I have seen alot of people in pain in my job as have all nurses. It amazes me how little a majority of nurses actually use the pain scale to assess and relieve a patients pain level. I firmly believe in PCA's for patient comfort. Why not they get locked out, they can't OD if the nurse is competent, and their pain is relieved on demand with maybe an order for breakthrough pain. I am amazed how nurses want to discontinue that PCA in some cases 2nd day post op major surgery. I have gone rounds with some nurse and doctors in fact. Guys, pain is objective, If the patient states they have pain believe them, or take a liabilty chance for neglect. And get off that DRUG SEEKING crap. It's not your job to make assumptions, it your job to heal and relieve that pain. These issues should be placed in policy within a facility in order for all nurses to be in sync apparently. 10/10 pain - 8/10 pain consider pca; 7/10 - 5/10 pain IV Medication and 4/10 and below PO medication or something in that manner. Come on where is the compassion, trust me you will be in this position sooner or later. Also, these doctors that "dont prescribe narcotics" need a new line of work.

I agree that PCA's are great, however it's interesting how patients get worried about pressing the button too much - I've only used them several times (First year Nurse) and every patient was worried about overdosing themselves. Of course they needed education and after that seemed to help... still, I had one or two patients that still felt they were being 'weak' if they pressed the button too many times. I encouraged them to not feel that way but there is always the patients who feel handling pain is a measure of 'toughness'... usually men. I agree with the philosophy about helping patients manage pain... on the wards you usually find genuine people NOT the drug abusers trying to score through ED, so a different mind set needs to be there.