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.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I completely disagree. "MOST POSTERS" here are not saying that AT ALL. Go back and re-read the responses. They ARE saying they would give the meds as ORDERED IF vital signs and patient condition are safe enough to do so.

Because pain medications like all drugs can have bad side effects and pushing narcotics can have unintended consequences that most posters on here are not aware of. Most posters on here seem to think it is just fine to push pain medications if the patient is having pain and totally ignoring the potential consequences.
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Actually, narcotic abuse/addiction has gone DOWN in the US in recent years. One of our docs was just published in a journal with an article about it. I'll find it if you're interested.

And this isn't a blog. It's a message board.

I apologize, its a message board. Please forgive me. Would you be able to supply the article you are talking about? Seriously, I'm not trying to be smart, I would love to read the article. All the information that is available to me indicates the abuse is ever-increasing, except for one article about teens for the year of 2014 (which the rates were still high). Although this is encouraging, compared to the trend of just the past decade I feel more data is needed.

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We had this problem in our local ER. They ended up instituting pain policy. This consists of any patient coming to the emergency room who is on a pain contract with another pcp they must inform there pcp within so many hours. They also are only given enough pain med for a day or 2. I don't work in the ER but I get it on the other end with the clinics. It sounds like it really has helped our ER. From what I hear they are getting a lot less pain patience than before with this new policy. Unfortunately, it is not our duty to judge. We must do our best to put our feeling and frustrations aside. You never know what someone is feeling or what there pain may or may not be. Don't get me wrong I deal with a lot of pain management patients who take pain meds for a bunion, not really but you get what I'm saying. Either way, you can't really say what ones pain is, you have to take them at there word!!!!!!but I guess that's easy for me to say because I'm not on a busy med surge floor or ER. Maybe talk to your department on a pain policy

That does seem to be a very good idea and something I think my hospital can take advantage of.

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PS: Of course you have judgment, but you really would do better to leave morality out of it and just treat your patient. Also, you need to remember addiction is a disease in and of itself, and you are not going to fix it in an acute care setting. Again, get some education about the disease of addiction, and drop the moral judgments.

Are you saying I am not allowed to have my own personal opinion? You have your own personal opinion regarding my personal opinion...are you trying to tell me you yourself shouldn't have that personal opinion of my personal opinion?

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PS: Of course you have judgment, but you really would do better to leave morality out of it and just treat your patient. Also, you need to remember addiction is a disease in and of itself, and you are not going to fix it in an acute care setting. Again, get some education about the disease of addiction, and drop the moral judgments.

However, I do get what you are saying, that I would be better off not having these judgements. The entire picture is just very upsetting.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

You are only upset because you choose to be. Try to reboot your mind a bit. It's not worth all the pain to judge others' morality or lack thereof. It's your perception that causes you so much angst.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We ALL have opinions, but yours is getting in the way of seeing the forest for the trees. I have opinions, but I work hard not to let them cloud my judgment when rendering care to other (fallable) human beings. Again, please, please get some real education on addiction. I am earnest. Your practice will benefit.

Are you saying I am not allowed to have my own personal opinion? You have your own personal opinion regarding my personal opinion...are you trying to tell me you yourself shouldn't have that personal opinion of my personal opinion?
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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

Why isn't "sleeping, resp reg" good enough? Truly, if you woke me up for that, your Press Gainey, however that is spelled, would go in the toilet.

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jrwest, i think you need to use an alternate pain score system. the facial ones, etc. then you can score them while they sleep.

there are various ones, with numbers attached.

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Specializes in Education.

Wake not the sleeping patient, for they are quick to complain and even quicker on the call-bell...

OP, what people are saying is that yes, we understand. But part of learning about being in healthcare is taking our own personal opinions and acknowledging them as being our opinions, and then ignoring them when they come to our patients.

I lecture my alcohol and drug ODs not because of my personal opinion that drugs and alcohol are bad for you, but because they have admitted that they don't like waking up in my ER and not knowing how they'll get back to their stuff, or even if their stuff is still where they left it. It doesn't help their stress levels any because they're homeless and that bag holds all their personal possessions in the world. And even then all I say is to try to cut back, not stop completely. I know that they won't ever stop because that's all that they know. Wake up, try to earn enough to buy some food, some booze, some drugs, and numb themselves up enough to spend another night in the shelter if they can get a bed or in a local park.

If a patient wants to pray, or wants a blessing, it's not up to me to tell them no because I'm a different religion and it makes me uncomfortable. It's up to me to say no if it's a life-or-death situation or if they tell me to come back in an hour.

Having the patients come back every shift of mine for my entire week? I can say something, remind them that we've referred them to a local clinic or two, and give them the hand-outs that we've prepared, but it's also my job, my duty to treat them with the same compassion on night five as I did on night one.

It's easy to say "but this person doesn't do that." So what? That's their decision. I'm not about to tell a doctor that they can't yell at a patient because I've seen that the double-pronged approach can work. Doctor being firm and somewhat mean - "I don't want to see you here for this unless you've contacted your personal doctor or a specialist first, or you're dying" - and me saying "we can't really provide the best care for this. All we can do is determine that you're not going to die, which we've done. This person or your personal doctor are the best people to see about this."

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Specializes in Nurse Leader specializing in Labor & Delivery.
I apologize, its a message board. Please forgive me. Would you be able to supply the article you are talking about? Seriously, I'm not trying to be smart, I would love to read the article. All the information that is available to me indicates the abuse is ever-increasing, except for one article about teens for the year of 2014 (which the rates were still high). Although this is encouraging, compared to the trend of just the past decade I feel more data is needed.

Don't have the APA citation, but the physician is Dr. Richard Dart, the publication was The NE Journal of Medicine, and the article is entitled "Trends in Opioid Analgesic Abuse and Mortality in the United States". The study found that US abuse of Rx narcotics has declined from 2011-2013, and overdose deaths have been decreasing since 2009.

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I get what your saying misswiss44........you didn't offend me. I hope I didn't offend you.

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