I received an email fromMedscape about continuing education on Opiates today. I figured it would be an easy way for me to add to my licensing requirements because I happen to love opiates. Morphine is my favorite. Understand that I have only had it once after surgery but as a nurse, I can’t say enough good things about Morphine and it’s friends.
Did I mention that my clinical experience is mostly in the CCU and that I have a lot of hospice clients?
That last piece of information is very important. Morphine is a great drug for relieving pain and in the CCU, it has the added benefit of dilating constricted arteries which may be causing the pain thereby eliminating the source of pain.
In the home setting, opiates are a different story. Every day I read clinical documentation and I see where nurses teach patients how to take pain medications appropriately and how to manage side effects. I read nurses teaching alternative pain relief measures. Every once in a while I see a chart where I am suspicious of the amount of meds prescribed to a patient . But I never see anything written about Medication storage and disposal in home health. In hospice, you see a great deal of information about drug disposal after the patient has died.
I suspect that is because we have all assessed our patients are comfortable with the orders for pain meds that the MD has written. If our 90 year old patient is in pain we do not consider the possibility of addiction when treating her pain. What we don’t always think about is the other people who come into the house.
Here are some alarming statistics:
In this slide, shamelessly stolen off the Medscape Continuing Education activity, you see that buying drugs from a dealer is far less frequent that getting them from a friend or taking them from a relative. The internet pharmacies that were supposed to ruin America do not make a significant contribution.
This next slide (also stolen) should make us proud. It shows that America’s youth are more generous than Canadian youth.
What all this means is that we need to start teaching the risks of drug misappropriation to our patients. Even though they may know their own family,there are many people who have figured out that scoring drugs from an elderly confused patient is cheaper and less risky than buying them from a dealer. We should teach patents or assist them in putting narcotic pain relief out of sight or under lock and key. We should teach them proper disposal of medications. And if there is any suspicion of misappropriation, pills should be counted just as they are in the hospital or other setting.
I really encourage you to take advantage of this free continuing education from Medscape and use it in your practice. It doesn’t take long and it may open your eyes to a threat you never considered before and allow you take action before someone gets hurt.
Plus if you take thefree continuing education activity, Medscape will be less likely to write me nasty letters for stealing their stuff. I prefer to download the transcript but there is a video discussion for those of you who do not like to read.
By the way, don’t start talking about ‘Julianne, you know, the nurse who loves Morphine’. It just doesn’t sound right.