I have a question regarding a patient who opens her neurontin capsules and snorts/ licks the powder and also chews her dilaudid and Percocets as I'm administering them to her. I've explained several times she is not supposed to and that it can be dangerous but she is manipulative and begins to cry then tries to get me into trouble by saying I'm rude to her and she straight up lies to my charge and nurse manager. The patient has a well documented history of various substance abuse issues, but has had major surgery and clearly needs pain relief. I'm already uncomfortable administering a dump truck full of meds to this 90 pound wonder, but her unwillingness to follow admin outlines scares the hell out of me. I've brought it up with my charge nurse, who told me not to worry about it because "that patient will outlive us all." I also charted a note about it but I'm still faced with her uncooperative stance every shift. She's going to be on my unit for the next 30 days or so, which doesn't make it possible to just hang in there and wait for her discharge. I find her slumped over, slurring her words, and unable to stand, and I document this too. So... where do I stand if something happens to her? Overdose or a fall... Am I "allowed" to refuse to administer meds if she doesn't just swallow them instead of chasing a high by chewing and snorting them? Do I have the right to refuse to pass meds to her? This is a serious ethical (I don't want to feed an addiction) and safety dilemma in my eyes. Am I being overly cautious or is my charge nurse being flippant? I'm beyond frustrated not knowing how to reconcile the situation. Thanks for replies in advance.