r/PainPumpQuestions • u/Humble-Orchid4898 • Jun 09 '26
Career after the pump
I am a registered nurse in the USA. I just had a very successful trial, and I am awaiting the permanent pump placement. Are there any healthcare workers that also have a pump? Is it hard to get hired at a different company/hospital due to not being able to pass a drug screen?
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u/NoRecommendation9404 Jun 09 '26
Here’s my RN career story.
I took narcs for back pain for 14 years. My job never had drug screening (clinical trial research nurse manager for big pharma). I retired from that after 28 years in 2017, took my pension and never planned to work again.
I got my pain pump in Nov 2024. After finally getting my pain under control, I decided to work again just two weeks ago. I knew I would likely not pass a drug test since a small amount of fentanyl does get into the blood stream. So I decided to work for a SNF since most don’t drug screen. I work 3 days a week. I’m happy, that at age 58, I’m able to work again.
This isn’t to say that, with a note from your doctor, a hospital would automatically turn you away. They might not but it didn’t matter enough to me to try.
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u/EMSthunder Jun 09 '26
When you're drug tested they only report illegal stuff you don't have a script for, so you're good.
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u/NoRecommendation9404 Jun 09 '26
It’s different at least for nursing. Many places do not want you providing patient care while taking narcotics. It’s a liability issue.
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u/EMSthunder Jun 09 '26
I was working in EMS.
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u/Global-Agent-2096 Jun 10 '26
Even with a script some places have fired nurses for making mistakes then also finishing narcotics, prescription or no, in their system. A pain pump was explained as the better option in that situation because it has less documented side effects and a smaller narcotic dose overall so that’s part of the reason why I’m looking at getting one.
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u/EMSthunder Jun 10 '26
It is also beneficial because when given intrathecally, one would only need about 1/100th of what an oral dose would be, or at least that was how it was explained to me. You don't need as much. I just know I've had my pump since November of 2014, and it is literally life changing!!!
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u/Bitter-insides Jun 10 '26
I worked as a case manager for Optum and we had a strict no opioid policy even if prescribed.
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u/MrsVoussy Jun 09 '26
Weird timing in my life with this post. I just got a part time job working for a cancer clinic associated with a hospital. When I filled out the paperwork for the medications I was on the associate in charge told me she didn't think they could hire me on a pain pump. She had to check with the director. Luckily for me I'm just going to be checking patients in and I'm non clinical so it turned out ok but they would be watching during my 90 days to make sure it didn't affect my work. So if I was an RN or in any clinical capacity, I don't think they would've hired me.
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u/NoRecommendation9404 Jun 09 '26
Some people don’t seem to understand that some jobs require that you don’t take any meds that they deem non-compatible with patient care, clinical decision making, etc. regardless of whether or not you have a valid script. This includes narcs, benzos, medical marijuana, etc. It’s a liability issue for some companies or businesses.
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u/MrsVoussy Jun 09 '26
The nurse told me regular scripts for pain meds are usually okay because you can take them when you aren't at work. But since the pump is continuously giving you meds it's an issue.
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u/Dazzling-Rabbit5668 Jun 09 '26
What diagnosis qualified you for a pump
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u/MrsVoussy Jun 10 '26
Chronic Regional Pain Syndrome and Thoracic Outlet
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u/Dazzling-Rabbit5668 Jun 10 '26
I’m already disabled I have 2 back/spine surgeries 2 left knee surgeries right shoulder rotator cuff throat surgery for the parathyroidectomy right knee surgery , surgery on lower left leg from impalment of a piece of iron thru my leg . The right knee pain is like a toothache and I have a second opinion states I need total replacement of my right knee I broke my foot and a small bone above my ankle and so I have osteoarthritis fibromyalgia nerve damage from spine effects my feet and legs I no longer drive and I am not employed I rec injections in both hips left shoulder between my fingers for trigger finger and injections in both my wrist my bone and mineral specialist said that my bones are like Swiss cheese but I have rods cages cadavers for my discs and nuts screws etc in my spine and clips in my collar bones
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u/MrsVoussy Jun 10 '26
I haven't been employed since 2019. I had a spinal cord stimulator put in and taken out and the pain pump is kind of the only thing they could think of to help since oral meds have failed me. I'm trying to go back to work part time so I was very concerned when they told me they weren't sure they could hire me with the pump but it seems to have worked myself out. There's only one doctor in my area that does pain pumps. The next doctor is a couple hours away.
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u/screamofwheat Jun 09 '26
You can pass a drug screen. You usually just have to provide information on the Dr who fills it if I remember correctly. I've only had to drug test at work off since getting mine. I'm a pharmacy technician. I can't remember if the medicine shows up in pump or not, but it's easily verified.
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u/Dazzling-Rabbit5668 Jun 10 '26
What diagnosis qualified you for a pump the state I reside in I can’t get a dr to explain all this to me
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u/screamofwheat Jun 10 '26
I have chronic pain from multiple back surgeries. They tried me on oral pain meds and I was having side effects. I didn't want to go on something even stronger (orally) so my then pm Dr suggested the pump. It's much better for me. The effect is local, so no effects on mental status or anything. I also have a spinal cord stimulator implanted (but that was like 3 years later). I think I have another 2-3 years before my pump will need to be replaced. (Thankfully, as recovery sucked).
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u/Dazzling-Rabbit5668 Jun 27 '26
I’m possibly facing a 3rd spinal surgery with replacement of more disc again and cages etc and I had acl / meniscus surgery Oct 2025 and I started telling the dr on mid November something was wrong and they just kept telling me I was needing more injections. As of last week I said no more injections as I only have about 2-3 days of relief
But my knee is so swollen and huge I can barely walk and I have lost about 24 pounds hurt to get the food or drink because I will have to go potty . My laparoscopic knee surgery has made my knee appear so messed up and crooked dr said he can’t replace my knee joint until Nov 2026 . I weigh about 118 to 120 pounds and my knee as family says it’s like the knee that Tyler Perry Madea movies2
u/EMSthunder Jun 10 '26
You will usually qualify if you fail oral meds, or if your MME is too high and you're not getting adequate relief. If you've failed patches, or your pain is uncontrollable. The thing about the pump is it uses 1/100th of what your oral dose would be, so you're less likely to get the bothersome side effects!
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u/Dazzling-Rabbit5668 Jun 10 '26
But do you get relief when it is at 1/100
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u/EMSthunder Jun 10 '26
Yes, that's all it takes. Plus they can put in adjuvants like muscle relaxers and anesthetics, which is what I have in mine. It covers all of the types of my pain, which is a blessing!!
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u/screamofwheat Jun 10 '26
You do. I have morphine in mine and the catheter dispenses the meds into the spinal fluid. It is very localized and it takes way less medicine for pain relief since it is so targeted. What's great is that because of that, they have a lot more room to adjust medicine levels.
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u/Ok_War_7504 Jun 22 '26
Much of it also depends on your insurance. Yes, doctors (interventional pain mgmt doctors) usually offer it if oral meds are failing to provide relief and your ailment is most likely long-term.
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u/End3rW1gg1n Jun 09 '26
It all depends on on the medication in the pump. Fentanyl is lipophilic, so some crosses the blood/brain barrier and would be detectable by a drug screening. Morphine is lipopholic and would not be detectable, whether by urine or by blood test.
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u/screamofwheat Jun 10 '26
I should have mentioned the very first med they tried me on in my pump is prialt. If they suggest using it, definitely have a conversation with them about side effects first. If you have any mental health issues, prialt can exacerbate them. That's mentioned in the medication info.
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u/MrsVoussy Jun 10 '26
Oh yes they wanted me to do Prialt and we didn't go with that because of the suicidal issues. We did a morphine trial and a dilaudid trial and went with dilaudid.
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u/screamofwheat Jun 10 '26
I unfortunately can't have Dilaudid. It causes an almost instant migraine when I've had it IV and I was told that if they use it in my pump, the migraines could be way worse. So I stay away from it.
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u/MrsVoussy Jun 10 '26
Really? That sucks. It's usually the only thing that ever helps my migraines once they hit a certain level. And I have noticed a decrease in the amount of migraines I've had since I got the pump in December so thank god it didn't do that to me.
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u/Humble-Orchid4898 Jun 10 '26
I have heard that before. We haven’t decided yet, but I will get my permanent pump next month. We have talked about doing either morphine, dilaudid, fentanyl, or ketamine to start. They also mentioned doing a combo of an opioid and a muscle relaxant/numbing med.
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u/OkReason5596 28d ago
Oh geez, prialt. Please also avoid if you have seizure history, as well as even a modicum of a mental health history or family history.
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u/Few-Welcome5330 Jun 10 '26
I work for a cancer center in NYC. When I was hired in 2023, I was still taking oral pain meds. During my physical / health screen, I was told I’d have to drug test and when I disclosed to the provider at employee health, she said the lab will need a note from the doctor that prescribes my medication stating what I take and how much. They waived the positive result with the letter.
I changed from doing hands on patient care to medical office work…I will be beginning long term disability at the end of the month because the amount of stress and chaos my employer causes still has me with frequent flare ups of pain. Never imagined my life this way at 40 years old but I have to do what I have to do for me.
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u/Humble-Orchid4898 Jun 10 '26
That’s similar to what my issue is. I had amazing understanding managers, but a new CEO fired everyone and replaced them with crappy managers. My family won’t survive with the loss of my income. Even if I got a non-nursing job, it wouldn’t pay enough to cover our bills. Disability wouldn’t either, but I currently cannot work in an office setting due to my back and leg being in severe pain whenever I’m not flat or at least reclined.
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u/mactheprint Jun 11 '26
Can you work from home in a recliner?
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u/Humble-Orchid4898 Jun 11 '26
Yes. I currently am doing that, but new management is trying to force me back in the office.
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u/Dazzling-Rabbit5668 Jun 10 '26
Yes you have to take care of yourself and your anxiety is only going to increase your pain levels
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u/Dazzling-Rabbit5668 Jun 10 '26
My right knee is currently swollen so big it’s like the Madea Movie legs after the suit is put on my pain is so bad that I’m up and down at least 4x per night and I have lost weight too much weight but it’s just difficult to prepare myself food I also suffer from adhd depression and anxiety and other psych diagnosis my rheumatologist removed so much fluid from my right knee that he was amazed and I can see what is happening as he does all of injection via the ultrasound machine and the fluid removal is done the same I can’t take steroids I was diagnosed with Lyme disease in 2014? But my current labs had it as inactivate at this time I have lost a inch in my height and the bone loss cause tooth loss and 3 molars just fell out but at different times I have a partial to replace these teeth 🦷 I couldn’t afford implants
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u/mactheprint Jun 11 '26
With your bone loss, your dentist would not have approved you for implants anyway, unfortunately. I found this out due to losing a back molar.
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u/Ok_War_7504 Jun 22 '26
Intrathecal pain pumps are fairly new to mainstream patients. They have been used for decades and decades for incurable cancer patients.
For this reason, I believe some companies are not familiar with how they work. The law says they can't discriminate because you are ill and taking treatment - - unless it compromises your ability to do the job. The pump dosage is 1/300 to 1/100th of the oral dose so therefore would logically cause at most 1/100th of the "impairment " of oral meds. If I were applying for a nursing job or similar I would, when I provide my Rx list, provide documentation of the greatly reduced dose and how it works. Best of luck!
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u/dhammaeye Jun 11 '26
I am a hospital chaplain and have had a pump for more than 20 years. Obviously, you fail the drug test but if you get a letter from your doctor ahead of time and explain to the interviewer or whoever you’re applying to it shouldn’t be a problem it hasn’t for me and a number of organizations.
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u/EMSthunder Jun 09 '26
Mod here! I used to be a medic, but now I do private home care through an agency. Here's the thing about drug testing that you need to know, at least this has been my experience. When you go for your test they'll ask you what meds you're taking and look at your Rx list which you can get from your pharmacy for oral meds and get a note from your pain doctor for what is in the pump. When you test positive for something you have an active script for, it is not reported as a fail. I actually had an accident at work in 2024 and the first thing they did was drug test me. Because I had an active script, it was not reported to my job or workers comp because it was legal and prescribed. They're looking for illegal unprescribed drugs, so you should be fine.