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.

For example, another patient had no abnormal testing but kept asking for IV dilaudid...even when the doctor came in to discharge this patient, they asked the doctor for "one more dose of IV dilaudid" even when the doctor d/c'd it prior the the patient's discharge.

I actually do work hard for my patients in pain, even asking doctors to readdress their pain medication regimens for a better fit but I also believe that IV pain medication should be given out sparingly, especially when patients tolerate a PO diet. So please do not try to tell me I dismiss my patient's reports of pain. Yes, I may think they have an opiate dependence but I definitely do not let that determine whether I give them pain medication or not. Clearly, if I gave my patient 8 mg of IV dilaudid within 10 hours, which was ordered, I was not ignoring her reports of pain and definitely spent a large amount of time with her. My point being, I give my patient what they need as long as it is ordered but sometimes I feel burned out, and yes, taken advantage of at the end of my shift.

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

That is too funny, you made me laugh.

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.

I try not to take it personally, I know it is not, but it still bothers me.

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Specializes in Oncology.
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.

Yep, that's what we are. Just hand maids there to carry out doctor's orders. There are people trying to treat emotional pain with narcotics. It's true. And they will require higher and higher doses and never be comfortable until they address their issues head on or it kills them.

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Yep, that's what we are. Just hand maids there to carry out doctor's orders. There are people trying to treat emotional pain with narcotics. It's true. And they will require higher and higher doses and never be comfortable until they address their issues head on or it kills them.

(my bold)

That's not at all how I see myself. I just don't think that it's realistic to try help a patient with drug addiction in the acute care setting. If a patient is under my care for one shift or a few days in a hospital and that patient isn't motivated in the least to battle their drug addiction, nothing I'll do will accomplish a major change for the better for that patient. I'm not being defeatist, I'm being realistic. Also, an addict can be in pain. I'm not comfortable withholding meds for no better reason than my own opinion/ theory of what the patient is genuinely motivated by. What if I'm wrong?

That's why I say that if the medication is ordered, the patient reports pain and it's safe to give, I will do so.

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Specializes in Pediatrics, Emergency, Trauma.
Yep, that's what we are. Just hand maids there to carry out doctor's orders. There are people trying to treat emotional pain with narcotics. It's true. And they will require higher and higher doses and never be comfortable until they address their issues head on or it kills them.

And that's IF they want help. :blink:

Again, we, as nurses, are not in the business for micromanaging patients, but we are "health managers"; we address the acute stage by assessing and intervening; refer to pain management when needed, and go from there.

I can't "make" someone who has an addiction seek help if they don't want it; not will I withhold medication in someone with an opiate addiction; there is too much of a risk of complications involved with that, and since I am a "health manager"; I'm going to minimize complications by assessing and intervening when necessary and whenever possible, refer when necessary, intervene the best way possible, document and collaborate with the providers involved.

I sleep very well at night by being about my nursing business, and handing it in this matter.

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I do not know where the whole "withholding pain medication from patients" came from...if you read my main post I said nothing of the sort...

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Specializes in Pediatrics, Emergency, Trauma.
I do not know where the whole "withholding pain medication from patients" came from...if you read my main post I said nothing of the sort...

I read your post clearly, if you are speaking to me; it would be better to use the quote function; and my post was directed at the person I quoted, it you have been following my previous post.

I will say that here are a percentage of nurses that fall into a trap when managing pts with pain issues; I have witnessed nurses undermedicate and withhold pain medication due to their own burnout with dealing with pts that have an addiction or a pain management issue; some having family members that have the same issues; as well as falling into the trap of people's coping issues; whether their belief that these people are "manipulating them" because of their pain issues, or any other issue due to their unhealthy coping.

As a nurse there are going to be the most vulnerable, down in the gutter people and families involved; the best way that had helped me through my 15 years of healthcare free of burnout is utilizing psych 101 and my skills I learned from metal health when dealing with mere mortals whether it be my peers or my pts and even administration all the way up to the corporate level is those techniques HELP especially when dealing with complex issues. :yes:

Again, it's all about my nursing business; I look at it with objectivity and brevity; I don't take it home with me, and I know I do my best; that's all that matters at the end of the day.

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Specializes in LTC.

The only behavior you can change is your own. Stop taking it personally, give the ordered pain med if it is safe to do and move on.

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LadyFree28, another post said something about withholding pain medication...I am not out to fight with you or single you out, I just wanted to make it clear I do not withhold pain medication from my patients. If a blog is going to be this aggressive I think I may not participate anymore.

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Specializes in Anesthesia, ICU, PCU.

Yeah we get them at my hospital and yeah it is pretty easy to just give them their ordered meds and yeah I know the seeking type and have lost compassion for them. We get some pretty hardcore addicts where I work whose pain or "pain" is never relieved to their satisfaction because, let's be honest, their normal level of "analgesia" is somewhere between sedated and St. Peter. Where is your pain? "Oh it's everywhere" with all the fireworks and acting. I had an addict attempting to sway my compassion by telling me about how she had to be intubated 13 times, probably because of overdosing. How many critically ill patients have we lost who would've loved a second chance let alone 14? She signed out AMA because we weren't giving her IV dilaudid. This type has more consistently made my job hell and distracted me from my other patients than any other, especially with the extreme gearing towards customer service in our network. I love those holier than thou pricks, completely detached from healthcare who like to preach about the trials of addiction and lack of mental health treatments. What the hell have you done? Legalize the drugs and stop treating overdoses for 6 months and the drug problem in America will be solved.

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The only behavior you can change is your own. Stop taking it personally, give the ordered pain med if it is safe to do and move on.

Those really are words to live by, thank you.

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Specializes in Pediatrics, Emergency, Trauma.
LadyFree28, another post said something about withholding pain medication...I am not out to fight with you or single you out, I just wanted to make it clear I do not withhold pain medication from my patients. If a blog is going to be this aggressive I think I may not participate anymore.

And as I reiterated before, my post was directed to the thread; again, like how I practice, I post with objectivity and brevity; it is NEVER personal :no: and it's the Internet, once one posts, the post take a life of their own-like my siggy line says...it's meaning is that it's really in the grand scheme of things, it's never personal...no need to take everything personally-ever...it's business-nursing business.

:cool:

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