What do you do when you need to take pain meds and work?

Genista, BSN, RN · Mar 5, 2004

Try contacting employee health & asking them about it. I think this type of situation depends on what you are taking, when you take it, and what the hospital policy is. Some healthcare professionals are on routine opiods for chronic pain, and they know the type of physical response they have, since they are on it daily. But if you are taking prn meds & are not sure of how they will affect your brain & cognition, then maybe you need to think about those implications & stay home on those days. I would definately talk to employee health and ask for their input & find out policy.Don't do anything w/o first finding out policy & evaluating implications. Be proactive & open with your employer. Find out what you need to do, then you won't have to worry. You might have to call in sick if you are "impaired" on those days. I just don't know. But I'm sure you're not the first person to have this dilemma.

Good luck!

Brownms46 · Mar 5, 2004

If I have to take pain meds to go to work, I don't work! But that is me, and I don't have to deal with chronic pain. Also I don't like taking meds of any kind.

Tweety, BSN, RN · Mar 5, 2004

Here, you can't work. It's against our policy to use narcs and work. Non-narcotic pain meds are allowed.

I do belive it's against the nurse practice act here in Florida to work under the influence of narcs, even if prescribed for chronic pain, but don't quote me on that.

If you are in that much pain, you can't concentrate and can't perform your job physically, and should be on sick leave or disability. Plus the narcs impair might impair your judgement. Too risky in my opinion. When I recently had surgery I returned to work the next day and just took motrin during the working hours and percocet when I went to bed.

mattsmom81 · Mar 5, 2004

Good answers. Whatever nurses do, they shouldn't take a prescribed Vicodin, Percocette, etc for that tooth abcess and go to work without thinking it through, and considering the ramifications. That's probably how a few of those nurses got in trouble with their BNE. I take Aleve and Tylenol arthritis at work. If I need more than that I figure I probably shouldn't be there (at least in MY job...Vicodin and others would fuzz my brain and impair me.)

elkpark · Mar 5, 2004

I would never consider working with any narcotics in my system. A number of years ago, I fell and broke my wrist -- I was in a lot of pain at first (of course!), and had Percocet ordered by the orthopod who casted me. When I called in and told my nurse manager that I expected to be out sick for a couple days while I was taking the Percocet, and I would return to work once I could manage on Motrin or something, she tried v. hard to talk me into coming on into work (3rd shift, only nurse, on a psych unit). I thought at first maybe she had just misunderstood me, and explained again, "No, you don't understand, I'm taking NARCOTICS ..." :uhoh3: She said, oh no, it would be FINE for me to come to work, not a problem at all, really.

But you know whose license would have been in trouble if anything went wrong on the unit one of those nights, right? I doubt she would have been stepping forward to say, "It's really MY fault, because she didn't want to come to work, but I told her it would be ok ..." The hospital would have left me hanging in a heartbeat.

I'm not interested in being one of those names listed in the BON newsletter discplinary section! :chuckle

Rapheal · Mar 6, 2004

I agree that you need to speak with employee health to know your hospital's policy. Even if you feel you function well on narcotics, there could be a problem if you received an injury at work. Most employers will make you take a tox screen test for any worker's comp. injuries. Better to be safe and know the policy.

duckboy20 · Mar 6, 2004

I think the only legal way you could go to work and be on pain meds is if it required no patient contact such as doing clerical type work for that time if perhaps they would let you. If you had nonopioids, then yes you should be fine to work as well. Just depends on the policy of your hospital

nurseygrrl, LPN · Mar 6, 2004

I can't even function at work on 25mg of Benadryl let alone a narcotic. I had to leave work once because I got a few hives and that itchy all over feeling (still don't know what it was from) and I needed to take Benadryl, so I left because I know it makes me pass out within an hour of taking it. Narcotics make me sleepy and nauseous so I avoid taking them at all costs. It all depends on if you can function on the med...not really what the med is, in MHO.

IamRN · Mar 6, 2004

I make sure they are only non-narcotic. If I were required to take narcs for whatever reason, I would consider myself to ill to be at work and would call in. Personally, no matter what the policy was at the institution, I wouldn't risk working under the influence of narc.

I do hope you find something that works for you.

Kaye · Mar 6, 2004

Thanks for all your input. While at this point NSAIDS work well, I've been wondering what other nurses do. We are held to a very high standard and yet as Elkpark pointed out, hospitals hold us to the standard when it works in their best interests, but can want us to ignore those same standards when it comes to staffing.

Of course this is not a subject that can be discussed at work, be cause we know what is right, and would never say different. I say that, knowing how many nurses work with bad backs and joints everyday. I've discussed this with my MD and was told "tell the DON I ordered these meds for you, and it should be O.K". This clashes so much with the values I've always nursed by, that I thought I would ask you all how you make your choices. I'm sticking with my nsaids for as long as possible. Hopefully I can retire before I have to depend on stronger meds to function.

Home Health Columnist / Guide · Mar 6, 2004

as with most chronic pain sufferers, we take our meds and go to work.

opioids are thought to worsen the performance of psychomotor tasks due to their sedating and mental-clouding effects. as a result, some safety regulations currently restrict the use of opioids when driving or using heavy equipment. we investigated the psychomotor effects of long-term opioid use in 144 patients with low back pain. all subjects were administered two neuropsychological tests (digit symbol and trail making test-b) before being prescribed opioids for pain; tests were re-administered at 90- and 180-day intervals. test scores significantly improved while subjects were taking opioids for pain, which suggests that long-term use of oxycodone with acetaminophen or transdermal fentanyl does not significantly impair cognitive ability or psychomotor function.

neuropsychological effects of long-term opioid use in chronic pain patients.