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 get repeat offenders which is sad.
So anyways, thats the background. So I get my patient, 20 something year old female drug addict who had recent heart surgery. I got report in the morning and of course pain was a major issue. The night nurse was like I gave her vicodin and that seemed to help. So I come on and shes crying and visibly in pain. The vicodin is due, so I give that. Hour later she is still crying so I look on the mar and she has a small dose of morphine. So I give that. '
Next day nurse confronts me and says why would you give an IV drug user morphine? She goes on to say she was only giving the patient Tylenol. I tell her that the night shift nurse told me she was taking vicodin. She says he should not have even given her that.
Did I do wrong? The patient was clearly in pain and the medication was ordered by the surgeon. If the patient is in pain shouldn't we treat it?
On 11/2/2016 at 2:31 AM, Been there,done that said:
The patient is not a "drug addict", the patient has a history of drug abuse. Medicating the patient for an acute condition is the same as medicating any other patient.
GET THEIR PAIN UNDER CONTROL. Give any ordered pain RX, if it is not effective get another order. The nurse that gave Tylenol needs to be educated and written up.
If you’re a nurse, you should know that an addict is an addict for life, even if they’re recovering. So yes, this person is still an addict. Having heart problems from drug use is a huge indicator of an addict as well. Use your nursing judgment and common sense.
If you’re a nurse, you should know that an addict is an addict for life, even if they’re recovering. So yes, this person is still an addict. Having heart problems from drug use is a huge indicator of an addict as well. Use your nursing judgment and common sense.
As described, this is a post-op patient in acute post-operative pain with what sounds like a reasonable and legitimate order for acute pain control from her providers. What does your nursing judgement and common sense tell you is the right thing to do?
If either your nursing judgement or your common sense tells you to do anything other than attempt to control the patient’s pain you need to consider your biases.
K
4 Posts
If you’re a nurse, you should know that an addict is an addict for life, even if they’re recovering. So yes, this person is still an addict. Having heart problems from drug use is a huge indicator of an addict as well. Use your nursing judgment and common sense.