Pain in my butt!

[rnet]

Ok, fellow troubled nurses who are in "RecoveryTrek" -- I have been on a prescription pain med for many yrs, after major surgey,

& have NEVER taken more in a day than I was supposed to! They say we have to totally abstain from ALL pain meds. My MD is very upset, because we finally got my pain under control after tweaking it for quite a while. He doesn't want me to go below 3 tabs a day (was taking 6) . Does the recovery program go by what the MD says, or how does that work? I am not in the program for this particular med, but another one, which I didn't have a script for. New to this & scared to death!

[SpankedInPittsburgh, DNP, RN]

I don't have first hand knowledge of this. However, it was brought up in one of my nurse support groups by our counselor that the folks at the monitoring board (social workers) can "review" you medication management prescribed by your Doctor. They can then effectively take you off these meds if they deem it appropriate. Sounds retarded? It is!!! I brought this up and was told to basically shut up and stop being so negative. I'm in Pennsylvania & am sure that your state has its own guidelines. Good Luck!!!

[StillRN]

I can't see how the BON can tell you to stop taking a medication that a DOCTOR prescribed!! Even judges allow those charged of drug possession to take narcs that are prescribed! That just doesn't even sound legal! We can take anything that is prescribed.. as it should be. Maybe consult a lawyer on that one!

Spanked... I wish u would tell those Nurses in your group to **** sometimes!!

[Recovering_RN]

I know that TPAPN states that people who are on long term narcotic pain meds may not be a candidate for their program.

From the TPAPN participant Handbook, section 8.d.

PARTICIPANTS WITH CONDITIONS REQUIRING LONG-TERM USE OF ABUSABLE MEDICATIONS MAY NOT BE APPROPRIATE FOR TPAPN.

So I guess in Texas, anyway, if TPAPN won't take you due to meds that you're on, then you get punted back to the BON. Since generally the BON's first response is to shuttle everyone to TPAPN, and in this case that can't happen, well....heck, idk what the BON would do.

[SpankedInPittsburgh, DNP, RN]

Still. I do my friend!!! Alas it does no good. In that particular incident I went on a good while about how stupid it was that some social worker was reviewing a Doctors orders for medical necessity. Not only did it fall on deaf ears but I had to stay after group for a warning that further "outbursts" may get me kicked out of group & thus the monitoring program. These programs don't make sense. They don't have to as they hold all the cards

[malamud69, BSN, RN]

I was told that the word of my shrink...15 yrs Hx. was too..."subjective"....hmmmm...would the word of my cardiologist matter in a similar circumstance? Of course anything approaching evidence based scientific knowledge will be summarily discarded in place of a dung heap of psuedo religious mumbo jumbo and slogan speak based on the musings of a deranged detoxing socialite

[catsmeow1972, BSN, RN]

I am pretty sure they'd be happy to refer you to thier "approved" snake oil salesman, excuse me "addictionologist" who, for a substantial fee, will tell you that you don't need to be taking the medication that your doctor (y'know the one who actually knows you and has been treating you) has determined that you need.

Interestingly, in my state, right out of thier book o'rules (participant handbook) it says "if the continuing use of mood altering medication is required as determined by thier treating physician, they strive to ensure that the practitioner can practice with reasonable skill and safety with no harm to the public while taking the medication." The catch is, I think that what they consider an acceptable "treating physician" is debatable. Now this does refer to psychiatric mood altering medications.

I should think with chronic pain, a person could be required to be in a pain management type contract. To me it seems absolutely barbaric to insist that a person stop a regimen that works well. They require reports from therapists and such. Fine. Require additional P testing and reports from pain management. So far as I know, an ethical pain management practice keeps thier clients on a very tight leash with drug testing, contracts and pill counting, right?

Oh wait, common sense, evidence based practice and something that actually aids the nurse instead of punishes. And, it doesn't bring in the bucks.

[SpankedInPittsburgh, DNP, RN]

Yes these are the arguments I made!!! In addition I said that it was absurd that Social Workers (yep that's how they do it here) review MDs orders. After all they haven't been to medical school, did a residency or most likely even had any education in pharm. It's Alice in Wonderland stuff & worse I was scolded for basically making an "irrational" argument. Its NUTZ!!!