10/10 pain..venting!

CCU NRS · Dec 15, 2003

Originally posted by imagin916
Earlier this week I had a patient that apparently comes into the ED frequently always with abd pain, they can never find anything wrong with him. He must have thought I was an easy target because I have never seen him before. (I only started on the unit in August) Chief complaint? Constipation x 2 days. Takes multiple narcotics, hx of abuse, ect. He is complaining that he has 10/10 pain, as he is sitting up calmly, and is asking for pain meds. I went to the doc and was like, this guy claims 10/10 pain, but look at him. So he goes and does the abd exam with no tenderness on palpation. I had 9 patients that night (some of them really sick) and his wife was harrassing me every minute for something, I was like (in front of the patient too) I have a lot of patients, many sicker than him, that I need to attend to right now, I cant get a pill/give him dilaudid/get him another blanket. The nice lady in bed 2 is about to be intubated and she needs my attention right now. Give me a minute please. He starts saying to me that he is very sick and dying and that I need to focus my attention to him mainly. Than he tells me that I need to order Klonopin for him NOW because he takes it at home and he missed his dose and if he doesnt take now it its "very dangerous". (The doc was getting the d/c papers as we were speaking). He than becomes mad when he finds out he was being d/c'd, he "demanded" to be admitted. Sorry, but a clear CT and x-ray is not going to buy you a day or two free drug stay!

Thank you all for listening to my vent!! I love this site, I can vent about this and you all have been there done that and understand!

May I suggest if he ever shows up on a slow night Harrison drip enemas till clear!

Gompers, BSN, RN · Dec 16, 2003

I love Toradol! I'm not an ER nurse (I work NICU) but twice I was in our ER with large kidney stones and recieved the med both times. My pain went from about a 7 to a ZERO in five minutes. And I loved that I was able to just drive myself home after that without being in a haze. My urologist, on the other hand, was NOT happy because he said that Toradol decreases renal blood flow. I didn't care - it was absolutely wonderful stuff!!!

NYCRN16 · Dec 16, 2003

Originally posted by CCU NRS
May I suggest if he ever shows up on a slow night Harrison drip enemas till clear!

Great Idea!

:chuckle

:devil:

athomas91 · Dec 16, 2003

i love it when someone comes in w/ abd pain and then refuses the iv, and labs......"can't ya just give me some medicine"

well......hmmmm..... not until we kinda know what's wrong.....

laurakc · Feb 9, 2004

I really know what you mean. They come in with their bag packed, crying, screaming, carrying on. Give them the narcs and they are sleeping...appears to be gone..Go in to arouse them to discharge them though and it is 10/10 again...amazing..

Or, they say just give me something to put me out..Obviously there is not as much pain when you are out, because if I have heard that once, I have heard it a thousand times. And believe me, I do not enjoy watching someone carry on, whether it is real or not, that says they are in pain. Do you want something for sleep or for pain? Many of them will tell you what drugs they want...amazing how they know their body so well...and they know the drugs so well...some of our regulars even tell me that I should give it faster because it really only works if you push it faster...now tell me how it works better if you push it faster, huh?

Oh, and I can't take anything with tylenol, asa, etc.

The guys we deal with are very specific...strange they are so knowledgeable...

Oh, by the way, I had a patient that signed out ama last night because the doctor would not order demerol instead of percocet because percocet does not help her...did not even try it to see..but said she was going to sue me because I did not try to alleviate her pain..this is an impossible game...and it really stinks because people are so different and react so differently...

Anxiety is another biggie in our er...it is amazing that some people can loose a limb and never get overwhemingly dramatic but others can have a small lac and you would think they were dying.

life is 10% of what is happening and 90% how you respond to it..

MandyInMS · Feb 9, 2004

Originally posted by CCU NRS
May I suggest if he ever shows up on a slow night Harrison drip enemas till clear!

That's got my vote as well

FranEMTnurse, CNA, LPN, EMT-I · Feb 9, 2004

Hmmmm, sounds like my brother and his mouthy wifey.

Medic946RN · Feb 10, 2004

Originally posted by laurakc
.... Many of them will tell you what drugs they want...amazing how they know their body so well...and they know the drugs so well...some of our regulars even tell me that I should give it faster because it really only works if you push it faster...now tell me how it works better if you push it faster, huh?
Oh, and I can't take anything with tylenol, asa, etc..

Oh yeah. Had one the other day who proceeded to tell me that i should mix 2mg dilaudid with "whats the stuff that keeps you from throwing up, begins with a 'p'?" (phenergan) in one syringe and push it fast becuase that always works to aleviate her pain. Guess what? 3mg of haldol did too!

MAGIK GIRL · Feb 10, 2004

Originally posted by Medic946RN
Oh yeah. Had one the other day who proceeded to tell me that i should mix 2mg dilaudid with "whats the stuff that keeps you from throwing up, begins with a 'p'?" (phenergan) in one syringe and push it fast becuase that always works to aleviate her pain. Guess what? 3mg of haldol did too!

goooood ole vitamin h!:roll

obliviousRN · Feb 10, 2004

Recent Conversation:

Pt: You have to push that faster. It only works when you push it super fast into my vein.

Me: No

Pt: You have to do it fast. It doesn't work any other way

Me: No

Pt: YOu HAVE TO!

Me: No

Pt: I've had 2 months of nurses training before. I know that medicine only works when pushed fast

Me: No

Pt: You are so mean. Do you treat all your patients like this?

Me: No

Pt: Don't you say anything other than NO?

Me: No

:chuckle :chuckle :chuckle :chuckle :chuckle

liz75 · Feb 10, 2004

After I had heart surgery I got morphine while I was in ICU and I would have said that my pain was around 2 while lying still and maybe a 4 to 6 when moving depending on what parts of me I was moving (of course I didnt move much). But you know I really consider a 4 to be bearable pain. It is difficult to explain pain in terms of 1 to 10. The funny thing to me is that alot of doctors are reluctant to change their minds about pain meds once they start giving you something. Once they had me in recovery and off the morphine which was the day after sugery they went to darvocet and I started vomiting at every dose and still had pain so then they gave me percocet and I still had the nausea and vomiting. I got phenergen with it in the morning but within 2 days I kind of just waited until it had been 6 to 7 hours and my pain was back in full force to take the meds because I just couldnt stand the nausea and dizzy feeling I got from it. I did plead with the nurse over the percocet and ask her wasnt there something else I could take and she said doc says percocet and we will give you something for nausea if it gets bad. I didnt have anything else in mind but once I was d/c I had bottles of the stuff and I just took tylenol. Recently I went to afterhours clinic over a toothache so I could get antibiotics until I got to my dentist appointment. The doctor wrote me a perscription for darvocet and I threw it away- I dont want to see anymore darvocet or percocet ever again lol.

healingtouchRN · Feb 10, 2004

I would like for more health care professionals to update their training on pain management. So much new data & treatment plans, options....I believe some physicians get into a certain prescribing habit & then do not change with the times. So many treatments have such nasty S/E's or adverse reactions. It's nice to work with docs that give options on prescribing & listen to the clients. Just my $0.02 worth... :rolleyes: