RN's w/chronic pain, using narcotics

Specialties Pain

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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.

Specializes in ob high risk, labor and delivery, postp.

Just checked into this link again, not doing much better yet, although i am seeing a pain specialist now, and he cut my hours down to 4 which in itself helps. i am still not sleeping well, only about 4 hours a night. some have suggested that it is okay to take meds and work, but i KNOW that i don't feel alert when i take my meds, even when i take less than i need to take my pain away. I have always been sensitive to meds, even cold tablets and benadryls throw me. I'm not sure how the whole compounding thing would work. I can't take NSaids at all because they throw my BP through the roof. I think

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Specializes in ICU, Pedi, Education.

Until you have chronic pain, you have no idea what it does to you physically, emotionally and mentally. I would much rather have a RN taking care who is appropriately taking their pain meds than one trying to grin and bear it. MANY RNs are taking narcs, benzos, amphetamines, phenobarb, etc. and functioning quite normally. When you have chronic pain and are taking narcs appropriately, you are not impaired. What makes you impaired is when you DO NOT take the narcs and try to suffer through the pain.

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Specializes in Pain Management.
Just checked into this link again, not doing much better yet, although i am seeing a pain specialist now, and he cut my hours down to 4 which in itself helps. i am still not sleeping well, only about 4 hours a night. some have suggested that it is okay to take meds and work, but i KNOW that i don't feel alert when i take my meds, even when i take less than i need to take my pain away. I have always been sensitive to meds, even cold tablets and benadryls throw me. I'm not sure how the whole compounding thing would work. I can't take NSaids at all because they throw my BP through the roof. I think

Are you a candidate for any procedures or an implantable like a spinal cord stimulator?

Sorry if you answered this before but my Safari browser is running very slowly and it is taking too long to load the rest of the pages in this thread.

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Specializes in ICU, Pedi, Education.

I know that this question was asked of someone else, but I think it is a GREAT question. I have a spinal cord stimulator and LOVE it. It has not been enough to get me to where I want to be, so I am about to enter a clincal trial for intrathecal gabapentin. It is astounding to see what is out there today!

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Specializes in Pain Management.

If you don't mind giving out some information...how long have you had it, what condition do you have, and what treatments did you fail before you got down the list to the stimulator?

Don't feel pressured to answer.

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Specializes in ICU, Pedi, Education.

I don't mind at all. I had a wakeboarding accident (one binding did not release) and sustained a talar dome fx. After 2 surgeries to repair the talus, I was diagnosed with RSD in Spring 2005. We thought we had caught it early enough to put it into remission...but it did not happen. I had several LSBs, months of PT, biofeedback training and meds in the first few months after diagnosis. Unfortunately, the RSD continued to flair and eventually spread from just my right ankle to my entire right leg.

Before the stim, I had tried multiple different meds. We started with Lyrica and Neurontin...WAY too many side effects. High-dose Cymbalta worked somewhat and I am still on that. I ran through the course of Fentanyl patches (worked great...did not stay on well), Avinza (did not work well), and finally Methadone (worked fantastic). The opioids made me extremely fatigued and my QOL was significantly decreased.

So, we finally did a stim trial. It is amazing and I am so glad I had it put in. Unfortunately, it does not take care of all the pain and sensitivity, so I am entering a clinical trial next week. I have been accepted...now I will have a pump implanted to receive intrathecal gabapentin. They have had fantastic results and I am excited to see what will happen.

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With all due respect, I have a quick question for all: How would you know that the physician was taking pain medication, on a long term basis to control chronic pain, unless he shared it with you? Please share with me how you would reach such a determination.

Grannynurse :balloons:

Hi all, brand new to the boards, but have to chime in on this b/c it hits homem for me, being a chronic pain patient on narcotics for 3 years.

In addition to Grannynurse's comment, I want to reiterate what someone said earlier. People who have severe chronic pain are often in much WORSE state of mind (in relation to caring for a patient) when in pain than when in not pain (at the hand of a narcotic). I can speak for one that when my pain is at an 8/10 because I'm NOT taking meds, I am a WRECK. I cannot think straight for anything. So I would MUCH rather have a doc who is a chronic pain patient be on his meds than off. Now, would you rather a doc who wasn't a chronic pain patient at all? Sure, in a perfect world. Just wanted to reiterate that point, because it's spot on.

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Until you have chronic pain, you have no idea what it does to you physically, emotionally and mentally. I would much rather have a RN taking care who is appropriately taking their pain meds than one trying to grin and bear it. MANY RNs are taking narcs, benzos, amphetamines, phenobarb, etc. and functioning quite normally. When you have chronic pain and are taking narcs appropriately, you are not impaired. What makes you impaired is when you DO NOT take the narcs and try to suffer through the pain.

AMEN. And unfortunately, this is something that non-chronic pain sufferers will never agree or admit to, because they just DON'T GET IT (not meant in a mean way - there are some things that you may not have experienced yet, but can imagine what it might be like almost exactly; chronic pain is NOT one of those...unless/until you have experience it, you have NO IDEA what it's like to be in pain 24 hours a day, 7 days a week, and NEVER BE ABLE TO GET AWAY FROM IT (i.e., certain positions do not make it less - it is the same ALL THE TIME). Anyway, the thought above is exactly right.

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Specializes in ICU, Pedi, Education.
AMEN. And unfortunately, this is something that non-chronic pain sufferers will never agree or admit to, because they just DON'T GET IT (not meant in a mean way - there are some things that you may not have experienced yet, but can imagine what it might be like almost exactly; chronic pain is NOT one of those...unless/until you have experience it, you have NO IDEA what it's like to be in pain 24 hours a day, 7 days a week, and NEVER BE ABLE TO GET AWAY FROM IT (i.e., certain positions do not make it less - it is the same ALL THE TIME). Anyway, the thought above is exactly right.

The biofeedback therapist at my PM clinic finally got it through my head that chronic pain is a very lonely and frustrating journey for the exact reason above. You simply CAN'T UNDERSTAND the journey a chronic pain sufferer if you have not been down that road. The one thing I hope nurses (and other HCP) who do not have chronic pain understand is that someone in chronic pain is not going to present with pain the same way other patients do.

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Specializes in US Army.

I can't imagine having to deal with both chronic pain management and fear of losing ones profession as a nurse.

Unfortunately, this is so typical of the nursing profession... We preach pain management to others, but when it comes to one of our own dealing with it, then they all of a sudden become "impaired" and have to find another job. We are our own worst enemy.

I wish all of you fighters out there good luck.

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Specializes in Pain Management.

If you are in chronic pain that needs to be managed with narcotics then you obviously should take them.

I've worked with people that were on methadone for chronic pain and they performed just as well as those that weren't. But if being on narcotics impairs your ability to perform your nursing duties, then you need to find another job. Your right to proper treatment does not supersede the right of the patients to have an unimpaired nurse.

That being said, as one of the docs I work with always says: "there's always a plan B."

Acupuncture, biofeedback, PT, morphine pumps, spinal cord stimulators, RF, epidural steroid injections...

If your pain doc is unwilling to do anything other than keep you on narcotics, find a new one.

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Specializes in Pain Management.
I don't mind at all. I had a wakeboarding accident (one binding did not release) and sustained a talar dome fx. After 2 surgeries to repair the talus, I was diagnosed with RSD in Spring 2005. We thought we had caught it early enough to put it into remission...but it did not happen. I had several LSBs, months of PT, biofeedback training and meds in the first few months after diagnosis. Unfortunately, the RSD continued to flair and eventually spread from just my right ankle to my entire right leg.

Before the stim, I had tried multiple different meds. We started with Lyrica and Neurontin...WAY too many side effects. High-dose Cymbalta worked somewhat and I am still on that. I ran through the course of Fentanyl patches (worked great...did not stay on well), Avinza (did not work well), and finally Methadone (worked fantastic). The opioids made me extremely fatigued and my QOL was significantly decreased.

So, we finally did a stim trial. It is amazing and I am so glad I had it put in. Unfortunately, it does not take care of all the pain and sensitivity, so I am entering a clinical trial next week. I have been accepted...now I will have a pump implanted to receive intrathecal gabapentin. They have had fantastic results and I am excited to see what will happen.

Do you know the parameters of the study, and how long will it last?

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