So, as a nurse it's my #1 priority to serve your narcs on a platter...

Psychcns · May 11, 2014

There is new thinking about long term management of pain. Narcotics are recommended for short term use. I believe they don't work well long term and you may be medicating withdrawal. Maybe you could google "Long term pain management." And then talk with the prescribers..

Esme12, ASN, BSN, RN · May 11, 2014

Personally....if I had all of my rights removed and my personal belongings taken away from me and I no longer had any say over my personal life or my daily living...that I had to be told when to get up, when to eat, what to wear, how to wear it, wait for someone to help me go to the bathroom...I'd rather be drugged so I didn't know how disrespectful I was being treated.

If the only relief I got was from pain meds and the only thing I could control was when I got them YOU BET I'D WANT THEM ON TIME!

I think the fools who think long term pain can be handled without relief need to have chronic pain and I want to be their nurse.

I think we as nurses need to pause for a brief moment and consider the patient and how they feel. How would you feel in their position? How would you feel if this was your Mom? I think we need to remember it is the patient that we are there for and we need to be thankful we have sick patients so we had jobs.

I think taking a moment to put ourselves in their shoes can be enlightening.

Nola009 · May 11, 2014

^ Well, Esme, I'm not "thankful" for people's health problems even if it means job securityfor me. I would actually rather there be more healthy, happy people --for their own sakes and society as a whole. I think a lot of what I see at one particular employer (a ritzy SNF for suburban middle-aged to early elderly folks) is the CREATION of an addiction problem through over prescription of opiates coupled with the unrealistic expectation/right to feel NO pain. When they ask, they get MORE. On a q 4 hr schedule. For weeks and months. When the party's over what do you think some of them will do? Our area has a growing heroin problem. Msny claim they became addicted post op. I don't want a pos job that does more harm to my community than good. Seems like it's kind of a machine to me...There's even a ritzy addiction/methodone clinic nearby built for this kind of thing, so my concerns are founded

NurseGirl525, ASN, RN · May 11, 2014

Agree with Esme whole heatedly. It's not your job to decide whether or not someone needs a particular med. Live in chronic, horrible, pain for even a week and we will see how pleasant you are. Wake up with pain, all day live with it, you can't sleep because of it. It can drive someone insane I tell you. It is the doctors job to deal with it and prescribe, not yours. If you can deal with it, find another job.

Nola009 · May 11, 2014

Agree with Esme whole heatedly. It's not your job to decide whether or not someone needs a particular med. Live in chronic, horrible, pain for even a week and we will see how pleasant you are. Wake up with pain, all day live with it, you can't sleep because of it. It can drive someone insane I tell you. It is the doctors job to deal with it and prescribe, not yours. If you can deal with it, find another job.

Ok, glad you two agree. And I agree with you in that I should have another job. The SNF with the haught, demanding patient families who threaten to sue just bc their mom's pain med was a little late?! Yeah. That's not for me. Hey--- I have 25 other pts who Alll want their own pd nurse.

Nola009 · May 11, 2014

...and again, I'm talking post op pain. That shouldn't become a chronic problem

Esme12, ASN, BSN, RN · May 11, 2014

^ Well, Esme, I'm not "thankful" for people's health problems even if it means job securityfor me. I would actually rather there be more healthy, happy people --for their own sakes and society as a whole. I think a lot of what I see at one particular employer (a ritzy SNF for suburban middle-aged to early elderly folks) is the CREATION of an addiction problem through over prescription of opiates coupled with the unrealistic expectation/right to feel NO pain. When they ask, they get MORE. On a q 4 hr schedule. For weeks and months. When the party's over what do you think some of them will do? Our area has a growing heroin problem. Msny claim they became addicted post op. I don't want a pos job that does more harm to my community than good. Seems like it's kind of a machine to me...There's even a ritzy addiction/methodone clinic nearby built for this kind of thing, so my concerns are founded

Don't get me wrong I hear what you are saying....I have worked at that wealthy suburb where the retirement home likens to the Ritz Carlton with their mink hats and blue hair...but we all grow old and will someday need help to care for ourselves. I for one am not looking forward to losing my independence and the ability to have my things around me including a dog.

I understand the overall drug problems and I am very familiar with heroin issues being an ER nurse forever I am not sure how this affect the SNF though.

I'm sorry you are frustrated but just take a moment to place yourself in their shoes...even breifly.

Esme12, ASN, BSN, RN · May 11, 2014

...and again, I'm talking post op pain. That shouldn't become a chronic problem

again to play devils advocate....Sorry :shy: .

Depending on what the surgery was for there can be residual pain. Like a knee or hip replacement.

I agree "addicts" need treatment but not all chronic pain patients are addicts.

It is admirable you want positive change.

Sassy5d · May 11, 2014

I think the key wording was 'scheduled'. You didn't say prn pain meds, you said scheduled.

I tend to get frustrated with people who think I should just remember that it's been 3 hours since your last prn and I should remember to bring it to you as if it were a scheduled.

I hear your frustrations though, op

Nola009 · May 11, 2014

again to play devils advocate....Sorry .
Depending on what the surgery was for there can be residual pain. Like a knee or hip replacement.
I agree "addicts" need treatment but not all chronic pain patients are addicts.
It is admirable you want positive change.

Thank you... I had a bad night. A few things went wrong, but the squeaky wheel was the son of the pt yelling that one measly pain pill was half hour over due (sheesh), it's getting to be a PROBLEM (hey, im prn there), he demanded to speak with on call mgmt (ok, sure) and proceeded to write down every med I gave (wth) all night. Wow. Found out after the fact he'd ben doing that for awhile (um, couldve told me in report, it would have been nice to not be ambushed). I don't know about this individual, but it seems as though some of these folks first BECOME addicted post op at our SNF where the narcs flow free. Then they go see your people in the ER later, I dont know? Whatever the case is, I don't wanna be treated like a narc waitress. I had a lot of other things, pts that needed my attention and this guy ate up too much of my time with his yelling and threatening behavior. To top it.all off, 5 min after I gave the med said pt was.walking around no probs/distress. Yeah, I know that this place isnt for me. That's why I went from FT to PRN. I'm just trying to get enough experience built up so that I can move on. I DO have a lot of adorable/decent, and nice pts, but these "bad apples" (mostly family members) really spoil it

imintrouble, BSN, RN · May 11, 2014

I have to agree with Nola on this one. Post op ortho surgery patients frequently end up in SNFs for therapy.

I always find it suspect, when the patient 2 weeks post op, needs more meds more frequently than they did on day one.

We can argue about residual pain, chronic pain, phantom pain....

Nola's just venting about a very particular kind of patient. Since I'm familiar with SNF post op patients, I can sympathize.