Tuesday, July 22, 2008

So, where do you draw the line between being a nurse treating a patient's pain and becoming a drug dealer?

We have a young woman on our unit, admitted for "sickle cell crisis/social difficulties". This is the first social admission I have seen where the patient is under 75 years old. Yes, this young woman has a very questionable background (drugs, prostitution?)... but this young woman is basically a healthy and able bodied young lady. If she was in fact in sickle cell crisis when she came in it has since resolved. The problem is that she continues to have her pain meds as if she were in crisis. Dilaudid 4-6mg S/C Q1H PRN. She gets her pain meds on average of every one and a half hours. Plus Gravol 50mg S/C Q4H PRN (and she is not vomiting!) Inbetween pain meds, she is walking around the unit and hospital. Goes out for a smoke, visits with friends. This has repeatedly been brought up with her doctors, who have said flat out that they will not touch her meds.

So.... where is that lovely grey line between treating pain and becoming a drug dealer? Because drug dealers get paid a lot more than we do! ;)

1 comments:

Caroline said...

I think of this all the time. I guess I tend to just to think that if they say they are in pain, then they are...even if it's sometimes against my better judgment. My understanding is that a sickle cell crisis can be incredibly painful, so maybe there is some residual left? I dunno....I would just hate to NOT treat someone's pain rather than give them a little "too much."