You can tell a lot about a person by their allergies. And I don’t mean the seasonal variety.
I don’t judge if you’re allergic to cats or dust or pollen. I do, however, judge you if you’re allergic to morphine, oxycodone, ibuprofen, tylenol, Zofran, Reglan, Compazine, repositioning and hot packs. Because, awe shucks, looks like the only thing left that you can possibly tolerate for pain and nausea management are dilaudid and phenergan. At the same time. While you’re eating a hamburger from food service that you’ve complained about but are still eating. And it just so happens that those are the two most potent, euphoria inducing pain and nausea medications that we give. Funny that. (I just said that in a British accent)
There are some patients that think either their nurse is dumb or their acting skills are so stellar that I won’t see through their Oscar worthy attempt to get high. I once had a 23 year old male that came in with a small bowel obstruction. Not the most painful malady, especially after a decompressing NG tube placement, but certainly no walk in the park with your dachshund. He just so happened to be allergic to every possible pain medication except Dilaudid, which is about 10x stronger than morphine. So that being our only option I acquiesce to his request for pain medication. As I’m drawing it up (with him twice verifying the dosage) to administer through his central line (his veins being rubbish after using them for other recreational purposes) he first requests that I not dilute it in saline (denied) and then as I’m administering it he performs a song and dance about how bad it tastes and if I could just “push it in faster” so the unpleasantness goes away quickly (denied). Anthony Hopkins in the house folks! Somebody go get the golden statue! Little did he know he had just purchased his ticket to a slooooooow, American Society of Medication Safety by the book practice recommended 5 minute administration for every single dose there on out from this nurse. I didn’t think I looked that dumb. I am blonde though….
Another thing with allergies…you only know you’re allergic to something if you’ve received and had a reaction to it. I hate when I’m researching a patient at the start of my shift and the first two things on their allergy list are Haldol and risperidone. Shit. That means that they’ve A) been in the hospital a few too many times and B) have needed an anti psychotic more than once, and C) what the hell’s left for me to give if I need it?!?