oharnp

Im a nurse practitioner who works in a 69 bed er and the attending docs are constantly telling us the midlevels were not very good at treatingpain.they are telling us to order narcotics as a first line treatment for ALL complaints of pain. yesterday i had a young py.with a stubbed toe for pain i ordered 1 gram of tylenol. the doctor that was there seen the pt. canceled the order dor tylenol and ordered the patient as follows Dilaudid 4mg IVP,valium10mgIVP,and Percocet 10/325 x 2 tabs. i avout died the only thing wrong with the patient was a stubbed toe.

Yes narcotics are always ordered first

I am a ARNP and work in an er. I am so annoyed with doctors telling me how to.treat pain. They tell me to start with narcs. i have my own orders which are a combo of any of the follwing meds: Reglan benadryl ativan Diazepam ketorolac motrin tylenol zofran I do not order narcotics unless there is evidence of a painful conditon.Am i wrong. what is it like in you er

Yes i am being told by the prividers to order narcotics for all complaints of pain

I agree i have had kidney stones my self and the doc in the er ordered at first Dilaudid 4 mg IVP and Zofran 8 Ivp then i was still in pain. So he ordered 2 of morphine i recieved toradol ivp and was instantly pain free.

We have providers that routinely go straight to the iv demerol. i absolutley will not order iv and not order any dose higher than 12.5mg IM i wold prefer to order toradol abd norxo for pain.

I have several kidney stone patients come through the ED daily as it is common where I work. Every doctor I work with is seeming to decide to go with morphine IVP or Demerol IVP for the patients pain. I have always tried to prescribe a less sedating approach. Zofran,Toradol,and bentyl. I have been aggravated with the docs telling me to order the narcs,because I don't like to prescribe narcs until a underlying cause is verified. And when the patient (As some are) is there once a week with the same complaint or different complaints,seeking pain relief. I will not just jump and order a narcotic when they are several alternative options for effective pain control. I have a young lady who come in every week who has been seen 89 times this year who always is asking for narcotics. Idont give in when I pick up her chart. What do your providers start with? What do your drug seekers come in and ask for ? do they get it? What are some of your seeker stories? and I know there are threads out there like this.