"If you feel the medication isn't managing her symptoms well-enough, the patient is requesting/using medications inappropriately and/or the patient is constantly complaining about not getting the "right" medications, then notify her PCP so they can evaluate her and her medications. The PCP will decide if medication changes are necessary."
I agree with this 100%...but I have seen too many instances where the docs are just ignoring the patient's extreme use of pain meds while admitted to an inpatient service. I recently reviewed (third party) a chart where the patient was taking everything and anything written for her and "right on schedule". Two to three times nurses documented finding other narcotics (not prescribed for the patient) in the room, falling out of her handbag and on her bed. No one addressed this, no provider notes, nothing...not even a psych consult was ordered! She came in with a psych diagnosis and was already taking Xanax and Ativan outside of the hospital. (she was taking her husband's Percocets in the hospital) Oddly enough, the patient was admitted even though all her imaging and tests in the ED were negative. She had a managed Medicare policy which in some hospitals is an automatic admission $$$$$ (until they get denied) Pain should be treated but addiction should be addressed. If that patient were to overdose while in a hospital bed who do you think will be the first discipline to be blamed for negligence? Nurses!! I would be reporting this to administration and if they don't address it, then report it to the state. Protect your license!