dave4151

In answer to the question should opioids be pulled from EDs? Absolutely not. This is a crazy backward swing on the pain management issue. For years we've been told to treat all pain. Now that some patients are abusing them, patients who have a true need for such meds are being left in agony through no fault of their own. A good practitioner should be able to assess whether a patient is truly in pain or not. Also, based on the state, a provider can check a database (PDMP - Prescription Drug Monitoring Program) to see if the patient is receiving opioids from other providers. It takes an extra 5 minutes but that database is there for a reason; to allow patients to receive opioids while providers state-wide can monitor their use of opioids. Please see CDC page State Successes | Drug Overdose | CDC Injury Center showing excellent results from use of these databases. There should be a nationwide version.

Yes you must know med math. If you're having trouble with it, you'll need to sit down with a nursing calculation practice book and practice, practice, practice. You're not only going to be dealing with meds dispensed by a Pyxis or similar. If you're an RN, you have to be able to calculate IV flow rates; 250 mg of K+ infused over 30 minutes is going to have a catastrophically different outcome than infusing the same amount over 24 hours. Also as patient advocates we are the last line of defense against med errors. It's your patients' lives and your license/livelihood at stake. Don't take a nonchalant attitude towards math. I know it's tedious and boring but it's absolutely necessary. As for the instructor who told you that you don't need to know med math, they need to be reported to your department chair.