Pain Seekers

[missswiss44]

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.

[BlinkyPinky]

From my days at the hospital: I remember that, for some reason, the ppl who were there with " pancreatitis" were really there for other reasons. Or do I was told by other nurses. But it seemed to bear out

Yes OP, I had this while working at the hospital and between the 11 other Pts I had , PLUS the " pain seeker" who demanded " his" pain med religiously Q one hr and 45 mins, well I couldn't eat and got UTI from not peeing, sometimes the entire shift. Add to that being pregnant, then a nursing mother whose would engorge way before my shift would end-- well I switched jobs and have been OUT of the hospital ever since. Good luck to you

[JWG223]

My life became much easier when i dumped the judgement. I can't save everyone, I can't change them. I give them whatever they have ordered, whenever they want it, as long as in my clinical judgement it is safe to do so. Their pain is what they say it is, that's all. Some people just like to get high, that's true. But as a previous poster stated, I would rather not under medicate someone who is truly in pain.

Exactly. Your job is not to judge, diagnose, or psychoanalyze.

[canigraduate]

Tylenol is not an NSAID. Kidney function is what is important with an NSAID.

Sorry. Been grading care plans and the stupidity has contaminated me.

You are absolutely right and I stand corrected.

[blondy2061h, MSN, RN]

(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.

I guess we're coming at this from different perspectives. My patients are on my unit for far more than a few days. I work in oncology so ALL of my parients have legit pain, no doubt, and our drug seekers are far and few between, but we do get our occasional patient using pain meds in an unhealthy manor, frequently because they want to be snowed through their admission, which does no good for anyone if they get pneumonia or DVT's and can't participate with PT.

[blondy2061h, MSN, RN]

Also, I've been on the other side f this scenario too. I have chronic neck pain and can't take NSAIDs. It's extremely hard to manage muscoskeletal pain without NSAIDs. So I really try to withhold judgement.

Once I get someone in pain to sleep I only wake them up if absolutely necessary (ie, oral meds that can't wait). If I'm concerned, I throw them on continuous pulse ox.

[Catch22Personified]

I sometimes feel how you do OP but I try to be as professional as possible. If the patient is asking for pain medication, I will relay their concerns to the primary and nothing more. If both the primary and me both know the patient is a pain seeker, I still will relay the patient's request.

If it's ordered I will give it if I find it safe.

[martymoose, BSN, RN]

Finally, if I am your patient and I have finally gotten comfortable enough to fall asleep and you come and wake me up to make sure you can, I do not know that you are trying to make sure I am not dying. I just think you are an a-hole.

I get that part too, but we are audited on a daily basis for reassessing the pain number exactly one hour after it's given. We are given warnings when we don't do this( have a re-score)

If we weren't hounded for that, I'd let "the sleeping dog lie"

I'm used to pissed off patients now

[mariebailey, MSN, RN]

I have a hard time with the pain patient who is relaxed as can be on her cell who tells me her pain is a 9 out of 10.

[mariebailey, MSN, RN]

[video=youtube_share;ay5_HgZLDoE]

V

[ak2190]

Yes, everyday. If it is ordered and they are able to handle the dose, I give it. I'm not going to cure them during their 3 day stay in the hospital and frankly, it's not my job to fix their addiction issues. Not to mention, I am not qualified to determine what is "real" pain and what is not.

[blondy2061h, MSN, RN]

I get that part too, but we are audited on a daily basis for reassessing the pain number exactly one hour after it's given. We are given warnings when we don't do this( have a re-score)

If we weren't hounded for that, I'd let "the sleeping dog lie"

I'm used to pissed off patients now

"Sleeping and easily arousable" is an acceptable pain reassessment for our charting. I make my best guess on if they're easily arousable

[martymoose, BSN, RN]

ugh. we have to enter a number 0-10/

It was easy with one of my pts she was getting oxy q4hrs pretty much atc, and her pain never went down more than one point.I always knew the answer, so didnt bug her.