Example 1 (These are the available meds that a patient has)
Dilaudid 0.5 mg IV for pain 4-6
Dilaudid 4mg P.O (pain >6)
Phenergan 6.25 mg IV
Zanaflex (muscle relaxant)
She states her pain is 9/10. I brought in the P.O dilaudid but she refused. I told her that it wasn't time yet (she had to wait another 30 minutes). I finally gave her the IV dilaudid. Less than an hour, she said she was nauseous and wants her phenergan. In no time, she is anxious and wants xanax plus Zanaflex. I know pain is what the patient says, but who is in pain wants to wait 30 minutes when something else is available. Is it safe to give all these meds pretty much at the same time? The Doctor wrote it this way. How do you guys deal with this situation?
Example 2 (Patient has Chronic Inflammatory Demyelinating Polyneuropathy which is similar to MS and her joints get painful and swollen)
Percocet 10/325 PRN
MScontin (rscheduled dose)
Lyrica (scheduled dose)
I gave her the MScontin with her Lyrica along with her nighttime meds. 2hrs later, she wants the Percocet which she was due for and 30 minutes after she said she wants ambient because she couldn't sleep.
Example 2 doesn't bother me much but example 1 seems like she is trying to get high. I know the doctor ordered her medications that way. But is it even safe to get that many of these types of meds? The nurse that had her 2 nights later said at one time, she went into the room after she had called for her meds and she was so drowsy. She pretended to draw up the meds but instead with saline and she didn't even know the difference and continued to sleep like a baby.
Please guys how do you deal with drug seekers. If the doctor orders it , do you just happily give it? Please help me because I don't want to be contributing to someone's addiction.