RN's w/chronic pain, using narcotics

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I am currently, and have been, for 3 years, taking oxycontin for chronic pain. My question is, Is is legal for a nurse to work while taking pain meds? I am unable to work, or hardly move unless I get some relief from the pain. A nurse friend told me it is against the nurse practice act for a nurse to care for patients while under the influence of narcotics. Looks like I will have to stop working if this is the case. I have been a nurse for 27 years...what else could I do? What else would I want to do? answer to that last question is easy..I don't want to do anything else. Thanks for your time, and any help or suggestions.

When I'm in severe pain I am the worst aide that you've ever seen. When I'm with a pt. all I can think about is lying in the fetal position and crying. This past weekend at work I took half a vicodin for the first time(at work) and didn't get high or feel any other side effects. After taking the medicine I was a much, much better aide. My mind was on the pt. and not myself. My philosophy--don't ask, don't tell.

I need to give you some advice. What you did is risky behavior. You had no idea, I believe and could be wrong, how the medication would affect you. You need to discuss your pain situation with a pain specialist.

Grannynurse

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Grannynurse:I appreciate your concern but let me clarify something. It wasn't the first time that I had taken vicodin ever. It was the first time I'd taken it at work and I took the smallest dose possible.

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Specializes in Clinical Research, Outpt Women's Health.

Buttons,

I am sorry. I didn't mean to come down on you or your actions. I just feel the need to defend people with chronic pain who are well managed in a pain management function, and who have the right to earn a living IF they can do it safely.

I just have seen many excellent nurses who have been hurt on the job, and then tossed in the garbage even if they are able to function safely.

I hate the jugemental opinions by some professionals who have not educated themselves well on the subject (not you!). I just wish those people would "walk a mile in their shoes" and then let us see what they think.

Pain management is an art that can lead to a happy fulfilling life and I just really, really support that.

I wish you all the best, and respect your opinion.

Grannynurse,

It is a hard battle to fight, but if you can get through to people and change opinions then it will be worth it. Battle on!

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Specializes in trauma er, dialysis.

I was an ER nurse, micn, trauma, charge nurse, until that fately night shift under staffed as usual 2 nurses to be exact. So of coorifice i was doing radio, triage, and had 4-6 patients. Well anyways i went to get a guy 300 lb patient out of a cab and he collaspe on me. well it turned out that i got 7 herinated disc and severe weakness left arm and left leg, with severe lower back pain, and left arm pain and left leg pain. Yets see i have had 4 surgeries now still have severe back pain restricted ranged of motion, pain in my perineum testicles and member. including unable to void, have bm or get an erection due to nerve damage. So i let my finacee go how humble right? I still have severe pain to lower back, perineum, and privates, but with 50 mcg patch and 8 mg dilaudid every 6-8 hours i can sleep a little and do my adls, and some light exercises, but without i cant sleep, or do anything really because the pain is unbearable. Well i guess my nursing career is over 10 years in the er down the dain!!!! The depression is fun too, but if i want to see a phd cant because the workers comp denies it!!!! well go to run just want to share my story with all the other injured nurse out there. I feel for all of you. Maybe if these money monger companies would hire more staff, lift teams ans devices to help nurses lift and carry patients this would not be such an epidemic. well thanks for listening or reading take care all nurses who work too hard and it will only get worse before it gets better.

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I was an ER nurse, micn, trauma, charge nurse, until that fately night shift under staffed as usual 2 nurses to be exact. So of coorifice i was doing radio, triage, and had 4-6 patients. Well anyways i went to get a guy 300 lb patient out of a cab and he collaspe on me. well it turned out that i got 7 herinated disc and severe weakness left arm and left leg, with severe lower back pain, and left arm pain and left leg pain. Yets see i have had 4 surgeries now still have severe back pain restricted ranged of motion, pain in my perineum testicles and member. including unable to void, have bm or get an erection due to nerve damage. So i let my finacee go how humble right? I still have severe pain to lower back, perineum, and privates, but with 50 mcg patch and 8 mg dilaudid every 6-8 hours i can sleep a little and do my adls, and some light exercises, but without i cant sleep, or do anything really because the pain is unbearable. Well i guess my nursing career is over 10 years in the er down the dain!!!! The depression is fun too, but if i want to see a phd cant because the workers comp denies it!!!! well go to run just want to share my story with all the other injured nurse out there. I feel for all of you. Maybe if these money monger companies would hire more staff, lift teams ans devices to help nurses lift and carry patients this would not be such an epidemic. well thanks for listening or reading take care all nurses who work too hard and it will only get worse before it gets better.

Hi, a bit of free advice. Contact your state's Division of WC. Get from them the free handout they have with your rights and responsibilities as an injuried employee. They must have it and must provide a copy, free, to all injuried workers. In it, you will find information regarding your rights of appeal for any negative judgement against you, in regards to your WC injury, as well as the number of days and months to file. It will also provide information regarding attorney represenation and who pays what and when and why and how. You may have to fight for your rights but don't give up. I fought for seven years and finally won.

Grannynurse:balloons:

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This is reference to onelegswife. Could you tell me the corporation that owns your hospital?

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Specializes in med/surg, neuro, ortho, cardiol.

I had to go to the BON about a month ago because I had been reported to them. I was excorted to a small room with a table, and a young man asked me if I wanted to tell him about it. I could only assume it was because I was fired. He asked me to put it all in writing, which I did. I wrote that I was asked to take a urine drug screen because one of the nurses thought that the pain med her patient asked for and that I gave was not needed, that said pt. was not in that much pain..first off, to me, the pain is what the pt. says it is, and if it is ordered, and checking that pulse, resp, and B/P are ok, and that it is time for pt to have the pain med, pt. can have the med. I think because I have been in so much pain since 1991, and how I was made to feel by docs when I did ask for something for pain, I do have empathy with those pt's complaining of pain, and I never make the pt's feel bad about asking for pain med. Sure, some of those asking for pain med may not be in that much pain, but you know what, hospitals are for acute care, not drug rehab. If I observe that a pt. by his actions, does not exhibit those actions that would make you think the pain is really a 9 or 10, then it is my job to discuss my observations with the doctor , but not go on a one nurse crusade to stop all narcotics for certain pt's that I personlly feel are just drug seeking. If pt's are drug seeking, they do have some problems that need to be addressed, but not in an acute care facility. The nurse manager said I gave more narcotics than any of the other charge nurses, (so that must mean I was taking them, right). I did give a lot of narcotics, counts were always right, wastes were witnessed and signed correctly, but some of the meds given were not charted in the nurses notes. Reeason being, most of the time the nurses had not charted on their pt's yet, and said they would chart it later, to keep thngs in order in the notes, or I asked them to give me the chart and I would take care of it when they were charted up to that point. My one big mistake was trusting the nurses to chart the med given, and being so busy throughout the day, that I did not pick up and read every chart to make sure it had been done. I had no incident reports while taking oxycontin, and I think I was well liked as a charge nurse cause I did get out there and help. The urine drug screen came back negative for oxycodone (negative for everything else also, as I knew it would) Since I was negative for oxycodone, the powers that be figured I must have done something to my urine, even though it was taken correctly, with proper chain of command. I tried to explain to the manager that oxycodone does not always show up in a opiate drug screen, as only the true opiates are tested for...heroin, morphine, and codeine, all other narcotics are synthetic, and must be tested for specifically. (I looked this up on the internet, cause it shocked me too) So, my pink slip said i was fired because I interfered with an investigation, not because I was taking oxycontin. But is was let it be known to me that the real reason was because I was taking a narcotic, but that was not put down on my pink slip. So who then decides if I am an impaired nurse ??? No mistakes, other than not going back and checking the charting of pain meds, ( probably about 10 charts total in 2 years), not calling out sick more than a few days in 3 years, no pt. complaints, no complaints from the nurses I worked with, other than a few whines about their pt. assignments, and that no matter how hard you try to make things fair, some nurse is gonna think she got the short end of the stick ! But I did go out of my way to always ask if any of the nurses needed help, how things were going, and if I could do anything for them. And a lot of times it was.."so and so just called for something for pain, and I just sat down to do my charting, can you go give it." And I get fired. Did the nurse that hung a heparin bag on a cerebral bleed pt. instead of aminophyline get fired..NO, even though pt spent 1 week in ICU. Did the nurses aid that was caught making up vital signs get fired..NO, even though she admitted it. Did the nurse that drew up insulin in a tuberculin instead of insulin syringe and give it to the pt. get fired, NO. Did the nurse that hung the wrong blood on a pt. get fired..NO, even though the pt almost died. I could go on, anyone that has been in nursing for any length of time has plenty of stories to tell. Please, I do not mean to sound that I am perfect..I have caught plenty of mistakes that I could have made, but by taking the few minutes to double and sometimes triple check, I avoided a good many of them. I am up this late because my back, hips, and legs are killing me and I can't get to sleep. I miss my job...but do not want to have anything further to do with the medical field. One quick note..the nursing board said they did not have to tell me the charges against me, or who reported me. They would make a decision and sent me a letter. Someone accused of murder at least has the right to know and face his accusers, and get a fair trial by the jury of his peers. I have no rights, I have no idea what the nurse manager told the board, nor exactly what I am charged with...for all I know she might have told them I ran down the hallway butt naked.....at this point, sure wish I had.

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Specializes in Case Management, Home Health, UM.
I had to go to the BON about a month ago because I had been reported to them. I was excorted to a small room with a table, and a young man asked me if I wanted to tell him about it. I could only assume it was because I was fired. He asked me to put it all in writing, which I did. I wrote that I was asked to take a urine drug screen because one of the nurses thought that the pain med her patient asked for and that I gave was not needed, that said pt. was not in that much pain..first off, to me, the pain is what the pt. says it is, and if it is ordered, and checking that pulse, resp, and B/P are ok, and that it is time for pt to have the pain med, pt. can have the med. I think because I have been in so much pain since 1991, and how I was made to feel by docs when I did ask for something for pain, I do have empathy with those pt's complaining of pain, and I never make the pt's feel bad about asking for pain med. Sure, some of those asking for pain med may not be in that much pain, but you know what, hospitals are for acute care, not drug rehab. If I observe that a pt. by his actions, does not exhibit those actions that would make you think the pain is really a 9 or 10, then it is my job to discuss my observations with the doctor , but not go on a one nurse crusade to stop all narcotics for certain pt's that I personlly feel are just drug seeking. If pt's are drug seeking, they do have some problems that need to be addressed, but not in an acute care facility. The nurse manager said I gave more narcotics than any of the other charge nurses, (so that must mean I was taking them, right). I did give a lot of narcotics, counts were always right, wastes were witnessed and signed correctly, but some of the meds given were not charted in the nurses notes. Reeason being, most of the time the nurses had not charted on their pt's yet, and said they would chart it later, to keep thngs in order in the notes, or I asked them to give me the chart and I would take care of it when they were charted up to that point. My one big mistake was trusting the nurses to chart the med given, and being so busy throughout the day, that I did not pick up and read every chart to make sure it had been done. I had no incident reports while taking oxycontin, and I think I was well liked as a charge nurse cause I did get out there and help. The urine drug screen came back negative for oxycodone (negative for everything else also, as I knew it would) Since I was negative for oxycodone, the powers that be figured I must have done something to my urine, even though it was taken correctly, with proper chain of command. I tried to explain to the manager that oxycodone does not always show up in a opiate drug screen, as only the true opiates are tested for...heroin, morphine, and codeine, all other narcotics are synthetic, and must be tested for specifically. (I looked this up on the internet, cause it shocked me too) So, my pink slip said i was fired because I interfered with an investigation, not because I was taking oxycontin. But is was let it be known to me that the real reason was because I was taking a narcotic, but that was not put down on my pink slip. So who then decides if I am an impaired nurse ??? No mistakes, other than not going back and checking the charting of pain meds, ( probably about 10 charts total in 2 years), not calling out sick more than a few days in 3 years, no pt. complaints, no complaints from the nurses I worked with, other than a few whines about their pt. assignments, and that no matter how hard you try to make things fair, some nurse is gonna think she got the short end of the stick ! But I did go out of my way to always ask if any of the nurses needed help, how things were going, and if I could do anything for them. And a lot of times it was.."so and so just called for something for pain, and I just sat down to do my charting, can you go give it." And I get fired. Did the nurse that hung a heparin bag on a cerebral bleed pt. instead of aminophyline get fired..NO, even though pt spent 1 week in ICU. Did the nurses aid that was caught making up vital signs get fired..NO, even though she admitted it. Did the nurse that drew up insulin in a tuberculin instead of insulin syringe and give it to the pt. get fired, NO. Did the nurse that hung the wrong blood on a pt. get fired..NO, even though the pt almost died. I could go on, anyone that has been in nursing for any length of time has plenty of stories to tell. Please, I do not mean to sound that I am perfect..I have caught plenty of mistakes that I could have made, but by taking the few minutes to double and sometimes triple check, I avoided a good many of them. I am up this late because my back, hips, and legs are killing me and I can't get to sleep. I miss my job...but do not want to have anything further to do with the medical field. One quick note..the nursing board said they did not have to tell me the charges against me, or who reported me. They would make a decision and sent me a letter. Someone accused of murder at least has the right to know and face his accusers, and get a fair trial by the jury of his peers. I have no rights, I have no idea what the nurse manager told the board, nor exactly what I am charged with...for all I know she might have told them I ran down the hallway butt naked.....at this point, sure wish I had.

Sorry, but you do have rights...even in our "at-will" state. Maybe a good, seasoned attorney can encourage our BON to come up with a Confessional in a court of law. This isn't Communist China, and you are being treated like dirt. I will be praying for you!

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Specializes in med/surg, neuro, ortho, cardiol.

Thanks for your reply csemgr1. It is not right that the board is all powerful..as we all know power corrupts, and absolute power corrupts absolutely. Who does the board answer to, and who oversees their decisions. What is the worst, I think, is that anytime a boss, co-worker, or any hospital employee can call the board of nursing and file a complaint against you and the board does not tell you who, what, when, where, or why, and they say they do not have to tell you. What country is this anyway. Is this not America......nurses must live in a country far far away, or is that a galaxy far far away ? !

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I am currently, and have been, for 3 years, taking oxycontin for chronic pain. My question is, Is is legal for a nurse to work while taking pain meds? I am unable to work, or hardly move unless I get some relief from the pain. A nurse friend told me it is against the nurse practice act for a nurse to care for patients while under the influence of narcotics. Looks like I will have to stop working if this is the case. I have been a nurse for 27 years...what else could I do? What else would I want to do? answer to that last question is easy..I don't want to do anything else. Thanks for your time, and any help or suggestions.

I am a nursing student and researched this topic due to the fact that I too am on oxycontin. The Az State Nursing Board stated that they do not judge what prescription drugs make people intoxicated. It is legal to practice under the influence of prescription medications. The important thing is that as a nurse you must not be intoxicated or put patient safety at risk. If a complaint is made against you for abusing a pt. or placing a pt at risk, the nursing board will make an investigation. Any pt. can react differntly to a variety of medications, for example, bendryl can make some individuals feel intoxicated while others, taking oxycontin, do not feel or become intoxicated. I would discuss your concerns with your prescribing physician to ensure you are not putting patients at risk. If you are safe then who is to judge what medication you are on.

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Specializes in OB, ortho/neuro, home care, office.

I have been living with chronic back pain for a couple of years. I finally had an MRI on Wednesday, still waiting on the results. In either case, originally I was prescribed 5/500 Lortabs. Those didn't work after a few months, I was moved up to 7.5mg lortab and now 10mg. I purposefully did not take these at work, for fear that it would be a bad thing. I never felt anything off from taking these, in fact, it only brings my pain down to maybe a 4 (which instead of a 9 is a great improvement). In either case, my new doctor prescribed me Ultram for at work. It helps some, from a 9 to about a 6 but it's better than nothing. I also have zanaflex for bedtime. Most of these don't work fully but simply take the edge off. Before being prescribed the Ultram, there would be days were even when I swore to myself that I would NEVER take my lortab at work, I would end up taking 1/2 my prescribed dose just to bring it down to maybe a 7. I have a high pain tolerance, but when the pain is constant, and is not relieved, it is very hard to deal with. I only resorted to use of the 1/2 prescribed dose 2 times. Other times I nearly made myself sick taking ibuprofen and tylenol, which never worked at all. But I kept thinking, if I just take a couple more.....

In either case, I know the Ultram will not work indefinately, and I am at least hoping the doctor will be able to find the problem so we can figure out how to treat it. I am furthering my education asap and hope to do a non-floor job in the future.

It sucks having to work in pain, pain so bad you wonder how you will properly assess the patient, pain that is excrutiating to move a patient. Just pain in general. I feel for you grannynurse. I know your pain. Wish I had answers for you.

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I have been living with chronic back pain for a couple of years.

I understand very much about back pain. I cannot do things like I use too. I have to do things in moderation. I cannot do things all at once or trying too. Every time I do not use moderation for the housework and activities ....the pain will increase to a ten and I am done for the rest of the day and the next. I feel you big time and we can feel the pain.

I also have zanaflex for bedtime.

I cannot get to sleep till five or six in the morning for a hour and sometimes I can get to sleep at 4 am for three hours. My back kick my butt and I take lots of meds at night to get sleep. In stead of putting me to sleep and I am so hyper you will not believe.

Most of these don't work fully but simply take the edge off.

I understand exactly what you mean.

I am at least hoping the doctor will be able to find the problem so we can figure out how to treat it.

Could you use a TENS unti while working? And the Ultratram

I am furthering my education asap and hope to do a non-floor job in the future.

I understand of not working on the floor and the constant pulling the patients and standing. I am moving off the floor myself because of my back injury that I had sustain at work. I needed t move on with my education and skills, boy I cannot wait for the new Job.

Therefore, you will feel so much better after you change jobs and have better pain control during working hours.

Oh have you tried to work every other day or work three 10 hours day and one 8?

Please let us know about the MRI's results. I have a herinated c-5,c-6, c-7, T-10, T-11, T- 12, L-4, L-5 ns he sacral area. Sometimes I cannot walk and lay in the fetal position and I fee better.

Have a great evening, hope everything will work workout.

Buttons

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