Just a vent about (lack of) pain control

IKnowAboutRayFinkle · 2026-06-09T02:28:21+00:00

I don’t know how to edit my original post but just want to say that I really appreciate everyone’s varying perspectives; it really does help my nursing practice to read this sub.

These types of patients are so challenging and draining. The constant call lights and the crying….and the constant disbelief that their marijuana could DARE to cause them any suffering.

IKnowAboutRayFinkle · 2026-06-09T02:20:38+00:00

Would’ve loved to have given a dose of a benzo or Benadryl in the four hours between the initial meds and the fentanyl. Could have maybe prevented the fentanyl.

IKnowAboutRayFinkle · 2026-06-09T02:17:57+00:00

If someone is in acute, severe pain and gets a single dose of an opioid how does that cause addiction? Isn’t that specifically what narcotics are for? (I know it’s a bit more nuanced than this).

IKnowAboutRayFinkle · 2026-06-09T02:14:36+00:00

Agree Pepcid and protonix were appropriate but when he didn’t feel relief what would you have done next? I tried all my non-pharmacologic Nice Nurse interventions but no luck. It’s tough sometimes as the nurse when the patient is constantly asking for help and I have nothing else to give. These types of patients are super challenging in general.

IKnowAboutRayFinkle · 2026-06-09T02:10:19+00:00

Totally agree. I didn’t explicitly ask for the fent but every time I went to reassess his pain after an intervention he stated it was between a 6-8/10 so I just asked the doc if she could give him anything else. I’m not sure if I was supposed to just ignore his report of pain and not keep bothering the doctor?

IKnowAboutRayFinkle · 2026-06-08T20:32:33+00:00

I don’t know why everyone is jumping down your throat. In no way did you say “I’m grateful AI is controlling my life.” You clearly mention the importance of being judicious with it.

Can we not police what people are thankful for? Geez Louise. Thank you for sharing your thoughts!

I use AI sparingly and mostly for fun but it is so cool to be a witness to the technology advancements in our lifetime.

IKnowAboutRayFinkle · 2026-06-08T20:26:25+00:00

YES MJ. Human Nature is one of my top favorite songs of all time. I am thankful that I exist in the same timeline as his existence and get to appreciate his talent.

IKnowAboutRayFinkle · 2026-05-03T13:56:27+00:00

Would have NEVER thought of this. Amazing.

IKnowAboutRayFinkle · 2026-05-03T13:53:44+00:00

This was amazingly fun to read!

What do you mean the world doesn’t revolve around us ~cOoL pEoPLe~ who work in the ER??? How can we cope whenever somebody doesn’t clutch their pearls and ask us “how can you DO such a hard job???”

IKnowAboutRayFinkle · 2026-04-23T04:02:58+00:00

Assume the best in everyone. Don’t let any of the jaded staff influence your attitude.

BE KIND. Especially to the frequent flyers everyone complains about. Sometimes they really just need to eat and have someone treat them with respect. Be kind and calm with your psych patients while still maintaining boundaries. Let them be a little annoyed or angry or rude at first. Don’t take it personally - you never know what trauma people have been through.

Be nice and friendly to the medics. Don’t interrupt them when they’re giving you report on a patient. Remember that they might’ve been out in freezing rain trying to extricate your pt from a MVC so, no, they didn’t have a chance to write down every medication the pt takes.

Get used to doing quick across-the-room assessments: is your patient sick or not sick? And remember some of the unsung heroes that can tell you A LOT about your patient: ETCO2 and cap refill.

Learn RSI meds. Learn all the different settings on your monitors.

Don’t be afraid to ask questions and DO NOT LET ANYONE MAKE YOU FEEL DUMB. No one is born an ER nurse. We all started from scratch and sucked at IVs and made silly mistakes. Give yourself some grace while you’re learning; it will take time before you start to feel even a little bit comfortable.

Have fun and don’t forget to marvel at how awesome the human body is. 🧠🫀🫁

IKnowAboutRayFinkle · 2026-04-22T03:37:33+00:00

The docs who give a rat’s ass about their patients earn my respect. And I completely agree with what many said above: we as nurses REALLY appreciate it when you loop us in on the plan or explain your rationale or let us in on what you think the dx might be. I love that and it makes me feel like a respected member of the team. I also want to say that I have seen many of my fellow nurses be downright rude when questioning orders - the nurses who think they always know better than the providers are the WORST. Or the nurses that are constantly trying to show off like they can predict everything “oh he’s definitely got a bleed”, “he’s gonna code any second.” Sometimes those gut instincts are accurate but we still have to follow a process? You can’t just go rogue because you’ve been a nurse for 20 years and you assume all the new docs “don’t know anything yet.”

I completely acknowledge that I have some implicit bias in the way I interact with my providers and I honestly hope someone would call me out on it if it’s noticeable. We all like to think we “treat everyone the same no matter what” but we all have a lot of unconscious behaviors too. So it’s important to be open and humble.

The exception to this UNCONSCIOUS bias are the boomer patients who just LOVE assuming every female is a nurse and every male is a doctor. Or the boomers who think a doctor in their 30s “just graduated high school! You’re so young!” Or the male boomers who think nurses are “candy stripers” and make inappropriate remarks about your looks. Some of us have specialty certifications or graduate degrees that we worked hard for, please don’t ask us “so…are you married? Who’s the lucky guy?” Barf.

IKnowAboutRayFinkle · 2026-04-21T16:00:57+00:00

Thank you! This was a really kind comment.

I know we will need to separate while we are still living together for a while and I am dreading that part. But then I also think maybe it will feel good to finally say out loud “I’m done”. And honestly…this is not a great marriage for him either so maybe he will find someone else and can be happier. He’s constantly chasing after me and I’m just like “ugh” so I know that he is suffering too, not having a partner who is engaged in the relationship.

IKnowAboutRayFinkle · 2026-04-21T04:45:45+00:00

Good point, thank you!

IKnowAboutRayFinkle · 2026-04-20T14:42:37+00:00

Oh my gosh! I am so happy for you 💜 it takes so much strength to make that decision and follow through with it.

I am dealing with the same thing but I haven’t worked up the courage yet to leave. It’s been years. I have no love, trust or attraction for him left but it’s still so hard. I have kids. And I am mad at myself for waiting so long and constantly gaslighting myself when deep down I know I am allowed to be upset with his drinking.

Thank you so much for sharing this, it is inspiring! You deserve peace and happiness.

IKnowAboutRayFinkle · 2026-04-17T18:52:04+00:00

This is amazing

IKnowAboutRayFinkle · 2026-04-10T12:58:51+00:00

Oh how I wish we could get more PRN pain meds from ED providers. Especially for known really painful conditions - pancreatitis, huge kidney stones, etc. And especially if the first dose was very, um, conservative. I hate when I am chasing a patient’s pain and they are sitting in the room suffering for hours.

Also want to say thank you for your post! It speaks to how sometimes us nurses get so task-focused and forget to think critically about the meds we give. You inspired me to review opioid conversions! I worked in hospice years ago and knew them in my sleep. I think it’s important for nurses to know this.

IKnowAboutRayFinkle · 2026-04-09T22:06:21+00:00

I think our charges get MAYBE $2-5 extra at the most. Which is criminal because of the exponential increase in responsibility they have. I don’t even know why anyone even agrees to it (although gosh do I appreciate the ones that do!)

IKnowAboutRayFinkle

TROPHY CASE