Pain Seekers

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I am just wondering if other hospitals have the same colossal amount of pain seekers? I feel like every single day I work I have a patient who only wants IV dilaudid mixed with IV phenergan mixed with IV benadryl mixed with IV ativan with a roxycodone to top it off. I just recently cared for this woman who I was giving pain medication every 2 hours and her pain never got any better; mind you I gave her 8 mg of IV dilaudid in about 10 hours as well as 3 doses of Percocet. I am just so tired of being a legal drug dealer, just to give these people their fix. No, I don't believe that their pain maintains a constant 10/10 when they are given this amount of pain medication and when they look high as a kite. And we just support this behavior! Because controlling patient's pain is so important and pain is subjective so we must believe them. This is not why I became a nurse and I am just wondering if this daily occurrence is just at my hospital or if its all over the country.

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It probably depends on which department you work in. If the drug seekers are getting you down, consider a move to a department where this is less of a problem.

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Specializes in PDN; Burn; Phone triage.

Do not think too hard about it. You are not going to change their behavior. Plus, they tend to get even more unpleasant if you deny them what they want...

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If everyday you have one out of 5? 6? patients, can you follow the prescribed med regimen for the one and do what you went into nursing for with the others?

Drug seekers have pain, it may not meet your criteria for treatment, but acute care isn't the place to start drawing lines, it's a complex out patient issue.

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Is it ordered?

Respirations/sat meet institution criteria?

Blood pressure handle it?

Write down the number they give you and give the drugs. Simple as that. Just like bringing ice, water, a towel, whatever. It doesn't take but a minute.

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JWG223, You make it sound so simple. Do you have patients like this that you must deal with?

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They are getting me down. Thank you for the advice.

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Specializes in Mental Health, Gerontology, Palliative.

Does it occur for a moment that these people may have genuine issues with ongoing chronic pain? For people living with chronic pain, its unlikely that any analgesia routine will ever completely deal with their pain.

It seems that if a person is able to voice what works for them in terms of analgesia then they must be a drug seeker?

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Specializes in Pediatrics, Emergency, Trauma.
You make it sound so simple.

Because it IS that simple. :blink:

Do you have patients like this that you must deal with?

Here's the deal: we "deal" with people who do not always measure up to our own moral compasses; most of our patients have coping issues and are in their most vulnerable states; regardless of addiction statuses, or not; many people have chronic pain disorders; I have migraines as well as complex regional pain syndrome and need a regimen when I come into the ER; for years, my migraines were not properly controlled when I sought medical attention; it has gotten better within the past 10 years for me; when I state I have CRPS, I am treated right away, which is a good sign.

I am very cognizant of pts that have pain issues, and a lot of uncontrolled pain deserves a pain management consult; along with assessing the pain and trying to not "chase the pain"-that is FAR worse than micromanaging someone's "addiction status", especially when there is NO WAY in determining that status or nothing that can be done, unless they want help; and even the it would be DANGEROUS to withhold meds in someone who is an addict; there is medication management if needed as well-it's a complex process.

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I guess what really gets to me about the drug seekers is the manipulation that comes with it; I don't appreciate it because I feel they are taking advantage of people there to help them.

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Specializes in Nurse Leader specializing in Labor & Delivery.

They're seeking pain, or pain medication?

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And here I thought this was going to be a thread about masochists ;)

Because controlling patient's pain is so important and pain is subjective so we must believe them.

Well yes controlling a patient's pain is important and pain is subjective.

If the medication is ordered and the patient reports pain and their vital signs allow safe administration, administer it.

My personal philosophy is that I'd rather medicate 100 "drug seekers" (I despise that term, anyone genuinely in pain will also in all likelihood seek pain relief, i.e. seek drugs), than withhold medication from a person in pain.

I guess what really gets to me about the drug seekers is the manipulation that comes with it; I don't appreciate it because I feel they are taking advantage of people there to help them.

Don't make this personal, you'll make yourself miserable. Who cares if they are attempting to manipulate you, it's only annoying if you allow it to be. Your mental energy can be more productively used elsewhere.

You can't be certain what another person is experiencing. Sometimes you can reasonably suspect that a person has a problem with drug addiction and that's the primary motivator for them asking for opioids, but you can't be sure. It's also entirely possible to be addicted and at the same time suffer from pain. Shouldn't that person get pain relief just because they happen to be addicts?

Also, if a person has received massive doses of opioids and still reports significant pain, it's good to consider if the pain could possibly be neuropathic in origin, and that the patient may benefit from other forms of medication.

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