You Experince in Cancer Pain is Valuable to Me

NAVRN · Nov 5, 2010

I worked on an adult oncology floor for about 3.5 years. We had protocols for dealing with pain. Depending on the patients pain level we were ordered to increase drips, and PCA by 50-100%. We also had great liberty in the use of PRN oral pain medications. This program was championed by our CNS and supported by the hospital pain clinic docs. Patients responded and were rarely in pain. I love working with them and at the facility.

1. From that experience I know that I can increase opioid dosing 50-150%

2. I have done this and was supported by the hospital.

3. We had separate pain protocols for opioid tolerant/opioid naive.

4. I assessed patients paid using pain scales and other means, I also followed up all interventions to ensure all was well.

gemimi · Nov 9, 2010

Hi NAVRN: I don't know how helpful this will be for you, however, I am a cancer survivor of 18 months now. I had a full bone marrow transplant in April 2009. At the time i entered the cancer institute I was being treated at I was on dilauded 2 mg prn which was all that I needed and rarely took unless I was experiencing the horrifying pain in my lower leg bones (felt like someone stabbed a knife into them and then ran it down the length of it ~ it would be so bad I could hardly stand and my feet would hyper-extend making it extremely difficult to walk it off. Trust me, I screamed). I digress. After the transplant my dilauded was increased to 20 mg which still was not enough as I had horrible mucocitis where the skin was in large white and red patches that literally hung off the roof of my mouth and tongue was white blisters from the chemo pre-transplant. My pain centered mainly in that area and my husband, God bless him, was my advocate dogging them until my dose was raised to 40 mg which pretty much put me out of it. He'd come on the unit and say, "how is she doing?" and the answer would be "pretty loopy" with a smile for about five days. Then we weaned it down and off. I will state what I said prior to this post on another post. God bless you for doing what you do each and everyday. An oncology nurse has got to be so difficult ~ you have to be prepared to have your heart broken and pieced together time and time again, see us suffer every day, some go home and others do not. You become our lifeline, our counselor, our friend and our source of information. When we get angry ior sad it is usually the nurse who hears it (fortunately for my nurses I didn't get angry). I appreciate you more than you will ever know ~ my nurses and doctors were the best team of people that ever walked the halls of a hospital and I owe my life to them. I was supposed to have been dead by Christmas of 2008 according to my first doctor who wanted to send me home on hospice (after a stint in ICU with kidney failure, septic, pneumonia, CHF and a slightly enlarged heart) he said I wasn't strong enough to make the induction phase let alone through a transplant. If I had listened I would have died right on schedule ~ thank heaven I didn't. My new doctor and nurses saved my life and I will be forever grateful. Because of them and people such as you, I have seen one daughter married, another will be next June, and a grandson born. Thank you for all you do from the bottom of my heart. (Sorry, I guess I didn't say a word about opioids did I? The regular narcotics did fine for me but others were so much worse. Thanks for keeping up with the pain side of things, it's definately not for the faint of heart.

NAVRN · Nov 9, 2010

Gemimi: I am so happy to hear that you have a supportive husband and family that was there to support you through such a difficult time. I am glad that you had such great nurses to help you through that time in your life. Thank you so much for the kind words. Yes it can be hard at times to be an oncology nurse, but rewarding to help someone through their darkest time. Thank you again, and I wish you and your family all the best for the future. Stay strong.

gemimi · Nov 10, 2010

Thank you NAVRN, I am trying to. Right now I am looking for work, however, with an eighteen month gap in employment because of the "C" word I will have difficulty ~ "insurance risk" is the first thing that companies think of, not experience or understanding, etc. Though I am 100% grafted and am in 100% remission, I still have a low immune system and need to be careful to a certain extent ~ which rules out bedside or close contact nursing. The cancer that I had is usually 2.6% of cancers and usually male over 60 (go figure ~ I'm female and 50+) so the odds of my contacting it were pretty slim and very little data is written on it. Hopefully someone out there will take a chance on an employee who wants to work another ten years, but who knows? Oh well, I'm alive when they said I wouldn't be, healthy when I wasn't supposed to be, and I have a lot to be thankful for. I know God didn't have me go through all of this to leave me now. Take care and thanks for listening.