Pain Medications

Nurses Professionalism

Published

I am happy to notice that doctors prescribe much less pain medications now then they did even five years ago. Some nurses say that new approach makes some patients to suffer unnecessary. Well, lets compare pain medications with antibiotics. Antibiotics save tens of thousands lives but at the same time some patients die due to adverse reaction to antibiotics such as anaphylactic shock. Should we stop using antibiotics just because one out of million patients may die due to anaphylactic shock? Of course not. A lot of Americans became addicted to pain medications, hundreds of thousands already died of overdose of pain medications. Should 60 thousands Americans die every year d/t overdose just because few patients have "ligimite" pain and suffer unnecessary d/t new strict prescription guideline? My answer is "No".

Specializes in Varied.
CBS/AP March 6, 2018, 3:45 PM

Opioids no better than Tylenol for chronic pain, study finds

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Last Updated Mar 7, 2018 9:24 AM EST

I don't know how to post links.....the above is an article I found on the Internet from CBS, but there are other sources with similar information.

I don't think the poster, or researchers, are accusing patients of abusing pain medications or planning to take away all opioids from patients in chronic pain.

New research is discovering acetaminophen words as well as opioids. In some cases, with some patients. Also complementary alternative methods have been found useful, yoga, acupuncture, meditation, etc.

Just as antibiotics don't need to be given for every infection, ear ache, sore throat, etc., opioids don't need to be given to every patient in pain.

Yes there are many times antibiotics are very appropriate, yes there are many times short and long term opioids are appropriate for patients.

No one is insisting no patient ever gets opioids. Just that it is time for doctors to rethink how they are going to treat a patient in pain. Use evidenced based research, or this is how we've always done it.

He accused chronic opioid users of causing other people to die.

He accused chronic opioid users of causing other people to die.

Yeah, I didn't even read his whole post, it was a rambling crazy mess. That is a stupid comment and prevents any sensible discussion about opioid use.

Specializes in Varied.
Yeah, I didn't even read his whole post, it was a rambling crazy mess. That is a stupid comment and prevents any sensible discussion about opioid use.

That's why everyone is being ugly. It's the way he approached the "research".

Specializes in BSN, RN, CVRN-BC.

When did we as a society come to the expectation that life should be without pain? I believe that much of this attitude came from the TJC's pain standards which were influenced by millions of dollars from Purdue Pharma and from marketing by Purdue Pharma and other drug companies. Most of our patients have medical problems that they should be experiencing pain. Once the goal was to control that pain with a goal that it would be mild and that the patient could continue their activities of daily living. The societal expectation of a pain free existence is totally unrealistic and unachievable. Pain management is as much about expectation management as it is analgesia.

I know of no chronic pain patients that are using opiates that are pain free. Most have tried non-narcotic meds and non-pharmaceutical therapies first and the opioids are the only meds that keep the pain to a reasonable level. They "buck up" and deal with pain every day.

If we're going to talk about people dying because of opioid overdose, let's not forget the people dying because their opioids were taken away and they simply do not want to live with severe daily pain, so they choose suicide. This really happens, it's not a scare story.

I do not have chronic pain, thank the Lord, but I am not happy with the way this crisis is being handled.

Specializes in Psych, Addictions, SOL (Student of Life).
CBS/AP March 6, 2018, 3:45 PM

Opioids no better than Tylenol for chronic pain, study finds

Share Tweet Reddit Flipboard Email

Last Updated Mar 7, 2018 9:24 AM EST

I don't know how to post links.....the above is an article I found on the Internet from CBS, but there are other sources with similar information.

I don't think the poster, or researchers, are accusing patients of abusing pain medications or planning to take away all opioids from patients in chronic pain.

New research is discovering acetaminophen words as well as opioids. In some cases, with some patients. Also complementary alternative methods have been found useful, yoga, acupuncture, meditation, etc.

Just as antibiotics don't need to be given for every infection, ear ache, sore throat, etc., opioids don't need to be given to every patient in pain.

Yes there are many times antibiotics are very appropriate, yes there are many times short and long term opioids are appropriate for patients.

No one is insisting no patient ever gets opioids. Just that it is time for doctors to rethink how they are going to treat a patient in pain. Use evidenced based research, or this is how we've always done it.

This is another series of studies with which I respectfully disagree. I tried the straight Tylenol route and in order to control my pain I would have had to take amounts that far exceeded the safe level to prevent liver toxicity? I am an armature researcher and I can find a study to support any theory. I do agree that Opiates should be prescribed with caution especially with new onset pain or acute injury. In my own case I have worked with my PMS to greatly reduce my opiate use but he would never cut me off.

Hppy

Specializes in Nephrology, Cardiology, ER, ICU.

IMHO, the pendulum has swung to the opposite extreme.

Specializes in Psych, Addictions, SOL (Student of Life).

The state of West Virginia has actually filed a class action lawsuit against The Joint Commission due to it's pain management standards set down in 2001. The general gist is that these standards set unrealistic expectations in patients that were impossible standards for facilities to follow in order to get high survey and patient satisfaction scores. It will be interesting to see how this plays out.

West Virginia cities sue Joint Commission over pain management recommendations

Hppy

Thank you for your input. So called "pain scale" is criticized a lot on doctor's forums but most nurses still believe in pain scale. It is my personal observation.

Specializes in Transitional Nursing.

I'm seeing a disturbing trend where I work where nurses are talking patients out of taking needed opiates. One patient is a complicated tib/fib fracture (tripped on a pot hole... eeeek) and she gets 2mg dialudid q6 PRN. Gets it twice a day usually, sometimes needs it a third time. Still less than she's "allowed" and I notice she is talked into Tylenol a lot of the time, even on therapy days where she is clearly in extra pain.

I think there needs to be a balance and I think nurses need to understand the different between addiction and dependence. This woman has been told by more than one nurse that she can become addicted. I've explained to her that yes, she can become dependent over time, but that actual addiction wouldn't be likely unless she begins to take them when she isn't in pain. She reports a 7/10 pain to me and I have a hard time accepting that apap is going to do the trick, although I do start with that I usually follow up an hour later and end up giving her the stronger stuff. I hate to see this epidemic leave those who need it without pain control.

Specializes in Emergency, Telemetry, Transplant.
I'm seeing a disturbing trend where I work where nurses are talking patients out of taking needed opiates.

I was with a friend, and we visited his mother who was recovering in the hospital from a surgically repaired hip fx. On this particular day, she was being transferred to a SNF for rehab. She asked the nurse for pain meds not to long before the ambulance was due to arrive and she would have to be transferred onto the medic stretcher. The nurses reply "oh, it's still 45 minutes before you can have another dose of oxycodone" (OK, fair enough....probably should have called the MD for a one time dose, but I can live with this). Then the nurse said, "and besides, you should not be taking this much pain medications." FWIW, it was nothing crazy, just the standard post op ortho regimen. The nurse added, "if you keep taking this, then I will just see you right back in here with stomach problems."

I was speechless. Here was an ortho nurse telling a pt to take fewer doses of the opioid right before the pt was going to start therapy for a broken hip. I understand that everyone needs to be more careful considering the opioid epidemic, but to tell a 70-something year old with a broken hip to take fewer oxys...right before the start of rehab? Society has made some believe that all pain meds are the devil, but some serious education is in order if ortho nurses are telling this to pts.

What I can say... the less opioids the better. if your friend's mother develops opioid induced constipation (it is not fun at all) neither your friend nor your friend's mother should complain... One of my patient died of opioid induced constipation. Couldn't move bowel for 2 weeks, then developed massive GI bleed...

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