Reflective Journal: Pain Control for the Addict in Recovery

Reflective Journal: Pain Control for the Addict in Recovery
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  • The Inspiration for the Strategic Plan
  • Please help! My stomach hurts so bad!  I need something for the pain!
  • Let's run some tests, but I'm hesitant to administer any medication due to your history.
  • The Inspiration for the Strategic Plan
  • This decision would be easier if there was a standard treatment plan, not only for her, but other patients as well.
  • So, this patient is a recovering addict.  I don't feel comfortable ordering opiates for pain.
  • Organization of the Plan
  • I feel like my patient may not be treated fairly because of her history.
  • I can't believe that's how you feel.  It's not our place to pass judgment.  We don't know her story and she deserves to be treated respectfully.
  • Well, it's not our fault that she made bad life choices. 
  • A patient arrives in the ER with abdominal pain.  The patient is seen by MD who is reluctant to provide meds after admits to a history of drug abuse, but has been sober for several years.  No standardized protocols exist for treating this type of patient fairly. 
  • Organization of the Plan
  • Thank you for providing me with all of the information so that I can make informed decisions about my healthcare choices.
  • The MD consults with the nurse regarding treatment ideas.  Both discuss the lack of standardized pain protocol or algorithm for the patient. MD and nurse both want to preserve the patient's sobriety, but treat her pain. 
  • Implementation of the Plan
  • Brainstorming Session Pain Algorithm
  • Later in the med room, the patient's nurse shares her frustrations about what treatment is best for a recovering addict with another coworker.  To her surprise, he was very judgemental about how these patients should be treated.  
  • Implementation of the Plan
  • Hi Mrs. Smith, we are calling to follow-up on your recent visit to our ER...
  • The nurse returns to the exam room to educate the patient regarding the course of treatment and possible risks associated with opiate administration, knowing that a standard treatment algorithm would improve this process. 
  • Ms. Smith, we want to treat your pain, but you need to be aware of the potential for relapse.  We encourage to remain connected with your support team. 
  • All medical staff begin a series of brainstorming meetings to assist in the development of a pain algorithm and standardized treatment plans for patients in recovery. These meetings will include ED physicians, mid-levels, hospitalists, PCP's and nurses.
  • As a result of brainstorming sessions, the nurse calls the patient to review the discharge plan and follow-up care.
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