deepbreathe

Let me be the first to say I believe in pain management. The key word is management. I've given conscious sedation to countless people, 8 hours a day, 5 days a week for well over10 years. I'm known for the fact that people are pain free during my procedures. I think what I said was, we've allowed the mentality of entitlement to go beyond what it was meant to do. Living a life as a legitimate junkie is ruining more than the patients life, it ruins those around them too. I'm talking about abusers, life time of seekers. Pain is a bodily function. Wake up, it is a signal that something is not quite right in the body. My dad died of complications of septicemia...he had rheumatoid arthritis for 20 years, was sure he wanted to pain free, took depomedrol IM for years (Through Dr.R. Kaye, Standford University Hospital), and it destroyed his inflammatory responses, while it kept him pain free. So a massive infection took his life, without even a whisper to let us know how severe it was....pain management is the key. I am not in favor of pain, but it is a reality. Keeping people in a pain free state can mean so dependent, or so out of it, they really are not themselves, and they are not without dangers of pain medications. Management to a level of reasonable, with the hope of either eliminating the source of the pain (thus the real answer), or providing a way to live safely, exploring the alternatives. That's what pain evals do... they look at the whole person, body, mind and soul.

I agree with the whole pain issue. Somehow, we as a society have become accustomed to the idea that pain free is the best way to be. The problem with that is that it really means anesthesized. We need to educate our patients on the dangers of opiate use, the problem with narc use when it comes to really needing pain relief ( i.e. post-op), the problem with not moving enough after surgeries ( due to over medication), on and on. Chronic narc users need to be counseled and put into a pain program whose goal is to eventually give alternative ideas for relief, and to get to the root of the problem. The primary MDs or Surgeons need to be spurred on to write the orders for pain evals. It puts restrictions on the use of meds, puts out the info to the ERs in town, the pharmacies, and eventually helps the patients live a better life. Please! have the fortitude to suggest this to your docs...they'll listen. I work in a PACU, just last week I gave 300mg. of Demerol, 20mg of Morophine, 100 mcg of Fentanyl, and 25 mg. of Phenergan to a back surgery patient who was still proclaiming pain at a level of 10, wide awake, on room air at 98%, less than 40 min after general anesthesia....c'mon, this is rediculous!!!! JCAHO standards need to be fully read, understood and interpreted, read them yourself, and lobby for the intelligent use of medication, and the professional judgement of the RN. Abusers are fully aware of their rights in regard to pain relief.