What is the pain med of choice?

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I have been a nurse for 11 years and in the past year or two I have noticed that we are giving more and more Dilaudid IV for complaints of pain. It doesn't matter what kind of pain, the house doc just orders Dilaudid 1-2 mg IVP Q 2 hr for pain.

Is this happening at your facility? Why the switch from morphine to dialaudid....It is causing a lot of problems for us because the drug seekers are coming out of the woodwork with "abd pain" to get Dilaudid.

We have had to narcan several patients due to over sedation. But if you don't give them Dilaudid they throw a fit. They are now asking for this drug specifically when they come in.

I personally went into nursing to take care of sick people not to be a drug pusher.

So what are thoughts on this? I am afraid that someone is going to get hurt if one of our "druggies" go off the deep end.

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I noticed our neuro docs giving dilauded to everyone as well. Especially w/PCA pumps. Have a headache? How bout some dilauded. I had a pump w/Dilauded after my surgery and it made me vomit. Honestly I can't understand how some people can take so many IV drugs and still walk!

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I wonder where this increased use of dilaudid is coming from. Was there something written in a medical journal that is encouraging the docs to prescribe dilaudid? I know it is making our lives on the med surg floor a living hell....I have a girl the other day (young girl not even 20 years old) demand dilaudid because she had bronchitis and a headache!!!

I refused to bother the doctor once again about this because he had already told the night nurse No....she started yelling at me and getting very agitated. I stood my ground and she demanded that I not be her nurse anymore....thank God...

She never did get her dilaudid, when she found out the doctor was not going to order it she decided she felt well enough to go home.

Go figure.... this is just one of a long line of cases that our floor is now seeing.

Why are the docs immediately going to the strongest pain med available for minor stuff?

I remember we used to only give dilaudid to cancer patients and major surgery patients.

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Specializes in CVICU, Burns, Trauma, BMT, Infection control.

I dunno,I've seen it too,it seems to be the drug of choice definitely. I've seen seekers list narcan as a drug allergy to avoid getting it.:uhoh3:

Riiiiight.

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Wow..Narcan as an allergy??? Now that is a professional drug seeker!!!

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I noticed our neuro docs giving dilauded to everyone as well. Especially w/PCA pumps. Have a headache? How bout some dilauded. I had a pump w/Dilauded after my surgery and it made me vomit. Honestly I can't understand how some people can take so many IV drugs and still walk!

I have a history of migraines and occasionally end up in the ER (once or twice a year). The last time I had a migraine I was given dilauded iv for the first time, and it took my excruciating pain away almost immediately! It was unbelievable! That was approximately 10 months ago (although I've had many horrible migraines since then but no trips to the ER), but I can surely understand why it is one of their first choices. When meds are used for which they are intended, it's a good thing.

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Specializes in Emergency & Trauma/Adult ICU.
I wonder where this increased use of dilaudid is coming from. Was there something written in a medical journal that is encouraging the docs to prescribe dilaudid? I know it is making our lives on the med surg floor a living hell....I have a girl the other day (young girl not even 20 years old) demand dilaudid because she had bronchitis and a headache!!!

I refused to bother the doctor once again about this because he had already told the night nurse No....she started yelling at me and getting very agitated. I stood my ground and she demanded that I not be her nurse anymore....thank God...

She never did get her dilaudid, when she found out the doctor was not going to order it she decided she felt well enough to go home.

Go figure.... this is just one of a long line of cases that our floor is now seeing.

Why are the docs immediately going to the strongest pain med available for minor stuff?

I remember we used to only give dilaudid to cancer patients and major surgery patients.

Why was she even in the hospital as a young adult with bronchitis & a headache???? :confused:

Agree -- I'm giving Dilaudid for abdominal pain & all kinds of musculoskeletal pain way too much.

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

She never did get her dilaudid, when she found out the doctor was not going to order it she decided she felt well enough to go home.

Whenever patients do that I always wonder what drugs they have at home.

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Usually when there is a trend to everyone getting the same type of meds, it indicates the docs either had the drug rep into the office pushing the drug, or they all went to a conference or read a new journal article.

The worst is when the residents learn something new and they start working all their patients up for diseases that you could only get if you had gone to one place on the planet - and of course NONE of the patients have been to that place.

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Specializes in Advanced Practice, surgery.

We are very lucky where I work, we have a team of acute pain nurse specialists and the docs will usually refer patients in pain to this team for review and advice about analgesia.

We tend to use a staged approach to analgesia and it will depend on the patients presenting condition. The recommendations for analgesia will follow WHO's analgesic ladder

We do get those patients who are drug seekers but working with the specialist nurses and we have access to the community drugs teams who give us some fantastic advice we are able to deal with these patients without feeding thier addictions.

We also have registers within our ED where our regular attenders are only able to access treatment if they agree to a treatment contract which is drawn up in collaborations with the community drugs team, acute pain nurses, consultant medic and consultant psychiatrist.

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Specializes in Oncology.

We use a lot of dilaudid and oxycodone, along with duragesic patches. Fentanyl or morphine drips on our more seriously ill patients.

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