Other than a select number of ballsy doctors who just don't play with these people, just about anyone who comes into the ER with generic abdominal pain and a multitude of allergies acting a fool will get some Dilaudid prescribed. Since a bullshit complaint against a doc is still a complaint in their eyes, the powers that be at Hood Hospital pretty much force them into it.
This is where the nurses come in. You can't just say no to an order because you believe your bi-weekly-call-light-happy visitor's complaint is not legit, but you can deliver it in a way that is not ideal to them.
Yup. If I have a patient I know to be a drug seeker, I sure will give that 2 mgs of Dilaudid in about 200 ccs of saline over about 10 minutes. Lots of nurses I genuinely respect will give it fast as requested, give the people what they want, and hope they will STFU and stay off the call light. This often works, but I won't do it.
Here's my logic- first, I'm not here to get you high. I give pain medicine slowly, as I was taught to in nursing school. If you wanna complain that I did things by the book and pushed your narcs too slow, I believe that is actually one issue that my gutless management will actually back me up on. And second, I do not reward foolish behavior. If you come to my ER, lie to me, take time away from my other sick patients, act abusive and generally unruly, I do not want to give you any motivation to come back by giving you your fix. And I don't wanna teach you that you'll get what you want by being demanding and rude. I don't know if this will actually deter anyone in the future, but I do know that it satisfies the idealistic part of me, as well as the passive-aggressive asshole part of me.
So, other nurses. Where do you stand on this issue? Discuss with your coworkers on your next lunch break (ha). I guarantee it's more interesting to them than your opinion on abortion.