Pain shots are us, not this nurse!

Published

Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).

:icon_evil: :icon_evil: :icon_evil:

Specializes in Med-Surg.
I think the use of the word 'enraged' was an exaggeration in order to express frustration. Just like pts have different pain thresholds for pain, nurses have different thresholds for pains in the tushes.

Thanks for acknowledging that the use of the word "enraged" was for the purpose of making this controversial subject more controversial...most of the time I am even tempered at work!!!

No, I'm not lying when I say I can't relate to someone else who becomes "enraged" at their patient.

I think the original poster did come back and clarify that rather than "engraged" she/he meant "somewhat annoyed", which I took as them acknowledging that "enraged" was a bit strong. See post #14 and decide for yourself.

Up Vote Up Vote ×

About the only time I get really frustrated at a patient is when I give them pain medication as ordered and find them taking their own supply from a purse or pocket. I have had this happen on a couple of occasions and it makes for a scary time not knowiing what else these people might have taken. One of them ended up on the vent for OD of more than one thing. We found the meds in her personal belongings(fell out of pocket) when we were moving her to ICU

Up Vote Up Vote ×
hello, telerner. hello, there, sweetheart. first, on behalf of all the naysayers, i want to apologize. because so many are talking about who shouldn't judge and all that, but yet, they are judging you based on one comment.

yes, i do feel where you are coming from. i don't get angry, but i do get frustrated when dealing with these types of people. these people know good and well what you mean. they know that they, too, have been frustrated at times. because i tell you, it really takes away from dealing with your critically ill patients when you are in a patient's room every hour pushing drugs to people that have no other problem except unresolved pain. the hospital is not where these people need to resided. there are pain management clinics out there for that. if they have chronic pain, then the doctor needs to handle it to the point where they don't always have to come to the er for drugs.

anybody who says that they can't relate to what you are saying is lying. they, too, have seen what you're talking about and they are not perfect. they have hang-ups, too.

anyway, i support you and feel where you are coming from. keep coming to allnurses.com. this is a good place to vent, as opposed to doing it in front of the patients.:balloons:

if by chance this was directed at me, i don't need anyone to speak for me. i can and do speak quite well for myself, thanks. also, just for the record, i, personally, was not "judging" the op for her comment. i was simply stating my opinion regarding the subject. when a person comes to a forum such as this they can't and shouldn't expect every other person to agree wholeheartedly with their statements. nor was i "lying" when i said i had never been enraged at a pt who requested their prescribed pain meds. sure we all get stressed out from time to time when we have too much going on, but "enraged," not me.

pts who are in the hospital "who have no other problem except unresolved pain" have just as much right to expect adequate nursing care as the next person. their physician likely admitted them to determine the root cause of their unresolved pain and attempt to relieve it, that's where we nurses come into play.

my post was also to point out that many ppl don't wear their pain on their sleeve, and may not display visible outward signs of pain. while at the same time my have vitals wnl and still be very painful. not everyone is going to curl up in the corner writhing from pain. people in general have varied levels of pain/pain medication tolerances. the whole concept of pain management is to find a therapeutic level of meds, along with treatment modalities to allow the pt to function, and have some sense of normalcy in their lives.

someone else said it's sad that pts feel they need to act a certain way in order to get their prescribed pain meds, i definately agree. it's very sad, indeed, that people have been programmed per se to display certain actions to make their pain appear believable. as far as others who may be talking to people, watching tv, walking around, doing puzzles, or whatever, perhaps they are doing such things to distract themselves from their pain. distraction can be a very good coping technique to many. as i said before, pain is what the pt says it is, plain and simple. it is not our job to pass judgement on our pts. it is our job to give good nursing care and comfort our pts with whatever means we have available to us. if that involves giving them prescribed pain meds when they request them, so be it.

________________________________________

:yeah: go gators!! :yelclap: sec champions!! :yeah:

:w00t: national championship bowl bound!! :w00t:

Up Vote Up Vote ×
Specializes in Cardiology, Oncology, Medsurge.

Through my starting this abnoxious post of "an enraged nurse" I have gained more understanding regarding this topic and have learned not to go by my gut reactions...besides weren't we taught in nursing school that pain is the 5th vital sign?!! Anyhow I have gained more clarification of this very important topic...And, I did happen to mention my post to a coworker who said a few years ago she went into ER with severe abd pain and bile emises and was denied pain medication...soon thereafter she was dx'd with bowel obstruction and spent 2 weeks in ICU after surgery LOL golly did I learn something!!!

PS. Thanks to all for your contributions to this forum.

Up Vote Up Vote ×
clemmm78, your post followed mine, wasn't sure who you were addressing in regards to apologizing for you?????

Sorry, I was referring to this post:

Hello, TeleRner. Hello, there, sweetheart. First, on behalf of all the naysayers, i want to apologize. Because so many are talking about who shouldn't judge and all that, but yet, they are judging you based on one comment.

I don't want her to apologize for me because she has no right to apologize on my behalf. I have nothing to apologize for. It really ticks me off when I read messages like that.

Up Vote Up Vote ×
I think the original poster did come back and clarify that rather than "engraged" she/he meant "somewhat annoyed", which I took as them acknowledging that "enraged" was a bit strong. See post #14 and decide for yourself.

Yes, but she specifically asked if we got enraged and many of us are saying absolutely not.

Up Vote Up Vote ×
Are you ever enraged by patients who really show no visual signs of pain but say that their pain scale is 10/10 and demand their pain shot every time it's due (thinking that they should know when it is due, as if it was a scheduled med not PRN).

:icon_evil: :icon_evil: :icon_evil:

Enraged? Are you serious?

When someone asks me for their PRN narcotic pain med I assess the pain first. Based on the assessment I may try alternative interventions before giving the med.

If someone has a narcotic PRN ordered say every q4° and they ask for it that often I will ask the doctor for a long acting med like MS Contin.

Up Vote Up Vote ×

It's their pain, their meds and their call. If it is a PRN med and it is time for them to request it and they do, then it is time to administer it. I'm a nurse in acute care. I'm not a doctor who has ordered it, a specialist in addiction nor a police officer. It's not my job to decide how much pain they are truly having. Patients have rights and one of them is to be given their medication as ordered and if PRN, as requested in a timely manner.

Up Vote Up Vote ×
Specializes in Emergency room, med/surg, UR/CSR.

Ok, I agree that pain is what the patient says it is. I have to admit that I was ashamed of my reaction yesterday to a patient. But let me explain. This young patient wants morphine every two hours IV, benadryl every four hours IV push, is on methadone 120 mgs every 12 hours, and has oxycondone 10 mgs PO ordered PRN as well as the morphine. Yesterday I thought that I would try the oxy instead of the morphine explaining to her that it was more potent and would last longer. Of course, she was not happy and when her mother came in, asked me why I had done what I had done, which I told her the same thing I told the patient. I told the patient to give the oxy an hour and see how it does. Well, low and behold, an hour on the nose, she wanted her morphine because the oxy "wasn't really working very well." In other words, she was getting pain relief, but not as much as she wanted. So, it was time for her benadryl as well, so I got her the morphine and PO benadryl. When I took it to her,she asked why she was getting the PO benedryl. (same dose), I started to explained to her that it would last longer, but she broke in and started whining that it didn't make her feel the same and it was going to take longer to start working. I think it was the whining that ticked me off. I told her fine, put her morphine in her medserver, (I'm ashamed to admit I shut the door harder than I meant too), and I went to find the charge nurse because I had to get the IV benadryl out of the cabinet that only she has access too. Needless to say, she had to wait longer than she would have had to to get her medicines because I had to walk up the hall to get what she wanted. When I went back in the room she was on the phone to her mommy so I'm sure I will hear about it when I go back to work. I didn't withhold her pain control, all I did was try give her something that would last longer, even though it would have taken longer to work. To me, and maybe I'm wrong, but if the patient would rather have an immediate IV pain shot rather than a longer lasting PO med, the then patient simply wants the buzz rather than the true pain control. I think that it's wrong to encourage the need for this feeling, and like someone else said, we should work on alternative ways to manage pain instead of getting patients hooked on that feeling of euphoria. OK fire away with the flames, I don't like feeling like I am just a narc waitress, there waiting anxiously for the next call lite to go off so I can spring to the narc room and triumphanty bear the holy vial of pain relief to the patient's room, waking him/her up to give it to them. I am so sorry for the vent, but we have had the most demanding patients and families lately that are just sucking the life from all of us at our facilty that I guess I am just feeling the stress. Please don't shoot the flames to hot at me!

Pam

P.S. and how was everyone's holidays?;)

Up Vote Up Vote ×
I think the use of the word 'enraged' was an exaggeration in order to express frustration. Just like pts have different pain thresholds for pain, nurses have different thresholds for pains in the tushes.

No. I think "enraged" is exactly what was meant. There were a myriad of other words or phrases the OP could have used (ticked, miffed...) and even went so far as to punctuate his/her "enraged" state by throwing in childish red blinking-eyed santas. The OP wasn't just "annoyed" when it was written. So, to answer if I ever get "ENRAGED" no, I don't get enraged and guess what? I don't even get annoyed.

Perhaps if this is causing the OP or anyone else some grief, in the future it will be in his/her best interest to choose a word that is better suited to his/her state of mind instead of simply pulling out a list of assumed synonyms and picking any word that is a remote cousin to the one you actually feel best describes your state of mind.

Up Vote Up Vote ×
Specializes in med/surg.

I have to say that in truth it does it grate me that I can have a patient who clock watches for pethidine for abdo pain but tucks into a HUGE Chinese take-away brought in by a relative!! Then as soon as you give the shot wants to go out & have a cigarette!!! This is no exaggeration of a frequent flyer we have.

I know that pain is what the patient says it is & all that jazz & I don't deny the pain relief either but yes, I do wonder!!! In truth it does annoy me a little because I have better things to do than mess around organising controlled drugs for someone who really cannot be in that much pain!

However, I want to stress that I do fill the order because if that's what the doc wrote & that's what the patient wants then I don't feel I have the right to deny it but hell yes I complain about it in the staff room!!

Up Vote Up Vote ×

To me, and maybe I'm wrong, but if the patient would rather have an immediate IV pain shot rather than a longer lasting PO med, the then patient simply wants the buzz rather than the true pain control.

Yes, you're wrong. When I'm in severe pain, I can't handle trying to wait for the PO med to kick in - the pain is too severe and often makes me nauseated. I can't take the chance of puking up the PO med and then having to have to go through it all over again, when an IM, SC or IV would have done the same thing but more effectively.

I don't understand the reasoning that PO lasts longer. A med has a certain half life, regardless of how it is given. One just starts working faster than the other.

Up Vote Up Vote ×
+ Join the Discussion