Sometimes it's hard to tell a drug seeker from a patient in pain.

Nurses General Nursing

Published

Specializes in LPN.

There are some people I care for that like the feeling of being high, and they admit it. It isn't my call, but the doctors who prescribe. If they know the magic words, I give pills. Drug seekers do take up a lot of time, so I feel it's better to get it over with and give them their high. However, there are times a patient can have all the outward signs of a drug seeker and have actual pain. Is it my job to deciede, or the doctors. I don't really want to drug a person silly, what is it you do? The other day I worked hard to wake a pt for a scheduled med. Instantly and still slurring her words from sleep, she rattled off a list of drugs she expected me to fetch for her. I waited to see if she would fall back asleep, but she was instantly awake and mad for the 10 min. wait.

Specializes in Case Manager.

It shouldn't matter to you what their reasons for seeking pain medication are. You're not her, so stop playing the moral police and let her have her drugs as long as it's prescribed legally and she's allowed to have them.

Specializes in LPN.

dear spikey I do give the pills, however in this case, she wasn't even awake. But, don't play moral police with me either

Just treat everyone like they are in pain.

It could be difficult at times, especially when you are sure they are drug seeking. However, it isn't your call to make.

The only person that can experience the pain is the patient.

I always feel like the energy that nurses spend on this issue wastes so much time. The most efficient way to handle it is just anticipate and plan the pain medicine as part of their care. If you know they are going to want it every four hours, plan to be ready to give it every four hours.

My only issue with IV pain medicine administration is when the patient encourages or insists that I administer it a certain way. I don't care how much they want to feel high, and I don't judge them for that because there is a reason it's called "high", but I refuse to risk patient safety for that. I will always closely monitor blood pressure and respirations, and ALWAYS dilute and push slowly. That's the nursing assessment and diligent safe practice that we are responsible for. However, I will also always validate someone's pain if they say that's what it is.

As long as you provide empathy and safe nursing care, you've done your job. Anything beyond that is bringing bias and opinion into the care of the patient, which isn't good for either of you. Your day will go so much easier the more willing you are to accept it that way. ;)

Specializes in Cardio/Pulmonary.

I've always gone with the whole nursing school thing "the pt is the only one who knows their pain" so if they are in a 10/10 pain and laughin with their friends and texting, i'll give them their medications as scheduled and if it is safe..

i just get annoyed with the pt who says " none of the other nurses push this medications so slow ".... thats totally frustrating!! ... I'm totally going to push it over like 5 minutes now :smokin:

Specializes in Orthopedic, LTC, STR, Med-Surg, Tele.

I struggle with it too sometimes. Keep repeating to yourself "the pain is what the patient says it is". It's hard for me to deal with sometimes, but when I feel like I am giving the patient too MANY pain meds, and they keep asking for them, I say, "look, I don't want you to be in unbearable pain, but I don't want to overload you with meds either. You can have X again at such-and-such a time, and I will bring it when it is due. I can also offer you Y and Z in the meantime, but (if you just gave it) let's wait a little bit and see if X kicks in." Most of my patients can deal with that.

Believe what they are saying. Pain is subjective, and it's a balancing act with pain meds.

Specializes in Oncology; medical specialty website.
I always feel like the energy that nurses spend on this issue wastes so much time. The most efficient way to handle it is just anticipate and plan the pain medicine as part of their care. If you know they are going to want it every four hours, plan to be ready to give it every four hours.

My only issue with IV pain medicine administration is when the patient encourages or insists that I administer it a certain way. I don't care how much they want to feel high, and I don't judge them for that because there is a reason it's called "high", but I refuse to risk patient safety for that. I will always closely monitor blood pressure and respirations, and ALWAYS dilute and push slowly. That's the nursing assessment and diligent safe practice that we are responsible for. However, I will also always validate someone's pain if they say that's what it is.

As long as you provide empathy and safe nursing care, you've done your job. Anything beyond that is bringing bias and opinion into the care of the patient, which isn't good for either of you. Your day will go so much easier the more willing you are to accept it that way. ;)

I still haven't forgiven the nurse who slammed in my dose of Dilaudid IV when I was in the hosp. a few years ago. It scared the crap out of me...I felt like I couldn't breathe and had the worst head rush.

Have had many patients tell me to , " just slam it in!, why did you dilute it sooooo much", blah blah blah

Specializes in Medsurg, Homecare, Infusion, Psych/Detox.

Welcome to my world of straight up drug addicts wanting more and more drugs.

Please keep in mind that a doctor can write an order for anything he chooses. However it is the nurse who administered it will be held liable if something goes wrong.

A patient can OD and slip away from you just like that, (just ask Conrad Murray).

Specializes in LTC Rehab Med/Surg.

This is one of those topics that polarize this site. Always has, and always will.

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