overdose on RX meds

[pm2rn]

Do we as nurses in the ER be held accountable for the recent rise in RX meds overdose. I know the doctors write the RX but we give it to them. I see the same people every week yelling if they don't get their lortab/norco. my hospital ER gives it out like tic-tacs due to increase in survey numbers. just wanted to hear everyone's thoughts.

[Anna Flaxis, BSN, RN]

Do we as nurses in the ER be held accountable for the recent rise in RX meds overdose. I know the doctors write the RX but we give it to them. I see the same people every week yelling if they don't get their lortab/norco. my hospital ER gives it out like tic-tacs due to increase in survey numbers. just wanted to hear everyone's thoughts.

No, we are not accountable because we are not prescribers. It is the prescriber who is in the hot seat as far as this goes.

I'm fortunate to work with physicians who by and large, take their obligation to relieve pain and suffering very seriously. Yet at the same time, they are careful to prescribe the analgesic that is medically indicated for the condition being treated. Just because someone has pain doesn't mean they need an opiate. Ibuprofen, Tylenol, and aspirin are great pain relievers, along with appropriate home care such as rest, ice or heat, elevation, etc., and this is often what the doctor prescribes. Sometimes, opiates are medically indicated, and we'll send them with a prescription or an indigent supply. Usually, the doctors' decisions on which medication is appropriate make sense, and I don't get the feeling that we're handing out opiates like candy.

It can be frustrating to deal with the repeat customers who come in with an agenda and throw a fit if they don't get what they expect. I've noticed that in my area, most of these folks have moved here from out of state, and that is part of their rant that goes something like "I'm going to sue that doctor's ass! The hospitals in (insert some other state) are so much better, they always give me (insert medication patient wants), not this ibuprofen crap! If I wanted ibuprofen, I'd just go buy it at the store!"

[Altra, BSN, RN]

If I wanted ibuprofen, I'd just go buy it at the store!"

See, there is always a teachable moment. :smackingf

[Roy Fokker, BSN, RN]

http://news.nurse.com/apps/pbcs.dll/article?AID=2011111140003

How's the "War on Drugs" workin' for ya?

Personally (from an ER nurse perspective),

* Most docs and nurses don't begrudge the obvious cases: e.g. Pt. with stage IV pancreatic cancer with mets to bone, liver and lung. Ordered 10 mg of Dilaudid IV ...

* The question is usually when we face "repeat offenders" - folks who have been seen at the ER for the SAME problem MULTIPLE times (i.e. "migraine"). Who still show up, for the "same problem", despite counseling and multiple referrals to out patient clinics (pain management) and specialists (Neurologists).

NO, we are NOT accountable.

cheers,