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

[tiroka03]

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.

[Born_2BRN]

I use several approaches and make wise clinical judgement when dealing with patient who is known diverted with real pain or diverted without real pain (just want to get high). We nurses have obligations to treat pain also knowing patient may not in pain. Not treating pain it's considered neglect and worse an abuse. First I would give them pain med if they ask for it. However, if pain medication effects their vital signs bottom their BP or they cannot response to normal conversation while on it I will let them know. I will let them know how it's effecting them and then provide them with available options of less potent pain meds. I also would notify MD how it's effected pt overall. He or she will make the judgement call either talk to the pt or recommends something else. Then again it's the nurse who do the explaining. It's difficult to treat pain but again we have to follow MD's orders and make sound clinical judgment to benefit all members involved.