Anyone else notice a growing trend of providers avoiding narcotics when they’re actually indicated?
*Healthcare workers only please*
I work in a rural critical access hospital that has major staffing retention issues. Most of our nurses are travelers, and the majority of our doctors are brand new attendings right out of residency here for PSLF. In general they tend to follow protocol based care more rigidly than our older more experienced docs, which I largely support.
However, a trend I have noticed in these new providers is complete avoidance of controlled substances at any cost. Many of them will refuse to give any analgesics for bedside reductions (even ketamine), and very minimally for tubed/vented patients, even in the context of burns. I appreciate the consideration for overprescribing, especially in outpatient settings, but as one of our old docs says “substance use disorders don’t come from emergency pain management”.
In addition to witnessing untreated pain, it’s also an issue with our psych patients. We don’t have an inpatient psych unit or psych ER, so we end up providing a lot of longer term psych care. Many of our psych patients are violent offenders and are waiting admission to our one forensic psych hospital in the state for weeks in our department. When these patients become physically aggressive with staff, these young docs will refuse to order safety meds except offering the patient a dose of their daily meds, or oral hydroxyzine, often saying they don’t want to “reward drug seeking behavior”, even with antipsychotics. This has led to significant staff safety issues, and increased fear/resentment in caring for this population.
Has anyone else noticed this change? If so, is it a general sign of the times, or do you also specifically notice it in more recently trained providers?
EDIT: I really appreciate everyone sharing their experience from the patient perspective, but I should’ve clarified that I was hoping to hear from other healthcare workers specifically about their observations/experiences with this phenomenon. I do not doubt that many of you have stories of your pain being untreated/undertreated (as I have witnessed at work - which I alluded to in my post) but I’d love to hear from people providing the care and interacting with new guidelines
EDIT pt. 2: Even after my disclaimer at the top and edit, non HCWs are continuing to flood this post with their personal experience as patients. Guys, this is a subreddit for people who work in the emergency department. It is not for the public to share anecdotes. I posted this to engage in information sharing with other HCWs. There are chronic pain support subreddits, this one is for sharing information with healthcare workers.