pain in the ed


i am wondering if a percocet or an oxycontin drive thru right in the waiting room would be the answer. then perhaps, we would have the time to give quality care to our patients who are really sick.

our er uses the pixis and computerized mar's. the doc orders a drug, you have to wait, wait, wait, and then go to the pixis, get a witness for a waste (if you don't need all of the pre measured dose), and then give the pain patient his dose. never mind the fact that on the way to the pixis you have 6 other things that suddenly need to be done and that pain patient has sent each of his 6 visitors individually at 5 minuet intervals to complain that the 2 hour er stay is rediculous and that he missed his dinner and wants you to fix him something to eat.

by the time you get to the patient, the award winning draumatic preformance is simply breath taking!

now i know that some pain is true. but if i have a kidney stone, an acute appendix, labor pains, or chest pain, the er nurse shouldn't have to come out to the smoking area, tell me to put out my cigarrette, put down my big mac and accompany her to a room where my vs are 120/80 - 70 - 16!

thanks for allowing a "newbw" to vent!


1,173 Posts


Here we go again...


629 Posts

Definately a thread that the Pain Management NP is going to stay out of.

On a side note to Nurse Complainer. Since you dislike pain so much, have you considered dermatology nursing?

-Dave, who reminds people that PAIN is what the PATIENT says it is...not the Nurse/PA/NP/DO/MD says.


1,173 Posts

Bravo, Dave NP!

To all you who gripe and kvetch about pts. who have pain...may you never find yourselves in the same unfortunate position, being cared for by people who are so short on empathy.

Specializes in Inpatient Acute Rehab.


Different people have different pain tolerance.

Did you not learn that in Fundamentals of Nursing in school?:rolleyes:


34 Posts

Hey, Magik Girl, I can relate. While the patient's perception is what we need to focus on, it's frustrating to be busy and have a social butterfly or fast-food junky demanding meds while not missing a step in their quest for more fries, etc... Ya get used to it...

To our other advanced practice folks and "old salts" - Lighten up! You guys descend like piranah! Why jump on her education??? Why jump on her compassion??? Geeze Louise!!! We're all in this together!!! Give her a chance! You can't teach compassion. And it takes a while for the true ED nurse to come through and bloom! :-)

gwenith, BSN, RN

3,755 Posts

Specializes in ICU.

As you all know I have jumped on this particular bandwagon before so here goes.

The problem with inadequate pain relief is not education - If the nurse does not know that pain is what a patient says it is then they will know 10 minutes after posting on this BB:chuckle

The problem lies in us recieving conflicting information from the patient - hearing a report of X amount of pain while seeing no evidence. Part of this is an unconscious expectation that people in pain should display xyz symptoms and partly because of persistant myths about pain and partly this is an area that IS poorly addressed in texts. i.e. what are the myths, what are peoples expectations of pain and behaviour that is fueling this conflict.

So, instead of us just coming out with the same old tired platitudes let us try to find out what that person believes and see if they are truly operating on myths.


1,173 Posts

It's one thing to ask because you don't know, quite another to come across with judgemental and sarcastic attitudes based on ignorance but offered as expertise.


299 Posts


slam! dunk! he scores!!!!!!!!!!!!!!!!!

again, perception is 9/10th' of reality......

ya'll should lighten up. i didn't realize that i was entering the twilight zone. i thought i left all of my uptight nursing instructors in college after i graduated 12 years ago!

sit back,relax, and enjoy the ride. life is too short!



34 Posts

Nope! They're hiding here with assumed names! :D


299 Posts

Originally posted by ERKev

Nope! They're hiding here with assumed names! :D

BRAVO! :chuckle


814 Posts

I just have to say it. Sorry but I have to say it.

I feel sorry for my patients who are in pain. Pain is subjective and I will administer the patients pain meds based on what they say it is.


In healthcare their is an allocation of resources. My TIME is a scarce resource. So when a person who has chronic pain issues and has PRN narcotics ordered starts DEMANDING that they need their pain medication NOW, and will cause such a ruckus if it is not delivered within minutes of their request it may become a problem. The problem may be that the little old lady down the hall has developed a heart arythmia or pulmonary congestion. She may not be screaming for help- in fact she may just lay there getting worse until you the nurse intervene.

That poor little old lady needs help now. She may not have the ability to call the NM and start screaming for help NOW. So then I have a decision to make. Sometimes my decision is not a popular one. Sometimes the person who can scream, can be demanding will do so at the expense of another, more fragile, more vulnerable patient. Hence- this nurse, or anothe nurse in the same position may feel frustrated. Resources should not be doled out based on the aggressiveness of a patients' demands.

There I have said it. I hope to not appear unsympathetic to our patients who are in pain. And although pain is the 5th vital sign, it may cause a life altering condition and not a life threatening condition. And I as a nurse will put a life threatening concern first. So some patients may have to be in pain a little longer than we both would like. We both end up frustrated, but sometimes that is just the way it is.

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