biggest pain trigger is standing. I still have bone swelling and pain from the infection. Over the holidays prolonged standing to make bread or dinner - big family dinner put me in a LOT of pain for about 3 days each time. I can stand and move around it is just if i stand for prolonged periods. Has anyone here done clinical with issues that prevented long standing or needed meds to deal with it? I am also working with my dr to try to sub some of my medication with non opiate but i have gotten gastritis in the past from too much ibuprofen so she is hesitant to have me take much else.
JP

I wish you a lot of success. However, I have suffered from chronic pain for 15 years now. It got so bad at times the pain went to a 10 +. I have learned over the course of my treatments to cut back when the pain is at a lower level, use a TENS unit when I can, a moist heating pad, keep up with my anti spasmotics, and use Tylenol often. Whatever I do, it seems to be working; usually.

Transplant Nurse, BSN, RN · Mar 5, 2008

Your best bet for chronic pain is to go to pain mgmt and have them prepare a statement to the state board that this is not altering you (and also for DMV for your protection). You become tolerant to it a great deal, eg I used to get sick on (1) tylenol#3 (2.5mg hydrocodone each) and now take lortab (10 mg hydrocodone each) without any change in alertness and no nausea, in fact I get more energy when I take them. I have chronic back problems and have had for 10 years. In fact I have seen the board (Indiana) review health hx and considering meds people were on request an eval by pain management for determining ability to perform as a nurse. Glad I dont need it ALL the time though, just when I throw my back out of whack by being superwoman. Narc tolerance is a weird thing to me. If I had to be a patient inpatient for surgery, people would assume I am a drug seeker/abuser because I require so much to be effective, but it is called tolerance. We all are taught about it, but forget and tend to judge pretty harshly when a patient like me rolls through the door.

bellcollector · Mar 27, 2008

Transplant nurse very good post. You are exactly right. It is unbelievable to me how quickly we forget what we are taught about pain meds acute and chronic. As another poster mentioned there is a HUGE difference between acute and chronic pain meds, addiction and tolerance. I have faced many a judgemental nurse myself it is truly sad. I hope you get the answers you need Don't give up I have never been given an extensive physical they usually just run you through very run of the mill rom, maybe ask a few questions and sign the paper. None of the 3 facilities I have worked at have ever asked me about medications I use and as far as lifting, it is just a paper you sign stating that nothing prohibits you from doing the tasks described in the job description. I think you will be just fine but you will definitely need that RN to give yourself more job opportunities. Good Luck

iwanna · Mar 27, 2008

Listen to tranplantnurse and bellcollector! Great advice from them! Getting a paper from pain mgmt. clinic regarding your ability. People with chronic pain are able to function on opiates. If they have been on meds for long time, they have high tolerance. The biggie is that your pain is controlled with the med dose that you are currently on.

As bellcollector suggested, please do get your RN, immediately. I wish that I would have. There are more opportunities for RN

llg, PhD, RN · Mar 27, 2008

Reading the OP, I had the same question as Caroladybelle. Are you sure that nursing is the best career path for you? Nursing often involves physical labor and you may be investing a lot time, energy, and money in a career that you will be unable fulfill because of your disabilities. There are lots of other health careers that would be a lot more "do-able" for someone in your situation.

Why set yourself up for failure? Why not give yourself the best chance of having a successful career?