Pain medicine to drug addict? - page 5
Hey guys I have a scenario I want to run by. So I work on a cardiovascular surgical floor. One of the things we do is heart valves. Every so often we get the endocarditis from drug use. Sometimes we... Read More
Nov 14, '16Occupation: RN Specialty: 7 year(s) of experience in Med/surg/ortho ; From: US ; Joined: Aug '16; Posts: 151; Likes: 98Addicts are entitled to pain control just like everyone else.
May 31, '17Occupation: Nurse-RN Specialty: 10 year(s) of experience in Med-Surg/Neuro/Oncology floor nursing. ; From: US ; Joined: Apr '11; Posts: 362; Likes: 787I don't even understand how this is even an issue. Bite the bullet went out the window a long time ago. So since a patient has a history of drug abuse that means they aren't entitled to pain relief ever? OP you were not in the wrong at all..you're colleague on the other hand really needs to reevaluate the way she does her job. Tylenol? Really someone who just had a valve replaced and she thinks Tylenol would suffice? That's just barbaric in my opinion, especially if the patient is crying out in pain. The teaching hospital I work at does a lot of valve replacements and since the hospital is inner city we happen to get a lot of drug abusers as patients. The admitted drug abusing patients that legimately need narcotics the docs dont hesitate one bit to give them what they need, even what they want. One doctor frequently says "they can score heroin by yelling out the window to one of the many dealers on the corner, unless they express a desire to go to the detox unit, we aren't going to fix their addiction in 4 days."
Now if a patient with substance abuse issues expresses in no uncertain terms that they want minimal narcotic intervention, if that then of course the patients wishes are respected. But addicted or not surgeries hurt, they are still human beings that can feel pain(at times their threshold is lower) and they deserve to have their pain treated. Period.
Jan 13Joined: Jun '06; Posts: 82; Likes: 211This is an old post, but reading it makes my blood boil and also makes me proud to be a nurse. The pride comes from the unanimous compassionate and educated responses. This situation happens all the time in hospitals every day and the attitude is not only reserved for addicts who abuse illegal drugs, but also handed out regularly to those with a history of chronic pain who are prescribed and have taken opiates for years.
What gives a nurse working on a surgical floor or in an ER the right to decide that the practitioner who has been prescribing pain medication to this patient for years or decades is wrong, has purposely turned the patient into an "addict" and it is THEIR job to fix it or "not enable" it? A nurse who thinks like the Tylenol nurse should leave the profession and he/she should be reported to the nursing management at the hospital and the patient's doctor. I have seen patients, who I know personally, denied pain medication after surgery in this type of scenario and it turned out the surgeon was not aware the nurse had done this.
It must be reported. Nurses like this need to be educated promptly or removed from their position. As was mentioned earlier, a post-op patient in uncontrolled pain is not healing properly and their post-op path has just been extended. It is the responsibility of the doctor to order the pain medication and the job of the nurse to administer it, period. If a patient who is addicted to whatever- street drugs or prescribed opiates, is in the hospital and their pain is unbearable, they will contact someone from outside to help them. No question about it. Is that what we want? Patients taking drugs that we don't know about when they are in our care? Patients who have had their pain disregarded by holier than thou sadistic nurses will also be permanently scarred by this experience and may avoid important healthcare they need at any cost. Very scary...
An addict in recovery who does not wish to take pain medication after surgery will tell the doctor or the nurse if this is what they want. They are aware of the potential problem. We do not need to make that decision for them or debate about whether the decision to medicate them will undo all of their hard rehab work. That is not our business. That is the patient's decision and it is their business.
Nurses who administer pain medications to patients are never "enablers". We are doing our job.
Jan 16Joined: Apr '03; Posts: 268; Likes: 288The doctor wrote orders for pain meds so there is no excuse to withhold them from the patient. Doctors will take the patients history into consideration when writing orders. Hell, I had an ortho doctor write admitting orders that included "3 beers with meals". When I asked he told me that he was not going to treat his alcoholism and did not want to send the patient into the DT's. If the doctor wrote for pain meds then that is the end of the story..