I would be interested to know what led to the rapid response as well.
I have had "that" frequent flyer patient who was a drug user who turned tricks to get her fix who would sign out AMA frequently only to return when her situation was dire. I have discharged patients to rehab instead of home, only to have them bounce back again, using. I work OB. Let that thought settle in a little bit and think about the implications.
It is hard. It wears on you. Yes, I get that. Addiction is a brutal disease, and in the acute care setting it gets really complicated. HOWEVER....that doesn't change the fact that addicts have pain, that their pain is real, and that yes, they do a lot of the time have a lower threshold for pain and need more medication than their non-addict counterparts. You still have to treat their pain, not for patient satisfaction, but because there is actual documented research out there that shows that poor pain control post op leads to slower recovery time which in turn can lead to greater post op complications.
You can't control their behavior outside of the hospital. You can only treat the after effects when they come to you for treatment. It's all you can do. I made my peace with that a long time ago, and am so thankful for people like Social Workers and Psych who can an do come in and do what I consider to be the "tough stuff" and confront the issues of the addiction, poverty, prostitution, etc., head on. Thank God for the multidisciplinary approach. You don't have to do it all.
The others made a great suggestion about asking for continuous o2 sat monitoring if you're worried about her respiratory status. Put the patient closer to the nurse's station so she can be observed closely. When you're burned out and feel you can't go into that patient's room one more time without screaming (it happens), ask a colleague to check the patient for you, just so you can take a quick mental health break. I get that she was a challenging (understatement) patient. I still assert that drug user or not, her pain needs to be treated based on what she is reporting, as long as her vital signs and assessment are WNL.