I work in the ED and our doctors are pushovers! I work night shift and we get a lot of chronic pain patients and drug seekers. We know them all by name and our doctors just go ahead and order all the Dilaudid, Phenergan, Benadryl or Demerol (or any combination) that the patients ask for. They even
It gets on my nerves - I feel like I am enabling these patients to get high. I know that pain is a personal thing and that it is supposed to be "whatever the patient says it is whenever they say it," but at the same time, if you can barely keep your eyes open and are practically slurring your words, somehow that makes me think your pain can't be a 10/10.
(Naturally I don't keep administering these meds if it's not safe.)
I want it to stop! All the nurses talk about it! It is our responsibility to help the patient, and sometimes that is by saying "no" to rounds and rounds of Dilaudid for 10 hours and refer them to get some help! How can we approach this topic with the physicians?
Lindsey
 |
|
|||||||||||
 |
||
search realityrn
sign up for weekly cartoons, tips, and blog posts
Register to win a pair of RX Medical Silver Fox Crocs
|
|
|
 |
August 6th, 2009 at 9:23 am
We have a few doctors in our ED that do the same thing, however, we have some great doctors that go into familiar patients rooms and tell them straight out that they are happy to order scans or whatever for their belly pain but since this is their fourth visit to the ED so far this month they will be receiving no narcotic pain medication. We have one doctor that I’ll just call Dr. D who gives everyone Dilaudid and zofran and phenergan, we call it the Dr. D special. It’s frustrating but its part of the ED life, I’ll sometimes ask him if he really wants to give that patient Dilaudid since it’s their millionth visit and sometimes he’ll say its up to you, or no don’t give it to them, but sometimes he still wants it.
August 6th, 2009 at 4:02 pm
Or the flip side: What about patients who you can SEE clearly need medication and been in the ER for 10 hours with NO HELP and screaming in PAIN. For instance a 30 year old severe diabetic patient , her entire family ( except for her brother) have died from diabetes . Her brother and she don’t have cars therefore he put her on a bus to take her to the ER on HIS way to work early in the A.M she is still in the ER at 9:00 P.M and comes to a dept to get a diagnostic test, one of her legs have already been amputated from the groin down the other is racked with ulcers and shes screaming in PAIN. She gets her story out to me…I call everyone I can think and DEMAMND this lady get some pain meds, at first no one listened then after several more calls , some nurse comes to the DEPT with an IV syringe for her …but CRAP I was about to CRY for this lady myself ,she told me she has been dying in pain all this time crying and NO ONE assisted her.
Angry is an understaetment…as it can go both ways.
August 7th, 2009 at 12:39 pm
I’m curious how experienced these doctors, firstly, their overall experiences, ie years in the ER and other intense areas, and secondly how familar they are with that particular patient as well as department.
If you really think this is a problem, take it up with your charge nurse/dept head. They will discuss this with the senior doctor/medical head who will hopefully deal with the issue. Don’t go in guns blazing attacking the doctors actions, stay civil and rational.
Hopefully this will work.
August 12th, 2009 at 1:01 am
A lot of our doctors are relatively new – 5 years or less. We have a couple of lifers (30+ years) that do full-time clinical work and a couple of other older docs moonlight when they get tired of the office.
Secondly, they absolutely know these patients. Some of them come daily.
August 18th, 2009 at 6:24 pm
You should first approach your manager. Then you could discuss with the head of Pharmacy. As a last resort, send an anonymous complaint to both the state Board of Pharmacy and the State Board of Medicine. The DEA would also be interested and there is a regional office for every state.
November 2nd, 2012 at 11:18 am
I am an LPN in LTC in central Illinois. I guess my faicilty is average. I make around $36,000 per year including OT. We don’t. Get bonuses or anything like that. But I think were all worth more monetary compensation but the relationships I have with my residents are a compensation that can’t be measured because that is priceless.GD Star Ratingloading…