PBeing a nurse with chronic pain this is hard for me. I often gave the same speech on they were getting the same amount, etc until an inpatient stay changed my mind on this subject.together the nurses, dr and I found a good regimen that worked well.until a nurse came on for his 12 hour day shift. Suddenly my pain was not being relieved.well at all. I made sure the dose and med was the same but all day I was in a lot of pain. On the last push of his shift i and the ruse he was giving report to on me noticed he had diluted the. 1mg of dilaudid in a rather large amount of saline(I'm not sure howuch exactly sn was used to dilute as I didntt notice until the coming on nurse asked if i had bad veins or why was he diluting it so much. As soon as the next night dose was given not diluted but pushed slow the normal pain relief came back. I will forever be convinced diluting narcotics can effect efficacy. I'm still carful not to push to fast as nobody wants vomit or bad stats to deal with but i just flush if needed rather than dilute. (My screed name notaseeker comes from being accused of seeking drugs and bc I know medical info & terminologyI have bn told nurses get addicted often" and finding pain mang. As a nurse is hard too