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Monday, January 13, 2014

screw Hippocrates

Lots of ERs have started to post policies about narcotic prescribing.  We have one in our ER. It is in triage next to the triage chairs.  It is a full page, single spaced, in other words, not reader friendly. It says that we do not prescribe narcotics for chronic pain.  We don't refill prescriptions.  You have to have an ID to get a narcotic prescription.

In essence this is what it is: A JOKE.  Our doctors don't follow it. They don't follow a corporate wide policy.  They do give scripts for chronic pain.  They do refill prescriptions.  You don't have to have an ID for a narcotic script.

The argument from doctors would be: it is up to the individual provider to decide what to do.  Its funny, there are nursing policies that we have no choice about following, but apparently doctors are exempt from following them.  They can pick and choose.

Therein lies the basis of the prescription drug abuse epidemic in the US. Gutless doctors.
Doctors who, rather than do the ethical thing, take the easy way out. They don't want to say no and have to deal with the angry patient.  They don't want to have a complaint against them because the patient wasn't happy.  Patient satisfaction and all that garbage.

So it goes on and on. Part of the hippocratic oath states:

"I will follow that method of treatment which according to my ability and judgement, I consider
for the benefit of my patient and abstain from whatever is harmul or mischievous..."

When you overprescribe narcotics so much that prescription drug abuse is an epidemic in this country,  kills thousands every year, are you benefiting your patients?

Hippocrates is rolling over in his grave.






1 comment:

nancy said...

it's a terrible problem. I am a VA nurse and we have a set up for chronic pain clinics and they make contracts. In our ER, we are NOT TO Rx any of the pain contract meds for chronic pain. The nurses are constantly getting yelled at by the directors because we triage these vets as an ESI 5 in Urgent care or Fast Track. What are we to do?? Some docs give them a 28 day refill, some give 10 tabs, some stick to the policy and this is where the nurses get the chronic pain. The patients are well educated, but they take a chane and get what they want and the nurses get grief.