The Customer is NEVER Right - A Nurse Practitioner's Perspective
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Narcotics

The state of Arizona now monitors our narcotic prescribing habits and here are my numbers from Jul-Sep 2015, which averages to some 768 patients seen. My numbers are in red and the state average of my peers is in blue. Outside of those mentioned the other pain relievers I prescribe are Flexeril, Ibuprofen, Tramadol and Tylenol with codeine (T3), in that order from most to least, with Tramadol and T3’s being very sparingly, in that order as well.

As for quantity of pills, the electronic health record (EHR) defaults to 20 pills; more can be ordered but less is more problematic than what it is worth, although sometimes 20 is just way to many so I take on the task of writing for less, however, it is painful. That mentioned, because if it were not so problematic I would write for less all the time thus prescribing even less than recorded here.

Nonetheless, I would have to say my narcotic prescribing habits are not over the top. Of the 768 patients 54 (7%) of them received narcotics. Keep in mind, during the recorded period I have only worked in the emergency department where pain, the only reason for pain prescriptions, would be most acute. Of the 768 patients one (receives narcotics from 5+ providers) got the upper hand. But then there is always one.

Interestingly, as noted at the bottom of the form, I am NOT currently signed up for access to the Prescription Drug Monitoring Program. And despite the reminder I will continue to NOT be signed up, as I do NOT need that system to say, “No”. More important, for me, I do NOT need that system to influence my prescribing habits and the evidence shows I am doing just fine without it.

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